PHYSIOLOGICAL

CHANGES DURING
PREGNANCY
 VULVA
 ODEMATOUS
 HYPERAEMIC
 LABIA MAJORA PIGMENTED
AND HYPERTROPHIED
 VAGINA
 ODEMATOUS
 HYPERTROPHIE
 MORE VASCULAR
 JACQUEMIER’S SIGN
 LENGTH OF ANTERIOR
VAGINAL WALL INCREASED
 JACQUEMIER’S
SIGN
 INCREASED BLOOD SUPPLY
OF THE VENOUS PLEXUS
SURROUNDING THE WALL
GIVES THE BLUISH
COLOURATION OF THE
MUCOSA.
 SECRETIONS
 COPIUS
 THIN
 CURDY WHITE
 Ph IS ACIDIC (3.5-6)
 UTERUS
 WEIGHT-900-1000GMS
 LENGTH-35CMS
BODY OF THE UTERUS

 HYPERTROPHY AND HYPERPLASIA

 STRECHING OF MUSCLES
 ARRANGEMENT OF
MUSCLE FIBERS
 OUTER LONGITUDINAL
 INNER CIRCULAR
 INTERMEDIATE
 VASCULAR SYSTEM

 UTERINE ARTERIES
 OVARIAN ARTERIES
 VIENS DILATED
WITH VALVES
 SHAPE OF UTERUS

 GLOBULAR -12 WEEKS

 OVAL-28WEEKS
 SPHERICAL-BEYOND
36 WEEKS
 POSITION OF UTERUS

 NORMAL ANTEVERTED TILL

8WEEKS
 ERECT
 LATERAL OBLIQUITY

 RIGHT(DEXTRO ROTATION)
 CERVIX DEVIATED TO THE LEFT
SIDE
 (LEVO-ROTATION) CLOSER TO
THE URETER.
 BRAXTON HICKS
CONTRACTIONS
 IRREGULAR
 INFREQUENT
 SPASMODIC
 PAINLESS
 WITHOUT ANY EFFECT ON
DILATATION OF CERVIX
 (IISPWED)
 ISTHMUS
 HYPERTROPHIES AND ELONGATES 3
TIMES THE ORIGINAL LENGTH
 CERVIX

 HYPERTROPHY
 HYPERLASIA
 FLUIDS ACCUMULATE BETWEEN THE
FIBER
 VASCULARITY IS
INCREASED
 GOODELL’S SIGN
 FALLOPIAN TUBES

 UTERINE END RISES UP AND

FIMBRIAL END IS HELD UP
 VERTICAL BY SIDE OF UTERUS
 AT TERM ITS ATACHMENT IS AT
LOWER END OF UPPER 1/3rd
 OVARY
 GROWTH OF THE CORPUS LUTEUM
 BRIGHT ORANGE ,YELLOW,PALE
 REGRESSION OCCURS DUE TO HCG
 COLLOID DEGENERATION OCCURS AT 12
WKS AND GET CALCIFIED AT TERM
 OESTROGEN ANG PROGESTERONE
INHIBITS THE RIPENING OF THE
FOLLICLES
 BREAST

 SIZE-HYPERTROPHIED,
PROLIFERATION OF
DUCTS,ALVEOLI
 VASCULARITY IS
INCREASED
 AXILLARY TAIL
 NIPPLES AND AREOLA

 NIPPLES BECOME LARGER,

ERECTILE,
DEEPLY PIGMENTED
 MONTGOMERY’S
TUBERCLE
 PRIMARY AREOLA
 SECONDARY AREOLA
 SECRETION

 12WEEKS-STICKY
 16 WEEKS-THICK AND YELLOWISH
CUTANEOUS CHANGES
 FACE-CHLOASMA
 ABDOMEN-LINEA NIGRA,
STRAIE GRAVIDARUM
WEIGHT GAIN
REPRODUCTIVE WEIGHT GAIN -6KG
 FETUS 3.3 KG
 PLACENTA 0.6KG
 LIQUOR 0.8KG
 UTERUS 0.9 KG
 BREAST 0.4KG
NET MATERNAL WEIGHT GAIN
 BLOOD VOLUME 1.3KG
 EXTRACELLULAR FLUID 1.2 KG
 ACCUMULATION OF FAT AND PROTIEN 3.5 KG
IMPORTANCE OF WEIGHT
CHECKING
 RAPID WEIGHT GAIN
 STATIONARY OR FALLING WEIGHT
HAEMATOLOGICAL
CHANGES
SR. VOLUME NON PREG TOTAL CHAN
NO PREG NEAR INCRE GE
TERM MENT
1 BLOOD 4000 5500 1500 30-40%
2 PLASMA 2500 3750 1250 40-50%
3 RBC 1400 1650 250 18-20%
4 TOTAL 475 560 85 18-20%
Hb(GM)
5 HAEMAT 38% 32%
OCRIT
HEART AND CIRCULATION

 HEART IS PUSHED UPWARD AND

OUTWARD
ABNORMAL CLINICAL
FINDINGS
 SYSTOLIC MURMUR
 MAMMARY MURMUR
 X RAY SHOWS
ENLARGE CARDIAC
SHADOW
 CARDIAC OUTPUT

 NORMAL-4.5 LT/MIN
 FIRST TRIMESTER-6.1LT/MIN
 SECOND TRIMESTER-6.1LT/MIN
 THIRD TRIMESTER-6.26LT/MIN
 BLOOD PRESSURE

 NORMAL
 HIGH LEVEL OF PROGESTERONE
 VENOUS PRESSURE

 VENOUS PRESSURE IS RAISED TO

20CM IN LYING DOWN
 80-100CM N STANDING POSITION
SUPINE HYPOTENSION
SYNDROME
PROTEIN METABOLISM

 POSITIVE NITROGENOUS BALANCE

 500GMS DIVIDED IN FETUS AN
PLACENTA
 500GMS DIVIDE IN UTERUS .BREAST
AND MATERNAL BLOOD
CARBOHYDRATE
METABOLISM
 ORAL GLUCOSE TOLERANCE TEST
WILL SHOW ABNORMAL PATTERN
 FAT METABOLISM

 3-4 KG OF FAT IS STORED IN

ABDOMINALWALL,HIPS,BREAST
THIGHS
 IRON METABOLISM

 TOTAL REQUIREMENT 1000MG

RESPIRATORY SYSTEM
ACID BASE BALANCE

 PCO2 FALS FROM 38-32MM OF Hg

 PO RISES FROM 95-105 MM OF Hg
 Ph RISES
URINARY SYSTEM

 RENAL PLASMA FLOW IS INCREASED

25-50%
 GFR INCREASED 50%
 URETER

 ELONGATION KINKING AND

OUTWARD DISPLACEMENT
 BLADDER
 HYPERTROPHY AND
CONGESTION
ALIMENTARY SYSTEM

 CARDIAC SPICTER IS RELAXED

 MUSCLE TONE NAD MOTILITY IS
DIMINISHED
 LIVER AND GALL
BLADDER
 ATONICITY OF GALL BLADDER
 HIGH BLOOD CHOLESTEROL LEVEL
NERVOUS SYSTEM

 CARPEL TUNNEL SYNDROME