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Maternal Changes During Pregnancy Explained

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Sameeksha SM
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33 views26 pages

Maternal Changes During Pregnancy Explained

Uploaded by

Sameeksha SM
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

MATERNAL CHANGES

DURING PREGNANCY

Presented by,
Sameeksha R G M
Roll no:143
WHY DOES MATERNAL
CHANGES TAKES PLACE?

Main reasons-
 To supply adequate oxygen and
nutrients to foetus
 Remove CO2 and waste products
from foetal circulation
CHANGES IN FEMALE 3

BODY DURING GESTATION


CAN BE CLASSIFIED INTO:
 Haemotological changes
 Cardiovascular changes
 Changes in endocrine system
 Changes in genital organs
 Renal changes
 Changes in GIT
 Respiratory changes
 Breast changes
 Cutaneous changes
 Weight gain
4

HAEMOTOLOGICAL CHANGES
Reason: to increase oxygen supply to the foetus

Changes in blood volume


Changes in blood coagulation factor
CHANGES IN BLOOD VOLUME :
 increased during pregnancy- increase in both plasma and cell components
 increases about 40-50% -from about 6th week
 Plasma volume:
 Increase- expansion of ECF volume
 increase- by 6th week,increase- about 50%
 Red cell count:
 increases-about 20-30%,after 16 weeks of gestation
 WBC count:
 Moderate leucocytosis
 Leucocytosis occurs mainly due to neutrophilia
 Platelet count:
 No change
PHYSIOLOGICAL ANAEMIA OF PREGNANCY:
• Increase in red cell count is slower than increase in plasma
volume
• Disproportionate increase in plasma and RBC volume leads to
the state of haemodilution(fall in haemocrit)
CHANGES IN CLOTTING FACTORS :
7

• The increase in procoagulant activity -third trimester of pregnancy


• hepatic synthesis of clotting factors by estrogen
• Fibrinogen concentration increases 2-4 times
CHANGES IN CARDIOVASCULAR
SYSTEM:
 Cardiac output:
• Increases- end of the first trimester
• Increase- maximum, i.e, about 40% in mid-pregnancy-remains elevated at that level till term
• increase in both stroke volume and heart rate
 Stroke volume:
 Increases by about 30%
 increased blood volumeincreased venous returnincreased end diastolic volume
 Heart rate:
 Increases by about 10-15%,reaching peak by term
9

 Systolic BP:
 increase in cardiac output
 in second and third trimester
 Diastolic BP:
 Decreases, least-20th week,increases to normal by term
 vasodilation effect of progesterone
 Pulse pressure widens due to increase in systolic and diastolic pressures
CHANGES IN ENDOCRINE SYSTEM:
 Placental hormones:
 Human chorionic gonadotropin-
 Induces secretion of progesterone by the corpus luteum of pregnancy
 Stimulates Leydig cells of the male foetus to produce testosterone
 Steroidal hormones-
 Oestrogen and progesterone together maintain pregnancy, increases the growth of uterus
 Oestrogen causes hypertrophy and hyperplasia of the uterine myometrium increasing the
accommodation capacity ,vascularity and blood flow to the uterus
 Development and hypertrophy of breasts. Hypertrophy and proliferation of the ducts are due to
oestrogen
 Both hormones are required for the adaptation of the maternal organ to the constantly increasing
demands of the growing foetus
11
 Pituitary hormones:
 Prolactin:
 increases-end of first trimester,at term-10 times
 The size of anterior lobe increases 2-3 times- increase in size and number of prolactin cells
 FSH and LH:
 Hypothalamo-pituitary-ovarian axis is suppressed by high levels of sex steroids
 This decreases LH and FSH secretion
 Ovulation prevented
 Others:
 GH decreased, ACTH secretion suppressed, TSH secretion remains same
12

 Thyroid hormones:
 Gland increases in size due to depletion of iodine
 Decrease in iodine is due to renal clearance of iodine as a consequence of increase
in GFR
 Pregnancy can give the impression of hyperthyroidism(due to increase in thyroid
binding protein) ,thyroid function is basically normal
 BMR is increased because of increased oxygen consumption by the foetus and the
work of maternal heart and lungs
CHANGES IN GENITAL ORGANS:
13

 Uterus:
 Non-pregnant state-60g, 7.5cm in length
 at term-900-100,35cm in length
 Hypertrophy and hyperplasia of uterus occurs under the influence of sex steroids
 The muscle fibres elongate beyond 20 weeks due to distention by growing foetus
due to which walls of uterus becomes thin
 Shape of uterus in non-pregnant females is pyriform
 As the uterus enlarges ,shape changes to circularelliptical
14
15

 Ovary:
 Growth and function of corpus luteum reaches its maximum at 8 th week
 Hormones –oestrogen and progesterone secreted by corpus luteum maintain the
environment for growing ovum
 Control the formation and maintenance of decidua of pregnancy
 Inhibit ripening of follicles
 Cervix and vagina:
 Vaginal walls become hypertrophied ,oedematous and more vascular
 Hypertrophy and hyperplasia of elastic and connective tissues of cervix
 Softening of cervix
 Blood supply increases to both vagina and cervix
RENAL CHANGES:
16

 Renal blood flow-increase by 35%


 GFR-increase by about 40% by mid-pregnancy
 Continues at that level till term
 Load of filtered glucose increase-no increase in tubular
capacity to reabsorb glucoseglycosuria
CHANGES IN GIT:
17

 GI motility-decreasedgastric emptying time-


increasedincreased transit time for chyme to pass through
intestinal lumenwater absorption-moreconstipation
 Towards term-enlarged uteruspressure on
stomachincrease in intragastric pressure
 Propulsion of acid-gastric content into oesophagus-reflux
oesophagitis
RESPIRATORY CHANGES:
18

 Increase in minute volume-due to increase in tidal volume


 Residual volume-decreases by 20%
 Expiratory reserve voume-decreases by 15%
 RV and ERV decreasefunctional residual capacity-decreases
 Inspiratory reserve volume-increases
 IRV and TV-increaseinspiratory capacity-increases
 Diffusing capacity of alveolar membrane-no significant change
 In 3rd trimesterelevation of diaphragmbut still ventilation-not impaired
BREAST CHANGES:
19

 Increased size of breasts


 Marked hypertrophy and proliferation of the ducts(oestrogen and
progestrone)
 Vascularity -increased
 Nipples become larger ,erectile and deeply pigmented
 sebaceous glands become hypertrophied
 Secretion(colostrum) can be squeezed out of the breast at about 12 th
week
20
CUTANEOUS CHANGES:
21

 Face:
 Chloasma gravidarum or pregnancy mask
 An extreme form of pigmentation around cheek , forehead and around the eyes
22
 Abdomen:
 Linea nigra- a brownish black pigmented area in the midline stretching from
xiphisternum to the symphysis pubis
 Straie graviderum- slightly depressed linear marks with varying length and breadth
found in pregnancy
WEIGHT GAIN:

• In early weeks ,the female may lose weight because of nausea and
vomiting
• During subsequent months, the weight gain is progressive until the last
one or two weeks ,when the weight remains static
• The total weight gain during the course of a singleton pregnancy for a
healthy woman averages 11kg
• Distributed to 1kg in first trimester and 5kg each in second and third
trimester
24

What is the effect of HCG on male foetus?

How is ovulation prevented during pregnancy?

What is physiological anaemia of pregnancy?


25

Stimulates leydig cells to produce testosterone

Increased sex steroidsnegative feedback


mechanismFSH and LH decreasedovulation
prevented

Haemodiltion due to disproportionate increase in


plasma and red cells
THANK YOU

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