Physiological Changes During Pregnancy: A Comprehensive Guide, Lecture notes of Psychology of Sex

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Physiological changes during pregnancy

Uterus  Size: increases to 20 times of its non-pregnant size due to  hyperplasia and hypertrophy. Wall: changes from almost a solid globe to a hollow vessel.  Weight: increases from 50 grams -1000 grams.  Volume: increases from less than 10 ml to 5000 ml,  Contractions: Braxton Hicks (irregular, painless contraction).  Shape: changes from that of an inverted pear to that of soft  globe. Endometrium: consists of 3 layers:  Decidua basalis: uterine lining beneath implantation.  Decidua capsularis: portion of the decidua that covers the  embryo. Decidua vera: all of the uterine lining that is not in contact with  the fetus.

Cervix 

Goodell's sign: softening of the cervix, formation of  operculum (mucous plug).  Ovaries and Fallopian Tubes 

Involution due to suppression of follicle stimulating  hormone (FSH).  Vagina 

Chadwick's sign: bluish discoloration of vagina.  Hypertrophy and hyperplasia.  Leukorrhea, acid pH 3.5 to 6. 

Vulva 

Increased vascularity. 

Fat deposition causes labia majora to close  and partially cover introitus.

Breasts 

3-4 weeks: prickling, tingling sensation. 

6 weeks: developing ducts and glands. 

8 weeks: bluish surface veins are visible. 

8-12 weeks: Montgomery's glands become  more prominent, primary areola become darker.

16-18 weeks: colostrum expresses. Secondary  areola appears.

Cardiovascular System  Slight enlargement of myocardium.  Shift in chest contents: Heart is displaced upwards  and to the left. Heart rate increases by 10 to 15 beats/minute.  Blood volume increases 40-50% physiological  anemia. Increase in clotting factors.  Hemoglobin and hematocrit decrease in relation to  increased plasma volume. Cardiac output increases by 30% during the first and  second trimesters.

Urinary System  Frequency of macturation due to pressure of the  growing uterus. Decreased bladder capacity and bladder tone.  Renal Function Changes  Changes occur to accommodate an increased  workload while maintaining stable electrolyte balance. Increased glomerular filtration rate.  Glucosuria may occur (may not be abnormal,  warrants further evaluation).

Gastrointestinal System  Mouth and Teeth  Gums become hyperemic and have a tendency to bleed.  Ptyalism is seen in some women.  Gastrointestinal Tract  Smooth muscle relaxation occurs related to increased  progesterone production. This can cause: Decreased peristalsis and constipation.  Heartburn, slowed gastric emptying and esophageal  regurgitation. Hemorrhoids from the pressure of the gravid uterus.  Appetite usually increases, after a temporary decrease due to  nausea and vomiting.

Integumentary System (Cutaneous Changes) 

Chloasma is the brownish" mask of  pregnancy".

Linea nigra (abdomen). 

Nipples, areolae, axillae, vulva and perineum  all darken.

Striae gravidarum (stretch marks) appear on  the breasts and abdomen. This is caused by increased fragility of the connective tissue.

LINEA NIGRA

CHLOASMAOR MELASMAGRAVIDARUM

Metabolic Changes 

Increase metabolic rate. 

Increase the demands for carbohydrate,  protein, and minerals.

Weight gain of 9-1 I kg. 

Water requirement is increased to supply  fetus, placenta and amniotic fluid.

Immunological System 

Resistance to infection is decreased. 

Maternal IgG levels are decreased. 

Maternal IgM levels remain unchanged. 

Pregnancy Signs and Symptoms

 Presumptive Evidence  Signs:  Amenorrhea.  Breast changes.  Chadwick's sign.  Chloasma and linea nigra.  Abdominal enlargement and striae. 

Symptoms:  Nausea and vomiting.  Urinary frequency.  Weight gain.  Constipation.  Fatigue.  Quickening.  Breast tenderness, tingling, and heaviness. 