Changes During Pregnancy

  Introduction 

The duration of pregnancy is very important to every woman . During this period various anatomical, Physiological and biological changes are seen in woman. 

* The changes ocurring during pregnancy in a woman are not confiend to the organ of reproductive system but these are seen in other bodiely organ such as respiratory organs, digestive organs, kidneys, blood vessels, Heart, Liver, endocrinal glands etc. 

1. Changes in Reproductive System

 i. Change in Uterus

• The uterus weight increased about 20 times.
• Its capacity increase by about 1000 times. 
• It's weight, length and thickness is also increase. 
• Uterus is situated in pelvic cavity but during pregnancy uterus become abdominal organ. 
• Change in the shape of uterus 

1.  6 week     - Hen egg ( oval )
2. 8 week      - Orange, Cricket ball
3. 12 week    - Globular, Fetal head
4. 28 week    - Papaya
5. 36 week    - Football, Spherical, Watermelon

• Non Pregnent women uterus shape is pyriform shaped, Pear shaped. 

 Fundal Height 

• At 12th Week :- At the level of symphysis pubis 
• At 16th Week :- At the time , fundal height locates at the junction of the lower one third and upper two third of the distance between the symphysis pubis and umblicus. 
• At 20th Week :- At the junction of upper one third and lower two third of the distance the symphysis pubis. 
• At 24th week ;- At the level of umblicus. 
• At 28th week :- At this time, fundal height locates at the junction of the lower third and upper two thirds of the distance between the umblicus and ensiform cartilage. 
• At 32 weeks :- At the junction of the lower two third and upper one third of distance between the umblicus and ensiform cartilage. 
• At 36 week :- At the level of ensiform cartilage. 
• At 40 week :- Lower down at the level of 32 weeks. 

 ii) Change in Cervix 

• The cervix is the tubular shaped lower part of the uterus which connects the uterus to the vagina. It is also known as neck of uterus. 
• During early pregnancy (6 week), the cervix ecome soft and feel like lip of mouth is called godell's sign. 
• Cervical vascularity incease and it become bluish. 
• Hypertrophy and hyperplasia in its tissues are also seen.
• Cervical secreation become thick, clear and viscous and trun into mucus plug.
• The cervical mucus plug seal the cervical canal and protect the fetus and feta membrane.
• During first stage labour, the mucus plug comes out alone with blood known as SHOW.

Iii) Change in isthmus

•  It become hepertrophied ( Increse cell size ) 
• After first trimester, the isthmus is expand to lower uterine segment. 

Iv) Change in fallopian tube

•  Fallopian tube vascularity increase. 
• It's lumen is congested. 
• It become longer than non-pregnent stage. 

V) change in ovaries 

•  The ovulation process is stop due to produce high level of oestrogen and progesterone
• The both ovaries are enlarge due to contain corpus luetum.
• Ovaries vascularity increase.

Vi )Change in vulva

• The vulva is swelling and soft
• The vulva blood flow and O2 level increase 
• Feeling of fullness or heaviness in vulva.

Vii) Change in vagina

•  Vagina vascularity increase.
• Vaginal wall become hypertrophied.
• Increases blood supply.
• Vagina become acidic (pH-3.5) 
• Hyperplasia and chadwick sign present.

2. CHANGE IN BREAST 

•  Breast size increase due to hypertrophied.
• Montgomer's Tubercles is present.
• Primary areola become more pigmented.
• Nipples also pigmented.
• Increase lobules and ducts.
• The milk secreate in 12th week and colostrum produce in 16th week. 

3. WEIGHT GAIN DURING PREGNENCY 

•  During pregnancy normal weight gain in approximately 11-12 kg.
• Duration of pregnancy                 Weight Gain
• First Teimester (0-12 week)           :-  1 kg
• Second Trimester (13-28 week)    :- 5-5.5 kg
• Third Trimester (29-40 week)       :- 5-5.5 kg

•  Breast                                  :-  0.4-0.5 kg
•  Placenta                              :-  0.5-0.6 kg
• Amniotic Fluid                   :-  0.6-0.8 kg
• Uterus                                   :-  0.9-1.0 kg
• Extracellular fluid            :-  1.3-1.5 kg
• Deposition of subcutaneous fat :-  2.5-3.5 kg
• Fetus                                     :-  2.8-3.3 kg

4.  CHANGE IN SKIN

 I) Linea Nigra :- Linea nigra is the brownish black colored narrow line which appears on the abdominal midline from the symphysis pubis to the sternum. It is also know as linea alba. 

                        It start appear at about 20th week of pregnency and disappear after child birth. 

II) Chloasma :-  Chloasma is irregular brownish pigmentation of the skin of forehead and face. It is also of forehead and face. It is also known as melasma or mask of pregnancy. It appear about 24th week of pregnancy and disappear after birth.

III) Striae gravidarum :-  These are streched / Depressed lines of pinkish colour which appear on the thigh, breast, buttocks and around umblicus. 

            This is not disappear after delivery It become silvery white, known as striae albican. 

 

5. CHANGE IN DIGESTIVE SYSTEM 

• Morning sickness 
• The stomach is displace due to fetus grow.
• She eat unnatural things is called PICA.
• Increase size of gall bladder
• Increase salivation 
• Constipation

6. CHANGE IN RESPIRATORY SYSTEM.

• Displace diaphram about 4cm.
• Increase chest circumference.
• Lungs capacity is decrease. 
• Decrease respiration rate.

7. CHANGE IN URINARY SYSTEM 

•  Increase glomerular filtration rate to 50%.
• Increase Renal blood flow 
• Mituration
• Increase Kidney size about 1.5cm.
• Urgency.

8. METABOLIC CHANGE.

• Increase metabolic rate.
• Increase fat storage.
• Increase requirement of calories, Iron, Calsium, Vitamins. 

9. CHANGE IN CARDIOVASCULAR SYSTEM 

• Increase blood flow and volume.
• Increase pulse
• Increase size of heart.
• Increase cardiac Output.