Question

Pregnancy

Pregnancy does not just affect the reproductive system, but the entire female body. Research the physiological symptoms of pregnancy. Based on your observations of others and your research, what are two or three physiological symptoms that seem to be the most common complaints? What are two or three symptoms that seem to be less common? What are the physiological causes of two or three of the symptoms you chose, and how do they relate to the development and growth of the fetus?

Answer 1

Maternal physiological changes in pregnancy are the adaptations during pregnancy that a person’s body undergoes to accommodate the growing embryo or fetus. These physiologic changes are entirely normal, and include cardiovascular (heart and blood vessel), hematologic (blood), metabolic, renal (kidney), posture, and respiratory (breathing) changes. Increases in blood sugar, breathing, and cardiac output are all expected changes that allow a pregnant person’s body to facilitate the proper growth and development of the embryo or fetus during the pregnancy. The pregnant person and the placenta also produce many other hormones that have a broad range of effects during the pregnancy.

Plasma volume increases progressively throughout normal pregnancy.2 Most of this 50% increase occurs by 34 weeks’ gestation and is proportional to the birthweight of the baby. Because the expansion in plasma volume is greater than the increase in red blood cell mass, there is a fall in haemoglobin concentration, haematocrit and red blood cell count. Despite this haemodilution, there is usually no change in mean corpuscular volume (MCV) or mean corpuscular haemoglobin concentration (MCHC).

The platelet count tends to fall progressively during normal pregnancy, although it usually remains within normal limits. In a proportion of women (5–10%), the count will reach levels of 100–150 × 10⁹ cells/l by term and this occurs in the absence of any pathological process. In practice, therefore, a woman is not considered to be thrombocytopenic in pregnancy until the platelet count is less than 100 × 10⁹ cells/l.

Pregnancy causes a two- to three-fold increase in the requirement for iron, not only for haemoglobin synthesis but also for for the foetus and the production of certain enzymes. There is a 10- to 20-fold increase in folate requirements and a two-fold increase in the requirement for vitamin B₁₂.

Changes in the coagulation system during pregnancy produce a physiological hypercoagulable state (in preparation for haemostasis following delivery).3 The concentrations of certain clotting factors, particularly VIII, IX and X, are increased. Fibrinogen levels rise significantly by up to 50% and fibrinolytic activity is decreased. Concentrations of endogenous anticoagulants such as antithrombin and protein S decrease. Thus pregnancy alters the balance within the coagulation system in favour of clotting, predisposing the pregnant and postpartum woman to venous thrombosis. This increased risk is present from the first trimester and for at least 12 weeks following delivery. In vitro tests of coagulation [activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT)] remain normal in the absence of anticoagulants or a coagulopathy.

Venous stasis in the lower limbs is associated with venodilation and decreased flow, which is more marked on the left. This is due to compression of the left iliac vein by the left iliac artery and the ovarian artery. On the right, the iliac artery does not cross the vein.

Most common changes

Breasts: Early in pregnancy they will feel tender and may be larger. As the pregnancy progresses breasts prepare for breastfeeding, they get even bigger and may leak an early form of milk called colostrum.

Congestion: The higher blood volume of pregnancy can lead to congestion and runny noses.

Frequent urination: Blood volume increases during pregnancy, putting increased pressure on kidneys. Plus, later in pregnancy the weight of the baby on bladder increases the pressure further increases feel of urination

Shortness of breath: By the end of pregnancy, with the baby pressing up against diaphragm, she may feel as if you can't get enough air. This is called dyspnea, or shortness of breath.

Constipation: Pregnancy hormones can lead to hemorrhoids. Get regular exercise, drink plenty of water and up the fiber in diet to reduce the symptoms

Heartburn and gas: Blame the crowded space in there for this symptom, which most pregnant women experience in the third trimester. The pressure of the uterus on the stomach, coupled with the relaxation of the valve between the stomach and esophagus, allows stomach acid to "reflux" into throat. Over-the-counter heartburn options like Tums, Mylanta and Mylanta Gas are considered safe during pregnancy.

Less common changes

Mouth and tooth changes: Body needs extra calcium for the baby; if pregnant don't provide it through diet, it will steal it from bones and teeth .Pregnant women may also find that gums bleed more easily.

Leg cramps: Pregnant women may experience sudden leg cramps, feel that something is crawling on legs or have an uncontrollable urge to move legs, particularly at night. This symptom may be caused by low iron or potassium. Stretching legs before bed and getting regular exercise can help, adding a potassium-rich banana to diet.

Aches and pains. During pregnancy, ligaments and tendons throughout body stretch, both to accommodate the growing baby and to allow the baby out during labor. This can lead to achiness and even pain, particularly in the lower abdomen. She may also experience carpal tunnel syndrome in one or both hands, caused by compression of the nerves that carry signals to the hand and fingers.