Various changes occur in almost every organ and system in the
body during pregnancy.
The expectant mother gains weight due to both the weight of
her baby and her husband and her attachments, as well as increased fat in her
body, increased blood volume, and an increase in the breasts and uterus.
- Water retention increases in the mother's body during
pregnancy.
- The blood volume increases. There is an increase in the
blood volume of about 1500 ml, 1200 ml of it consists of plasma and 300 ml of
erythrocytes. Dilutional anemia occurs as plasma increases more. Hemoglobin and
hematocrit value decreases.
- Triglycerides and total cholesterol, HDL, LDL, VLDL and
free fatty acids increase in blood during pregnancy.
- The need for iron increases and becomes unfavorable with
nutrients, additional iron pills are required.
- The volume of blood, which is normally 3.5 liters in a
woman, increases to about 5 liters in a pregnant woman.
- There is an increase in white blood (leukocyte) in the
blood during pregnancy. Leukocyte increase is from neutrophil origin,
lymphocytes do not change.
- Platelet level decreases.
- Acute phase reactants such as sedimentation rate and
C-reactive protein increase. The parameter that is mainly responsible for the
increase of sedimentation is the increase of fibrinogen.
- The immune system (humoral and cellular immunity) during
pregnancy is suppressed, that is, it is suppressed.
- Coagulation in blood, that is, the tendency to clot
increases during pregnancy.
- During pregnancy, the heart rate increases by 10 beats /
minute. The amount of blood pumped by the heart increases.
- During pregnancy, the rib cage expands and the diaphragm
rises.
- A small amount of glucose is excreted in urine, that is,
glucosuria is normal during pregnancy.
- Due to the pressure of the uterus and the effect of the
hormone progesterone, an enlargement of the urinary tract (ureters) may occur.
- Daily urine output increases and frequent urination occurs.
- Gum hypertrophy (epulis) and bleeding may occur.
- Hemorrhoids may increase during pregnancy.
- The risk of gallstones increases.
- Inclination increases in the lumbar spine (lordosis).
- Loosens in the pelvis joints.
- During pregnancy, tidal volume increases and residual
volume decreases in the lungs.
- Glomerular filtration rate increases.
- Plasma creatinine is reduced.
- Plasma urea decreases.
- Alkaline phosphatase (ALP) increases physiologically.
- Plasma total protein and album are reduced. Total globulin increases.
- During pregnancy, the level of bilurib in mother serum
decreases, bile acids increase.
- Liver enzyme levels (ALT, AST) decrease in mother serum
during pregnancy.
- Intraocular pressure decreases during pregnancy. Corneal
thickness may increase due to edema.
- Bicarbonate threshold decreases during pregnancy, blood
level decreases (to compensate respiratory alkolosis)
- Lipolytic activity increases in adipose tissue during
pregnancy
- Lipoprotein lipase activity decreases in the liver.
- Uterus size has a volume of 5 liters in the last month of
pregnancy. In the near term, the weight of the uterus reaches around 1000 g.
- Normally, a decrease in blood pressure (especially
diastolic pressure) is observed during the first trimesters of pregnancy, and
rises to the pre-pregnancy level again in the last months. During delivery, an
increase in both systolic and diastolic blood pressure is observed.
- During pregnancy, the heart rate and cardiac output
increase, it increases even more during birth. The first and third heart sounds
harden. Systolic murmur may be normal during pregnancy, but diastolic murmur
should always be considered pathological.
- ECG shows slight left axis deviation.
- Kidney sizes increase slightly during pregnancy. The
glomerular filtration rate increases. Urea, creatinine, uric acid levels
decrease in mother serum. Creatinine clearance increases.
- Daily urine volume increases.
- There is slight expansion in ureters (especially on the
right).
- During pregnancy, serum total calcium level decreases but
free calcium level does not change. Urine increases calcium excretion.
- During pregnancy, sodium (Na) and potassium (K) levels
decrease in maternal plasma.
- Breathing rate does not change during pregnancy. Due to the
increase of the diaphragm, total lung capacity and residual capacities
decrease. Minute ventilatory volume increases. Lung compliance does not change,
but total lung resistance decreases and airway conduction increases.
- During pregnancy, arterial pCO2 decreases slightly and
compensated respiratory alkalosis occurs. HCO3 (bicarbonate) decreases. Plasma
pH increases slightly, alkalizes.
- Since the pH increases in the blood, the hemoglobin-oxygen
dissociation curve shifts to the left, and the affinity of hemoglobin to oxygen
increases in the mother.
- During pregnancy, acid secretion in the stomach
decreases and mucus secretion increases, so patients with peptic ulcer heal
during pregnancy.
- Burning pyrosis (heartburn, pregnancy reflux) may occur in
the chest with the contents of the stomach coming back to the mouth.
- During pregnancy, slight growth is observed in the
pituitary gland.
- Total T3 and T4 increase during pregnancy, free T3 and free
T4 do not change (thyroid hormones). TRH and TSH do not change. T3 resin uptake
is reduced.
- The level of hormone hormone increases during pregnancy.
- Physiological hyperparthyroidism occurs. Calcitonin and
1.25 dihydroxy vitamin D3 levels also increase.
- Testosterone and androstenedione increase. DHEA-Sulfate
decreases.
- Estrogen and progesterone levels increase in mother serum.
FSH and LH are suppressed due to this increase. The most increasing estrogen is
E3 (Estriol), but still its level cannot exceed E2 (Estradiol), the highest
level is E2. The least amount of estrogen is E4 (Estetrol).
- During pregnancy, colloid oncotic pressure decreases in the
blood.
- Hemoconcentration occurs during pregnancy.
Skin
changes:
- Striae gravidarum: Cracks in the abdomen
- Dark spots on the face (chloasma, melasma, pregnancy mask)
- Red spots on the face (Vascular spider)
- Linea nigra: Color darkening in the middle of the abdomen
- Palmar erythema (Redness in the hands)
- Granuloma Gravidarum (Pyogenic granuloma)
Hemangioma: It often occurs in the neck and neck, disappears
after childbirth.
- Varicose veins (Prominence in veins): It is not a normal
physiological change in pregnancy.
Changes in
breasts:
- Pain sensitivity
- Breast growth starts especially in the second month.
- The nipple grows and becomes dark pigmented
- Areola expands and darkens
ADDITIONAL
INFORMATION:
- It is a thrombophilic condition in pregnancy, creates a
tendency to blood clotting. Coagulation factors such as factors 1, 5, 7, 8, 9,
10, 12 increase during pregnancy. Factor 11, 13 decreases, factor 2 does not
change.
- Protein C and Protein S levels decrease during pregnancy.
Antithrombin 3 level does not change. Activated Protein C level decreases,
Protein C resistance increases. Plasminogen activator inhibitor (PAI) and
plasminogen increases.
- Ferning test is negative during pregnancy and in the luteal
phase of the menstrual cycle. In the case of EMR and the follicular excess fern
test becomes positive. With the effect of estrogen in the follicular phase,
NaCl accumulates in the cervical mucus causes the fern test to become positive.
- Since there is proteinuria and aminoacituria in pregnancy,
amino acid levels decrease and albumin level decreases in maternal plasma.
Plasma osmality decreases.
-FALSE PREGNANCY
-PREGNANCY IN ADVANCED AGE
-PREGNANCY AT EARLY AGE
-CONSANGUINEOUS MARRIAGE
