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Physiological and Psychological Changes of Pregnancy: Debbie Amason, RN, Ms SPRING 2001
Physiological and Psychological Changes of Pregnancy: Debbie Amason, RN, Ms SPRING 2001
Changes
affect both parents physiologic psychological temporary state of wellness
Diagnosis
feelings can be good or bad confirmation early diagnosis important
Presumptive Signs
Probable Signs
Positive Signs
visualization by ultrasound
Physiological Changes
Local
Uterus
pre-pregnancy small semisolid pear shaped weight increases from 50Gm to 1000Gm enlargement primarily a result of hypertrophy of pre-existing myometrial cells
Uterine
development of new fibroelastic tissue between bands of muscles cells increase as result of estrogen measure lightening
Uterine
blood flow 15-20ml/min prepregnancy at term 500-700ml/min by end of pregnancy 1/6 total maternal blood volume is circulating through the uterus bleeding- serious problem
Uterus
Braxton Hicks
painless contractions estrogen distention of the uterus felt by 4th month practicing no cervical changes occur
amenorrhea
Cervix
Cervix
increased increased increased increased
Vagina
epithelium undergoes hypertrophy and hyperplasia estrogen
Ovaries
cease ovum production related to active feedback mechanism of estrogen and progesterone produced by the corpus luteum and the placenta
Breasts
changes are noted soon after first missed period increase in size and nodularity preparing for lactation 2nd month superficial veins are prominent nipples are more erect
Breasts
pigmentationof areola is more prominent sebacious glands enlarge (Montgomery Tubercles) 16th week colostrum
Integumentary System
nipples and areola areas of breasts are darker striae gravidarum linea nigra chloasma diastasis rectus
Respiratory
tidal volume increases 40% respiratory rate increases
oxygen consumption increases by 20% diaphragm is displaced >SOB no change in vital capacity
Respiratory
Respiratory
cumulative effect
SOB nasal stuffiness epistaxsis
Cardiovascular
pressure on diaphragm displaces the heart blood volume increases 30-50%
occurs gradually and peaks at 2832 weeks adequate exchange of nutrients compensate for blood loss
CV
CV
wbc, protein
GI
GI
hemorrhoids acidity of stomach decreases hypertrophy of gums and gingival bleeding
Urinary
alterations
fluid retention,renal, ureter, and bladder function
result of:
estrogen and progesterone activity compression increased blood volume postural influences
Urinary
total body H2O content increases must increase Na reabsorption retained to assist:
Urinary
excrete waste from mother and fetus breakdown protein compensate for blood volume UOP increases 60-80% specific gravity decreases
Urinary
GFR increases
decrease BUN increase filtration of glucose
Skeletal
no obvious changes in teeth noted joints of pelvis relax r/t hormone relaxin
Endocrine
placenta produces:
estrogen progesterone HCG HPL relaxin prostaglandins
Endocrine
thyroid
increased vascularity hyperplasia increased BMR increased oxygen consumption
Endocrine
pituitary
decreased FSH and LH Prolactin increases secretes oxytocin
results in:
anovulation lactation increased pigmentation
Endocrine
Psychological
gamut of emotions
need time to adjust
First Trimester
Developmental Task
acceptance of pregnancy 50% are surprises concerns center on self partners response
Second trimester
Acceptance of Baby
quickening start to make plans educate fantasize
Third Trimester
Emotional Responses
ambivalence grief narcissism introversion vs. extroversion body image and boundary stress couvade syndrome
Responses
emotional lability change in sexual desire change in expectant family