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Anatomic-physiological changes in the pregnant woman .

The anatomical and physiological changes in the pregnant woman are numerous. Read this article to learn more and understand why they occur.



Anatomic-physiological changes in the pregnant woman .
Anatomic-physiological changes in the pregnant woman .


The anatomic-physiological changes in the pregnant woman are due to the new demands and needs that come from her body and from the fetus.


 These changes involve all the organism's systems and systems, and not all women suffer them in equal measure. For this reason, in this article we offer you all the information regarding these changes.


Anatomic-physiological changes in the expectant mother


Reproductive system


The uterus is the organ of the reproductive system that undergoes the greatest number of anatomical and physiological changes in the pregnant woman . Its dimensions increase to reach, at the end of gestation, a capacity of about 5 litters and 1,100 grams of weight.


In the non-pregnant woman, the uterus is inside the pelvis. During pregnancy it becomes an abdominal organ and, as it increases in size, it is possible to palpate the bottom through the abdomen.

Uterine growth is one of the most widely used parameters in controlling the evolution of pregnancy. This growth is due to the action of the hormones oestrogen and progesterone, and to the distension caused by fetal growth from the inside.

Similarly, blood flow to the uterus increases with pregnancy, so that the placenta can be adequately flushed and, consequently, the fetus.


the reproductive apparatus is the one most affected by the anatomical-physiological changes in the pregnant woman



Other changes in the reproductive apparatus


In the cervix the secretion of the cervical lymph nodes increases, giving rise to the mucous plug, which will serve as a defense against the possible entry of microorganisms into the vagina.
It also increases its vascularisation and becomes oedematises, softens (sign of hegar ) and takes on a slightly bluish colour.


Vascularisation also increases in the vaginal and vulvar region, causing the tissues to become slightly edematous and cyanotic (Chadwick sign).

The vagina becomes more elastic in preparation for childbirth and increases the secretion of  dense and whitish va. The acid pH of vaginal flow protects against the attack of numerous infections, but it is also a culture medium for fungi. This makes fungal infections (candidiasis) frequent during pregnancy.

Roughly up to 7 per week of pregnancy, the ovaries contain the corpus luteum, which maintains the hormonal production which allows pregnancy to continue until the placenta becomes the leading producer of hormones.

The breasts increase in size, the pigmentation of the areola and the nipple grows and small reliefs appear on the nipple (tubercles of Montgomery), which are hypertrophied sebaceous glands. In the same way, the venous network of Haller appears and, starting from the 4th month of gestation, it is possible that the first milky secretion occurs.

In the context of the anatomical-physiological changes in the pregnant woman, the reproductive apparatus is one of those that presents the greatest number of alterations.

Skin

Hormonal changes are the cause of most skin alterations. During pregnancy may appear:
  • Hyperpigmentation in the alba line of the abdomen, nipples, areolas or vulva.
  • Stains on the face  (chloasma gravidarum).
  • Varices may appear on the face, neck, extremities or chest.
  • Breast marks  on the breasts, abdomen or buttocks.
  • Increased activity of sweat and sebaceous glands .


Metabolic changes


On a metabolic level, the body of the pregnant woman also undergoes alterations:
  • Weight gain. It is mainly due to the fetus and fetal appendages, the increase in blood volume and interstitial fluid, the growth of the uterus and breasts and new fat deposits.                                 
  • Metabolism of carbon hydrates. The production of insulin increases and, at the same time, a resistance of the tissues to its effect appears. increases peripheral glucose utilisation and decreases glucose production in the liver.                                                                                            
  • Fat metabolism. During the second trimester, both synthesis and absorption of cholesterol and triglycerides increase, as does the accumulation of fat in tissues.                                                       
  • Protein metabolism. The growth of fetal tissues involves a great demand for proteins.                           
  • Water metabolism. Water retention during pregnancy is physiological. Up to 7 litters of water are retained between mother, fetus and fetal appendages.


Respiratory system


Increased oestrogen during pregnancy causes hyperemia of the mucous membrane of the nasal passages, which generates episodes of rhinitis, nasal congestion or epistaxis (nosebleeds).


The rib cage also undergoes changes during pregnancy. The diaphragm rises and the width of the chest increases. These changes are due to the increase in size of the uterus and relaxation of the intercostal ligaments due to hormones.


the anatomical-physiological changes in the pregnant woman


Some alterations also occur at the level of lung function:
  • The total functional and residual capacity decreases.
  • Increase in inspiratory capacity and tidal volume.
  • Slightly increases the respiratory rate, especially in the third trimester.

Anatomic-physiological changes in the pregnant woman in the digestive tract


It is normal for pregnant women to suffer from nausea and vomiting. This phenomenon is mainly due to the presence and action of the hormone Beta-hCG and progesterone (hormones that act during pregnancy).


Also the mouth undergoes alterations during pregnancy, because, due to the action of hormones, the salivary pH is lowered, which could alter the bacterial flora. If adequate oral hygiene is not enhanced, this phenomenon can lead to the formation of caries.

Furthermore, oestrogen increases vascularisation, which can cause bleeding and inflammation of the gums.

The uterus, increasing in size, moves the abdominal organs, increasing the intra-abdominal pressure. Progesterone relaxes the gastrointestinal tract; as a result, intestinal transit slows down. This phenomenon can cause:

  • Pyrosis  ( acidity  or burning).
  • Constipation.
  • Slow and heavy digestion.
  • Hiatal hernia 
The action of progesterone also acts on the gall bladder, slowing its emptying, which increases the density of bile. These changes favour the onset of lithiasis (appearance of stones or "stones") in the vesicle.

Urinary system


During pregnancy, the kidneys increase in size with increasing vascularity, interstitial volume and dead spaces. The renal pelvis and ureters also dilate.


These changes are most marked in the right kidney (due to the rotation of the uterus) and can be observed starting from the first trimester of pregnancy. Furthermore, they cause urinary stasis which can lead to infections or lithiasis in the kidney.


The uterus increases intravesical pressure, which, added to the increase in urine production, gives rise to an increase in daily urination.


Anatomic-physiological changes in the gestational endocrine system

During pregnancy there are alterations in the secretion of different hormones, as well as new ones are released . The following are some of the hormones that affect during pregnancy:

Chorionic gonadotropin (hCG)

It is a hormone produced by the placenta; Beta-hCG is the subunit that has the greatest influence in pregnancy. During the first quarter his levels are very high and decrease to then remain stable during the rest of the gestation.

This hormone affects fetal growth, keeping the corpus leuteum until the placenta   is able to produce enough steroids and stimulates the fetal testicles to produce testosterone.

It is the hormone retested by pregnancy tests, both those of the blood and those of urine.


the anatomic-physiological changes in the pregnant woman are also reflected in the appetite


Placental lactogen (HPL)



This is also a placental hormone. Its functions are to increase lipolysis, increase insulin resistance, reduce gluconeo-genesis and induce breast tissue proliferation.


Estrogens and progesterone


These are also produced by the placenta. They intervene in most of the changes that occur during pregnancy.


Gonadotropin-releasing hormone (GnRH)


It is a hypothalamic hormone that  acts on the growth of the placenta; its levels increase during pregnancy.


Prolactin


It is a pituitary hormone. Its levels increase with advancing pregnancy in preparation for breastfeeding.

Thyro-stimulant hormone (TSH)


It is produced in the thyroid gland. Its levels fall slightly in the first quarter, with the increase in hCG (they have a similar structure). Then his levels return to normal.

Cardiovascular system


In the pregnant woman, the blood volume increases by about 1,500 - 1,700 ml. This increase in volume does not occur on a regular basis, because in the blood the plasma volume increases more than the cell volume, which leads to a hemodilution and a physiological anemia.

This increase in blood volume performs various functions during pregnancy:
  • Protects from blood loss  that the mother will suffer during childbirth. 
  • Meets new metabolic demands.  
  • Protects from the harmful effects of deterioration of venous return in pregnancy.

The number of leukocytes grows and the platelets may undergo a slight decrease.


The coagulation factors increase and the fibrinolytic activity is lowered, which, added to the blood stasis that the uterus causes on venous return, increases the risk of suffering from a thromboembolism.


Anatomically, the diaphragm rises and moves forward and to the left of the heart. Cardiac output (GC) increases, as does heart rate, which increases up to 15-20 beats per minute.
Similarly, blood pressure values ​​do not change during pregnancy and, in some cases, may decrease.


Other anatomophysiological changes in the expectant mother


Bones


During pregnancy, the pregnant woman increases the absorption of calcium and phosphorus, as well as activates the content of her bones to allow the fetus to develop properly. After giving birth, the density returns to normal.


It has been shown that  gestation is not a risk factor in the future onset of osteoporosis.


Musculoskeletal system


To adapt to weight gain, the spine accentuates its lordosis. Vertebral nerve roots can compress or relax. these changes can lead to low back pain or neuralgia.


alterations in the physiology of the pregnant woman


Immune system


During pregnancy, some immune functions are suppressed to allow a "foreign body" (the embryo) to be lodged in the body.


Sexuality


The modifications that have been previously described can affect sexuality  . Increased vascularisation of the genital region increases sensitivity, which may increase satisfaction but, for some women, may be annoying.


In pregnancies that follow a normal course, the contractions generated in the uterus after an orgasm are not able to cause birth, given their low intensity.


Regarding the anatomical-physiological changes in the pregnant woman remember that ...



During your pregnancy, do not hesitate to consult your midwife or your gynecologist about any doubts that may arise about the changes presented by your body.




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