1. Organs changes
1.1. uterus
1.1.1. uterus enlargement due to increase estrogen and progesteron, hypertrophy,hyperplasia,increase vascularity
1.2. cervix
1.2.1. estrogen and progesteron:vascularity and hypertrophy. prostaglandin and collagenase act on collagen fibers make cervix more softer. mucus gland becomes distended and secrete mucous plug (labour show)
1.3. vagina
1.3.1. vascularization due to estrogen and softeness due to progesteron. Discharge tends to be thick and white
1.4. Breast
1.4.1. Enlargment and Tenderness
1.4.2. Darkness of primary areola , appearance of secondary areola
1.4.3. colostrum: at beginning of lactation,provide the baby with efficient nutrient and improve body immune system
2. weight changes:11-16kg
3. Metabolic changes
3.1. caused by steroid,lactogen.cortisol hormones, also increase liver metabolism so increase in gluconeogenesis.
3.2. maternal insulin resistance and gestational diabetes
4. Hormonal
4.1. levels of estrogen and pogesteron
4.1.1. suppress hypothalamic axis and menstural cycle
4.2. Progesteron
4.2.1. produced first by corpus luteum, later by placenta
4.2.2. Relax bronchiolar smooth muscle, Increase in minute ventilation 50% greater than non pregnant
4.3. Prolactin
4.3.1. due to maternal pituitary gland enlargement by 50%
4.3.2. change in structure of mammary gland from ductal to lobular alveolar
4.4. Relaxin from placenta and ovary
4.5. Adrenal ' cotisol, aldosteron'
4.6. PLACENTA 7-9week
4.6.1. Estrogen: associated with fetal wellbeing
4.6.2. Progesteron
4.6.3. Relaxin: lax joints and ligaments
4.6.4. hCG
4.6.5. hPL 'human placental lactogen
4.6.5.1. stimulates lipolysis and fatty acid metabolism
4.6.5.2. conserving blood glucose for fetus
4.6.5.3. decrease tissue sensitivity to insulin (gestational diabetes)
5. Cardiovascular
5.1. cardiac output by 50% first trimester , Heart rate by 15% due to decrease vagal tone and increase sympathetic , Blood pressure slowly increases 40-50% due to increase aldosteron
5.2. progesteron
5.2.1. smooth muscle relaxation+overall vasodilatation= decrease resistance
5.2.2. Blood pressure between12-26 week
5.2.3. Blood pressure prepregnancy 36 week (if blood pressure becomes abnormally high indicates preclampsia and other causes of hypertension
5.3. Inferior vena cava syndrome: profound supine hypotension 3-11%
5.4. Edema lower limb at last trimester
5.4.1. due to increase adrenal hormones and increase capillary permeability
5.4.2. enlarged uterus compresses veins and lymphatic drainage from legs