Pregnancy induces systemic changes in almost all organ systems to support fetal growth and prepare the body for labor and delivery.
Reproductive System Changes
1. Uterus
- Size Increase:
- Non-pregnant uterus weighs 50–60 g and has a capacity of 10 mL.
- At term, uterus weighs 900–1000 g and has a capacity of 5–10 liters.
- Shape Change:
- Non-pregnant: Pear-shaped
- Pregnancy: Globular at 12 weeks, Spherical at 36 weeks
- Position:
- Normally anteverted and anteflexed.
- Pregnancy exaggerates anteversion; by 12 weeks, uterus rises out of the pelvis.
- Blood Supply:
- Uterine blood flow increases from 50 mL/min to 750 mL/min at term.
2. Cervix
- Softening (Goodell’s Sign) due to increased vascularity.
- Bluish discoloration (Chadwick’s Sign) from venous congestion.
- Increased glandular secretions leading to formation of the mucous plug.
3. Vagina & Vulva
- Increased vascularity → Bluish discoloration (Jacquemier’s Sign).
- Increased secretions (Leukorrhea of Pregnancy) → Acidic pH (3.5–6) to prevent infections.
4. Ovaries
- Corpus luteum remains functional for the first 8 weeks, producing progesterone until placental takeover.
5. Breasts
- Increase in size & vascularity.
- Montgomery’s tubercles (sebaceous glands) become prominent.
- Colostrum (yellowish secretion) is produced by the 16th week.
Cardiovascular System Changes
- Cardiac Output Increases by 30–50%.
- Heart Rate Increases by 10–15 bpm.
- Blood Pressure:
- Systolic & Diastolic BP Decrease in 2nd trimester but returns to normal by term.
- Supine position may cause Supine Hypotension Syndrome due to aortocaval compression.
- Venous Pressure Increases → Leads to varicose veins, edema, hemorrhoids.
- Physiological Anemia of Pregnancy:
- Plasma Volume Increases by 40–50%.
- Red Blood Cells Increase by 20–30%.
- Hemoglobin Dilution Effect → Hb drops to ~11 g/dL.
Respiratory System Changes
- Tidal Volume Increases by 40% (Hyperventilation).
- Respiratory Rate Slightly Increases.
- Diaphragm is Elevated by 4 cm due to uterine growth.
- Oxygen Consumption Increases by 20%.
Gastrointestinal System Changes
- Nausea & Vomiting (Morning Sickness) due to hCG (Peaks at 12 weeks).
- Delayed Gastric Emptying & Decreased Motility → Leads to Constipation & Acid Reflux.
- Ptyalism (Excessive Salivation) common in early pregnancy.
Renal System Changes
- Glomerular Filtration Rate (GFR) Increases by 40–50%.
- Increased Urinary Frequency due to:
- Early pregnancy: Uterine pressure on the bladder.
- Late pregnancy: Fetal head engagement.
Metabolic Changes
- Basal Metabolic Rate (BMR) Increases by 15–20%.
- Carbohydrate Metabolism Changes:
- Increased insulin resistance due to human placental lactogen (hPL).
- Risk of Gestational Diabetes Mellitus (GDM).
- Fat Metabolism:
- Increased lipogenesis in early pregnancy.
- Increased lipolysis in late pregnancy for fetal energy.
Hematological Changes
- Increased Clotting Factors → Hypercoagulable State (Risk of DVT & Pulmonary Embolism).
- Leukocytosis: WBC count increases to 12,000–15,000 cells/mm³.
- Platelet Count May Decrease Slightly but remains within normal range.
Endocrine System Changes
- hCG: Produced by the placenta, peaks at 10–12 weeks, maintains corpus luteum.
- Progesterone: Relaxes smooth muscles (prevents contractions).
- Estrogen: Increases uterine growth, breast development, and vascularity.
- hPL: Causes insulin resistance, ensuring glucose supply to the fetus.
- Relaxin: Relaxes ligaments, softens the cervix.
Musculoskeletal Changes
- Lumbar Lordosis → Lower back pain due to weight shift.
- Relaxation of Pelvic Ligaments → Causes waddling gait.
Skin Changes
- Hyperpigmentation:
- Chloasma (Mask of Pregnancy) – Dark patches on the face.
- Linea Nigra – Dark vertical line from pubis to umbilicus.
- Striae Gravidarum (Stretch Marks) – Reddish lines on the abdomen.
- Increased Sweat & Sebaceous Gland Activity.
Weight Gain in Pregnancy
- Total Weight Gain: 11–15 kg (25–35 lbs).
- Distribution:
- Fetus – 3.0–3.5 kg
- Placenta – 0.5–0.7 kg
- Amniotic Fluid – 0.8 kg
- Breasts & Uterus – 2.0 kg
- Maternal Fat & Fluid Retention – 4.0 kg
Summary of Physiological Changes
|
System |
Key Changes |
|
Cardiovascular |
↑ Cardiac output, ↑ HR, ↓ BP (2nd trimester) |
|
Respiratory |
↑ Tidal volume, Hyperventilation |
|
Hematological |
↑ Blood volume, Anemia of pregnancy, Hypercoagulable
state |
|
Renal |
↑ GFR, ↑ Urinary frequency |
|
Gastrointestinal |
Delayed gastric emptying, Constipation, Nausea &
Vomiting |
|
Endocrine |
↑ hCG, Progesterone, Estrogen, hPL |
|
Musculoskeletal |
Lumbar Lordosis, Pelvic Ligament Relaxation |
|
Skin |
Hyperpigmentation, Stretch Marks |
|
Weight Gain |
11–15 kg average |
1. Sepia Officinalis
- Morning sickness, especially from the smell of food.
- A dragging sensation in the abdomen, as if everything will fall out.
- Irritability, indifference to family, weeping tendency.
- Aversion to sex during pregnancy.
- Craving for sour foods and pickles.
2. Pulsatilla Nigricans
- Emotional sensitivity, weeping easily, needing consolation.
- Nausea worsens in a warm room and improves in fresh air.
- Irregular, weak contractions during labor.
- Varicose veins, swollen feet, and slow circulation.
- Craving for creamy and rich foods but indigestion follows.
3. Nux Vomica
- Severe heartburn, nausea, and vomiting after eating.
- Constipation with ineffectual urging to pass stool.
- Intolerance to noise, light, and odors.
- Sleep disturbances, waking up frequently at night.
- Excessive sensitivity to cold air.
4. Bellis Perennis
- Deep aching pain in the uterus and pelvic region.
- Swelling and tenderness in the abdomen.
- Fatigue and bruised feeling after exertion.
- Useful for post-delivery healing and perineal soreness.
- Helps with varicose veins and swollen legs.
5. Kali Carb
- Severe lower back pain, especially at night.
- Swelling of feet and hands (Edema).
- Shortness of breath, worse when lying down.
- Intense weakness and exhaustion.
- Feels better when sitting with legs stretched out.
Key Takeaways
- Sepia: Best for nausea, mood swings, and exhaustion.
- Pulsatilla: Ideal for emotional sensitivity and sluggish labor.
- Nux Vomica: Used for acidity, constipation, and irritability.
- Bellis Perennis: Helps in pelvic pain, swelling, and recovery.
- Kali Carb: Useful for back pain, swelling, and breathlessness.