Maternal Adaptation During Pregnancy

1
Maternal Adaptation During Pregnancy

• Chapter 11

2
Signs of Pregnancy

• Presumptive/Subjective- statement
• N/V, amenorrhea, fatigue, quickening
• Probable/Objective-observable
• Goodells, Chadwicks, fundal height
• Diagnostic/Positive
• Heart beat, gestational sac

3
Physical Changes

• Reproductive changes
• Uterus, cervix
• Ovarian, vaginal
• Breast tissue
• GI-N/V, delay in GI emptying due to progesterone
• Constipation and hemorrhoids

4
Physical Changes

• GI-N/V, delay in GI emptying due to progesterone
• Cardiovascular
• Pulse and BP
• Vena Cava syndrome
• Hemodilution and anemia
• Hypercoagulation
• Respiratory- increase volume, pressure on
  diaphragm
• Urinary- frequency, GFR increase, glycosuria

5
Physical Changes

• Musculoskeletal
• Teeth
• Posture
• Diastasis recti
• Skin
• Color
• Striae
• Alteration in hair growth

6
Metabolism

• Weight gain
• Water retention
• Nutrient demands increase
• Delay in gastric emptying

7
Endocrine and Hormonal

• Thyroid enlarges during pregnancy
• Posterior pituitary- Oxytocin contractions and
  milk ejection
• Vasopressin- regulates water balance
• Pancreas- may be stressed during
  pregnancy.Predisposition may lead to DM
• Adrenal produce more cortisol

8
Endocrine

• Hormones produced by placenta
• hCG- basis for early pregnancy test
• hPL- antagonist of insulin
• Progesterone- maintains pregnancy
• Estrogen-enlarges organs of female reproductive
  system
• Immune-decrease resistance to infection,decrease
  in IgG (to fetus)

9
Psychological Responses

• Maternal response
• First tri- ambivalence, disbelief, fear
• Second tri- excited, tells others, fear
  abandonment, body image
• Third tri- tired, fears delivery

10
Psychological Responses

• Spouse
• First tri- Only one to know
• Second tri- May be turned off by changes
• Fetal movement reality
• Third tri-Couvade, observance of rituals,
  development of s/s of pregnancy

11
Cultural Responses

• Wellness vs. Illness
• Food/Water
• Hot vs. Cold
• Herbs
• Healers
• Incorporate culture into care