Maternal Physiology Chapter 05 – Williams Obstetrics 23 rd Edition dr. Tizar Dwi Satyoputro -ZIO
Physical adaptations during pregnancy
Anatomical and functional changes • Metabolic Changes • Hematological Changes • Breast Changes • Reproductive Tract • Respiratory Tract • Gastrointestinal Tract • Cardiovascular System • Urinary System • Endocrine System
Weight : 70 g ( before pregnancy ) – 1100 g ( during pregnancy ) Volume : 5 L to 20 L or more (before pregnancy) Capacity : 500 to 1000 times greater (end of pregnancy) Reproductive Tract Shape : pear ( beginning ) spherical ( 12w ) ovoid Uterine contractions : intensity 5 and 25 mm Hg; frequency 10 to 20 minutes (near term) Appearance : Violet Uteroplacental Blood Flow : 450 to 650 mL/min near term color characteristic of regulation: estradiol and progesteron administration to Chadwick sign. modify vascular resistance Wall : increase in mucosal thickness , loosening of the Shape : pronounced softening and cyanosis (1m after connective tissue , conception ) Increased vascularity and edema , and hypertrophy of hypertrophy and hyperplasia of the cervical glands smooth muscle cells Containment : >50% of cervical mass cervical glands ( end pH : 3 to 6 ( acidic ) of pregnancy ) Cervical mucus : soon after conception, acts as immunological barrier Progesterone production : a single corpus in pregnant women (max. 6w to 7w of pregnancy – 4w to 5w postovulation) Musculature of the fallopian Diameter of ovarian vascular : 0.9 cm to 2.6 cm ( at term ) tubes : a little hypertrophy (during pregnancy) Fallopian tube torsion : increasing size of the gravid uterus
Uterine enlargement • Involves stretching and marked hypertrophy of muscle cells, whereas the production of new myocytes is limited • Effects: – increase of muscle cell size – accumulation of fibrous tissue (particularly in the external muscle layer) – increase in elastic tissue
Uterine Musculature • An outer hoodlike layer which arches over the fundus and extends into the various ligaments. • A middle layer composed of a dense network of muscle fibers perforated in all directions by blood vessels. • An internal layer with sphincter-like fibers around the fallopian tube orifices and internal os of the cervix.
Conclusion
dr. Tizar Dwi Satyoputro
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