Dr Richa Sharma , Dr Amit Basnotra
Pregnancy comes as a great news in a family adding on to the bonding of the couple. A pregnant lady need to take care of not only herself but of the growing babies she is carrying, for that she need to be aware as what all changes can happen in her body so as to avoid undue scare and anxiety more so in IVF conceptions with multiple pregnancies in first time mothers (Primigravida).
All she need besides the medical management is TLC (Tender Love Care) from her family especially the husband whom she has the maximum faith and she should religiously follow all instructions given by her physician in good faith. Via this article we are trying to making all those prospective and present pregnant ladies aware.
Maternal physiological changes in pregnancy are the normal adaptations that a woman undergoes during pregnancy to better accommodate the embryo or fetus. They are physiological changes, that is, they are entirely normal, and include changes in almost all organ to ensure the fetus is provided for. Increases in blood sugar, breathing and cardiac output are all required. Levels of hormones supporting pregnancy such as progesterone and estrogens rise continually throughout pregnancy suppressing the system at brain level to stop menstruation leading to amenorrhoea.
Physiological Body Adaption
Various changes happening are as under in various subsections.
Hormonal Changes-
Women experience increased levels of-
* human chorionic gonadotropin (?-hCG)
* Progestrone
* Estrogen
* Prolactin
* Most are produced by the placenta later on taking over function of a structure supporting early pregnancy called corpus luteum
* Parathyroid hormone Adrenal hormones such as cortisol and aldosterone also increase.
* Human placental lactogen (hPL)
Body weight
One of the most noticeable alterations in pregnancy is the gain in weight due to-
* Enlarged womb
* Growing baby
* Placenta
* Water bag around the baby (liquor amnii)
* Fat and water retention
Variation of weight gai-The weight gain varies from person to person and can be anywhere from 2.3 kg to 11kg.
Breast size
A woman’s breasts grow during pregnancy Once the baby is born and about 50 to 73 hours after birth, the mother will experience her breasts filling with milk . Once lactation begins, the woman’s breasts swell significantly and can feel achy, lumpy and heavy (which is referred to as engorgement). . A regular pattern of nursing is usually established after 8-12 weeks, and a woman’s breasts will usually reduce in size It has been observed that mothers of female infants have greater changes in breast size than mothers of male infants.
Cardiovascular
During the course of pregnancy, blood volume slowly increases by 40-50 increase in heart rate (15 beats/min more than usual), stroke volume, and cardiac output. Cardiac output increases by about 50%, mostly during the first trimester.
During pregnancy the plasma volume increases by 50% and the red blood cell volume increases only by 20-30%.
Blood counts also increase which may be falsely interpreted as sign of infection
A pregnant woman will also become hypercoagulable, leading to increased risk for developing blood clots and embolisms,
Edema, or swelling, of the feet is common during pregnancy, partly because the enlarging uterus compresses veins and lymphatic drainage from the legs.
Respiratory
There is increase in respiration rate also due to affect of hormones like progesterone.
Vitamins and Micronutrients=
All patients are advised to take prenatal vitamins to compensate for the increased nutritional requirements. The use of Omega 3 fatty acids supports mental and visual development of infants.
Kidney Changes
A pregnant woman may experience an increase in kidney and ureter size. The glomerular filtration rate (GFR) commonly increases by 50%, returning to normal around 20 weeks postpartum.Plasma sodium does not change because this is offset by the increase in GFR. There is decreased blood urea nitrogen (BUN) and creatinine and glucosuria (due to saturated tubular reabsorption) may be seen. Persistent glucosuria may suggest gestational diabetes.
Gut Changes and other gastric problems
During pregnancy, woman can experience nausea and vomiting (morning sickness); which may be due to elevated B-hCG and should resolve by 14 to 16 weeks.Additionally, there is prolonged gastric empty time, decreased gastroesophageal sphincter tone, which can lead to acid reflux, and decreased colonic motility, which leads to increased water absorption and constipation.

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