MATERNITY WEEK 2

The normal pregnancy cycle consists of various physiological changes that occur in the body during pregnancy.

Size Increase:
- Caused by hypertrophy of myometrial cells due to estrogen stimulation and growth of the fetus.
- Uterine contractions known as Braxton Hicks begin after the 4th month, assisting in accommodating the growing fetus.
- Hagar's Sign: Softening of the lower uterine segments.
Cervical Changes:
- Cervix softens (Goodell's Sign) due to increased vascularity, hypertrophy, and hyperplasia of cervical glands.
- Formation of mucus plug prevents bacterial contamination from the vagina.

Vaginal Secretions:
- Increased secretions are observed, characterized by a blue-purple hue of the vaginal walls by the 8th week (Chadwick's Sign).
- The pH of the vaginal secretions is acidic (3.5 to 6.0) and thick, white in color.
Symptoms to Monitor:
- Changes in vaginal discharge, vaginal itching or burning, leaking of amniotic fluid, spotting, or bleeding.

Breasts increase in size, with feelings of wellness, tingling, and heaviness.
- Superficial veins become prominent, nipples erect, and aareola darkens and increases in diameter.

Blood Volume Increase:
- Blood volume increases progressively, peaking at 40%-50% greater than pre-pregnant levels.
- Cardiac hypertrophy and slight systolic murmurs may occur.
- Heart rate increases by 10 to 15 beats/minute by the end of the first trimester.
Physiological Changes:
- Heart rate variability decreases, indicating higher physiological stress.
- Cardiac output increases by 40% by late 2nd trimester.
- Increase in red blood cell (RBC) count, with plasma volume increase leading to hemodilution (physiological anemia of pregnancy).
Hematocrit:
- Decreases by 4% to 7%; white blood cells may increase to 30,000/mm³ (X 10⁹/L) during labor and after delivery.

Increased depth of breathing with no change in respiratory rate; oxygen consumption increased by 20-40%.
- Diaphragm elevation leads to a transition from abdominal to thoracic breathing after week 24.
- Common complaints include nasal stuffiness and epistaxis due to estrogen effects.
Lung Capacity Changes:
- Total lung capacity, tidal volume, and other respiratory metrics are affected by physiological changes.
- Elevated diaphragm and increased respiratory drive lead to reduced arterial carbon dioxide pressure (PaCO₂).

Kidney Dilatation:
- Ureters and renal pelvis dilate due to the growing uterus, particularly on the right side.
- Increased urinary frequency in the first and last trimesters.
Risk of UTIs:
- Urinary stasis and decreased bladder tone due to progesterone will increase the risk of urinary tract infections (UTIs).

Gastrointestinal Symptoms:
- Symptoms such as gestational gingivitis, nausea, and vomiting are common due to elevated human chorionic gonadotropin (hCG) levels in the first trimester.
Digestive Changes:
- Decreased smooth muscle tone leading to slower digestive processes leads to complaints like heartburn (pyrosis) and constipation.
Gallbladder Changes:
- Increased emptying time and slight hypercholesterolemia may lead to gallstone development during pregnancy.

Increased lumbosacral curvature leads to changes in center of gravity, which can cause leg and back strain, increasing fall risk.
Relaxation of the pelvis due to the hormone relaxin contributes to a characteristic waddle gait.

Blood Volume Increase:
- Blood volume increases by 30% to 50% to support fetal growth.
Cardiac Output:
- Heart rate increases, cardiac output rises due to remodeling of heart and vasculature.

Weight gain is calculated based on BMI with recommendations for general weight gain during pregnancy ranging from 11.5 to 16 kg (25 to 35 lbs) depending on the pre-pregnancy weight status.

Passage:
- Refers to the pelvic passage the fetus must navigate for vaginal delivery.
Passenger:
- Refers to the fetus and the placenta.
Powers:
- Encompasses the uterine contractions and mother’s ability to push.
Position