Maternal Physical Changes
A. Menses ceases
B. Braxton-Hicks contractions
C. Breast changes: areola and nipples darken, colostrum is produced
D. Blood volume, stroke volume and cardiac output increases to meet demand of enlarging uterus and fetal oxygenation
E. Enlargement of uterus causes urinary frequency
F. As pregnancy progresses, body retains more water, resulting in dependent edema
G. Melasma- brownish “mask of pregnancy” (formerly called chloasma)
H. Linea nigra- darkened vertical line on mid abdomen
I. Striae- gravidarum- stretch marks on abdomen, upper arms and legs
J. Center of gravity shifts, so gait and posture change and low back pain may occur; posture described as lordosis
K. Ovarian hormone relaxin causes connective tissue of joints to relax, so risk of falls increases.
L. Potential for nausea and vomiting is greatest in first trimester from increased levels of HCG
M. Digestive system is cramped, decreased peristalsis from increased progestin levels
N. Pressure of uterus on the diaphragm may lead to dyspnea especially in third trimester
High Risk Pregnancy Characteristics
A. Age under 17 or over 35
B. Grand multiparity
C. Hereditary conditions
D. Chronic health problems
E. Complications in past pregnancies
F. Nutritional alterations
G. Substance abuse
H. Domestic violence
I. Poverty
J. Disability
K. Infection
L. Exposure to potential teratogens
M. Autoimmune diseases such as Lupus or Multiple Sclerosis
