| CVS | • ↑ Blood volume (plasma volume > RBC mass) • ↓ Systemic vascular resistance • ↑ Heart rate & cardiac output • ↓ Blood pressure •Physical exam→ Systolic murmur, S3, ankle edema and Dyspnea | | --- | --- | | Pulmonary | • ↑ Central respiratory drive (hyperventilation) • ↓ PaCO2 (respiratory alkalosis), ↑ PaO2 ◦ ↑ Tidal volume ◦ ↓ Functional residual capacity(elevation of diaphragm) | | Renal | • ↑ Renal blood flow & urine output • ↑ GFR, ↓ BUN & serum creatinine • ↑ HCO3− excretion (metabolic compensation) • ↓ Serum Na+ concentration (↑ ADH secretion) | | Hematologic | • ↑ Prothrombotic coagulation factors • ↓ Hemoglobin concentration (dilutional anemia) |
<aside> 💡 The increased cardiac output is accomplished by increased stroke volume in early pregnancy and by increased heart rate in late pregnancy.
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<aside> 💡 Nocturnal leg cramps are also common, likely due to a buildup of lactic and pyruvic acid secondary to increased metabolic demand, leading to involuntary muscular contractions.
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<aside> 💡 Mild tachycardia is normal in third trimester
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Physiologic hydronephrosis of pregnancy
Low back pain during pregnancy
Pregnancy, delivery, and the postpartum period place increased physical and metabolic demands on women in order to develop and provide nutrition for the fetus and newborn. During pregnancy, maternal folate and iron are depleted for fetal development, and the resulting maternal anemia is exacerbated by normal blood loss during delivery (eg, up to 10%-20% of blood volume). In breastfeeding women, continued nutritional demands from the newborn prevent repletion of normal folate and iron stores, resulting in prolonged anemia .