Pregnancy Module 5: Maternal Changes

Maternal Changes During Pregnancy

• Dietary Recommendations

  • High-fiber foods (whole grains, fruits, vegetables) alleviate constipation.
  • Regular exercise, like daily 20-minute walks, supports overall health.
  • Stool softeners and laxatives may be prescribed as needed.

• Hemorrhoids

  • Common during the second and third trimesters due to increased venous pressure and constipation.
  • Interventions include warm sitz baths, soft pillows, high fiber diets, adequate hydration, and prescribed ointments.

• Oral Changes

  • Gum tissue can swell and bleed due to elevated estrogen levels.
  • Maintain oral hygiene with soft-bristled toothbrushes.
  • Ptyalism (excessive saliva) may occur; sugarless candy can help.

Renal System Changes

• Urinary Frequency

  • Increased urination frequency during first and third trimesters due to uterine pressure on the bladder.
  • Recommendations include drinking at least 2,000 mL during the day, limiting evening fluid intake, regular voiding, side-lying sleep, using perineal pads, and Kegel exercises.

• Bladder Changes

  • Decreased bladder tone from rising progesterone and estrogen.
  • Bladder capacity may increase due to higher progesterone levels.

Endocrine System Changes

• Hormonal Changes
  • Placenta acts as an endocrine gland, secreting hormones inclusive of hCG, hPL, estrogen, and progesterone.
  • Basal metabolic rate rises; fatigue is common in the first and third trimesters.
  • Interventions include frequent rest, correct posture, and regular exercise.

Cardiovascular Changes

• Pulse and Blood Pressure

  • Pulse rate increases by 10-15 beats per minute to meet fetal demands; blood pressure usually decreases in the second trimester, then rises in the third.
  • Supine hypotensive syndrome can occur if laying flat; avoid the supine position.

• Blood Volume Changes

  • Total blood volume can increase by 40-50%, affecting plasma levels and leading to physiological anemia from hemodilution.

• Nutrition

  • Increase iron intake to 30 mg/day; iron-rich foods and supplements are advised for better absorption.

Respiratory System Changes

• Respiration Adjustments
  • Slight increase in respiratory rate and oxygen consumption (15-20%) to accommodate both mother and fetus.
  • Shortness of breath may arise in the second and third trimesters; relaxation and strengthening exercises are recommended.

Reproductive System Changes

• Uterine Enlargement

  • Uterus grows from 60 to 1000 g due to hyperplasia and hypertrophy.
  • Braxton Hicks contractions may begin around 16 weeks; Hegar’s sign indicates the softening of the lower uterine segment.

• Cervical Changes

  • Cervix softens (Goodell sign) around six weeks and may show increased friability with color and consistency changes, creating a mucus plug (Operculum).

• Ovarian Function

  • The corpus luteum secretes progesterone early in pregnancy due to human chorionic gonadotropin (hCG) secretion.

• Vaginal Changes

  • Increased vaginal secretions contribute to a more acidic pH throughout pregnancy.

This quiz covers key concepts regarding maternal changes during pregnancy, specifically focusing on managing hemorrhoids and constipation. Learn about dietary recommendations, the importance of exercise, and effective interventions such as warm sitz baths and medications. Test your knowledge on best practices for maternal health in the second and third trimesters.