Maternal Physiology Chapter 05 Williams Obstetrics 23 rd Edition - - PowerPoint PPT Presentation

Maternal Physiology

Chapter 05 –Williams Obstetrics 23rd Edition

• dr. Tizar Dwi Satyoputro
• ZIO

Physical adaptations during pregnancy

Anatomical and functional changes

• Metabolic Changes
• Hematological Changes
• Breast Changes
• Reproductive Tract
• Respiratory Tract
• Gastrointestinal Tract
• Cardiovascular System
• Urinary System
• Endocrine System

Reproductive Tract

Weight: 70 g (before pregnancy) – 1100 g (during pregnancy) Volume: 5 L to 20 L or more (before pregnancy) Capacity: 500 to 1000 times greater (end of pregnancy) Shape: pear (beginning)  spherical (12w)  ovoid Uterine contractions: intensity  5 and 25 mm Hg; frequency  10 to 20 minutes (near term) Uteroplacental Blood Flow: 450 to 650 mL/min near term  regulation: estradiol and progesteron administration to modify vascular resistance Shape: pronounced softening and cyanosis (1m after conception)  Increased vascularity and edema, hypertrophy and hyperplasia of the cervical glands Containment: >50% of cervical mass cervical glands (end

• f pregnancy)

Cervical mucus: soon after conception, acts as immunological barrier Progesterone production: a single corpus in pregnant women (max. 6w to 7w of pregnancy – 4w to 5w postovulation) Diameter of ovarian vascular: 0.9 cm to 2.6 cm (at term) Appearance: Violet color characteristic of Chadwick sign. Wall: increase in mucosal thickness, loosening of the connective tissue, and hypertrophy of smooth muscle cells pH: 3 to 6 (acidic) Musculature of the fallopian tubes: a little hypertrophy (during pregnancy) Fallopian tube torsion: increasing size of the gravid uterus

Uterine enlargement

• Involves stretching and marked

hypertrophy of muscle cells, whereas the production of new myocytes is limited

• Effects:

– increase of muscle cell size – accumulation of fibrous tissue (particularly in the external muscle layer) – increase in elastic tissue

Uterine Musculature

• An outer hoodlike layer

which arches over the fundus and extends into the various ligaments.

• A middle layer

composed of a dense network of muscle fibers perforated in all directions by blood vessels.

• An internal layer

with sphincter-like fibers around the fallopian tube orifices and internal os of the cervix.

Conclusion

• dr. Tizar Dwi Satyoputro