Anatomical, Physiological, and Metabolic Changes during Pregnancy - Literature review Example

Pregnancy Name Id Course Instructor’s name Institution Affiliation Location Date Pregnancy Reproduction is the biological process through which new individuals or offspring are brought into existence (Ferraretti et al. 2011. Reproduction takes place in two forms which include sexual and asexual depending on the genetic combination of the parents. In asexual reproduction, the offspring are created through simple cell duplication of the organism while in sexual reproduction there is the joining of male and female sex cells to form a new organism (Böhm et al. 2013). Pregnancy is the period during which an offspring develop within a woman (Liao et al. 2012). According to Böhm et al (2013) reproduction is important for human beings due to the following reasons; first it helps in the creation of the new generation through transfer of the unique genes. Secondly, it helps in the creation of variation in the species as two individuals involved have different species. Lastly, it helps in the evolution of the organism making it an important factor for survival ((Blackburn, 2014). Stages of pregnancy A normal pregnancy undergoes through three basic stages known as the trimesters. During these stages several changes occur in mother as well as in the foetus as discussed. According to Liao et al (2012) during the first trimester, the embryo implants itself into the uterine walls with the formation of other organs such as; amniotic sac to protect the foetus from injuries, placenta aiding in the exchange of nutrients and waste. And lastly the formation of the umbilical cord which connects the foetus to the placenta as well as help in the nutrient and waste transport. On the mother, the mammary glands enlarge causing the swelling of the breasts. The areolas enlarge and darken and at sometimes covered with Montgomery’s tubercles. The uterus grows and starts to press on the bladder causing frequent urination and lastly due to the surge in hormones, the mother may experience mood swings (Liao et al. 2012). In the second trimester the following changes occur. On the foetus, the placenta and other organs have fully developed. The foetus is in position to respond to certain stimuli, and it is able to make movements. The brain of the foetus undergoes important growth with its skin wrinkling and being red (Liao et al. 2012). The hair begins to grow on the foetus with the fat accumulating in it. The foetus becomes more than halve fully grown at the end of this stage with rapid growth in weight and size. On the maternal side, the appetite increase with the need to urinate often decreasing since the uterus grows out of the pelvic cavity relieving the pressure on the bladder. The uterus grows to meet the height of the bellybutton making the pregnancy visible and as it grows, the mother feels the itching on the belly due to uterus stretches (Hershkovitz et al. 2011). From Hershkovitz et al (2011) argument, in the third trimester, the following maternal changes occur; the ankles, hands, and face may swell due to the continued retention of the fluid by the body. Blood pressure decreases since the foetus presses on the main vein that returns blood to the heart. The skin temperature increases since the foetus radiates body heat. In the stage the mother feels the Braxton-hicks with the stretch marks developing on the stomach, breast, thighs, and buttocks. The mothers libido may decrease and the skin persisting to be dry, itching on the stomach area. On the foetus side, it starts to see and hear with the brain not fully developed. The kidneys and the lungs of the foetus continue to mature with the skull remaining soft for the purpose of passing through the birth canal. The baby at this stage is covered in vernix caseosa for protection of the body and at towards the end of this stage, the head turn downwards with the full developed brain (Hershkovitz et al. 2011). Reproductive changes during pregnancy According to Workman et al (2012) the following changes occur in the reproductive parts during pregnancy. First in the uterus, the uterus increase in size equivalent to five times its normal size at the term of pregnancy to accommodate the body and the fluids that are important for the baby development. Secondly, the cervix undergoes softening known as the Goodell’s sign to ease the movement and passage of the baby during birth reducing pain during delivery. Operculum; a mucus plug is formed in the cervical canal due to the enlargement of the active mucus glands of the cervix and the mucus serve to protect the foetus and its membranes from the infections. Thirdly in the vagina, there is increased circulation of the hue which changes its color from normal light pink to purple. Fourthly in the ovaries, the follicle stimulating hormones (FSH) stops its activities due to the increased production of the estrogen and progesterone which stops ovulation and menstruation which relieve the woman of possible miscarriage. The corpus luteum enlarges and at times forms a cyst on the ovary as well as producing progesterone which help in maintaining the lining of the endometrium in early pregnancy protecting the woman. Musculoskeletal changes during pregnancy From the arguments of Lerchbaum et al (2013) the following musculoskeletal changes occur in the body: first there is the body weight gain which ensures that there is balance in the stress placed across the joints of the mother to help bear the pregnancy. Secondly, there are the postural changes which are as a result of the increase in the body weight. The abdominal distention causes the pelvis to tip forward causing weakness in the abdominal due to muscles stretch. The center of gravity for the woman is changed to compensate for the adjustments on the lumber lordosis which helps the woman to effectively balance the entire weight and distribute it equally. The upper neck and the back also changes in curvature to allow for balance maintenance which reduces the chances of back pain and chances of falling for the woman. Thirdly the muscular imbalances take place and their compensation takes through muscle group reaction to keep the body upright. The balance for the woman is maintained by the muscles which work harder shortening and becoming very tight while the opposing muscles, which works less becoming weaker and loose to maintain balance. Lastly, the change results to the laxity of the ligaments due to the increase in the level of hormones relaxing and estrogen needed during pregnancy and childbirth. The muscles relaxation helps the woman during birth as it allows space for the baby development as well as for the passage during delivery. Image showing the musculoskeletal changes during pregnancy retrieved from (Lerchbaum et al. 2013) Changes in the gastrointestinal system during pregnancy As the pregnancy grows, the uterus causes gradual displacement of stomach and intestines. The push causes the stomach to attain a vertical position which changes the normal flow of the food. The mechanism ensures that there is increase in the intragastric pressure and change in the angle of gastroesophageal junction which result to greater esophageal reflux. The ribcage is also pushed upwards and o the diaphragm which causes the woman to breathe faster or even feel short of breathing. Also the pulmonary aspiration occurs due to active vomiting which causes atelectasis or lungs abscesses. The peristalsis is slowed due to the production of the progesterone which slows the rate of secretion of hydrochloric acid and pepsin causing reduction in absorption of nutrients whose symptoms are nausea and heartburn. The movement of water within the large intestine is slowed due to large water consumption in the area resulting which is symbolized by constipation (Rautava et al. 2012). Impact of pregnancy on the cardiovascular system The blood volume of the pregnant woman increases progressively from 6 to 8 weeks with the maximum being reached at 32-34 weeks (Savu e al. 2012). At the time of increase, plasma volume becomes greater than the red cell mass which creates the hemodilution and decrease in hemoglobin concentration. The increase in the blood volume helps in facilitating maternal and fetal exchanges of respiratory gases, nutrients, and metabolites. It also helps reduce the impact of maternal blood loss at delivery. The uterus concentrates the blood which compensate for the blood loss during caesarean sections a process known as auto transfusion. The blood constitute changes with red blood cells being at about 20-30% which is maintained at the upper limit with the increase in the number of the platelets below the upper limit to help prevent excessive bleeding at delivery (Savu et al. 2011). The cardiac output of the pregnant woman increases up to 30% above the normal rate during the first trimester period (Blackburn, 2014). The output of cardiac increases further during labor pain to respond to the increase in catecholamine secretion. The output ensures there is increased intravascular volume to the range of 300-500ml of blood from the contracting uterus to the venous system to help in autotransfusion. The blood pressure of the pregnant mother is slightly decreased and the pulmonary arterial pressure adjusts to maintain the normal pressure. The central venous and brachial venous pressure remains unchanged to maintain the normal pressure (Hegewald and Crapo, 2011). The heart is also enlarged by both chamber dilation and hypertrophy making its size to be bigger to accommodate the role of pumping more blood to the entire body of the mother. The heart is also shifted to the left and anteriorly through the upward displacement of the diaphragm by the enlarging uterus making it strategically placed for pumping. The mother’s aortocava compresses with the enlargement of the uterus as it compresses both the inferior vena cava and the lower aorta which ensures that there is no obstruction of the inferior vena cava (Hegewald and Crapo, 2011). Impact of pregnancy on respiratory system The nose swells in its lining, also the lining of the oropharynx, larynx, and trachea swell to the hormonal change in the mucosal vasculature of the respiratory tract creating discomfort in breathing (Hegewald and Crapo, 2011). The air movement resistance within the body is reduced through the progesterone-mediated relaxation of the bronchial musculature. The mechanical adaptation of the respiratory system involves the initiation of bleeding at the nose which ensures that space and balance is maintained in the nose for breathing. The increase in the foetus demand for oxygen triggers hypertension and bleeding of the nose to reduce the congestion for free air entry. The oxygen consumption increase gradually in response to the needs of the growing foetus and in this case the woman tends to breath faster to compensate for the oxygen demand (Savu et al. 2011). The volume of the lungs decreases slightly due to the upwards push by the uterus to compensate for the increase in the diameter of the chest. The hormonal effects reduce the stiffness of the ligaments which enables the change in the volume to be accommodated. The shape formed by the lungs enables it to reserve more oxygen which is used in serving the entire body. The alkaline level of the respiratory system is increased due to the alteration in lung volumes which is compensated by the renal excretion of bicarbonate which reduces the absorption of oxygen which is compensated through massive intake through faster breathing (Abduljalil et al. 2012). Impact of pregnancy on renal system The structural adaptations and changes in the renal system include; due to the increase in the renal vascular and interstitial volume, the renal size increases to accommodate the demand during pregnancy realized mostly on both kidneys. Also the progesterone produced results to the mechanical compression of the ureters at the pelvic brim to increase the capability to hold the urine. The ureteral tone, peristalsis, and contraction of pressure are developed within the urethra to ensure mechanical compression of the ureters during the renal activity (Tan and Tan, 2013). Changes in the renal haemodynamics takes place within a pregnant woman to ensure balance is maintained in the woman. Due to the elevation in cardiac output and renal blood flow it ensures there is rise in the glomerular filtration rate (GFR) which ensures there is reduced creatinine concentration (Helal et al. 2012). The adaptation also ensures that there is reduced level of the blood urea nitrogen (BUN) for the safety of the pregnant woman. The excretion of the relaxin increase endothelin and nitric oxide production within the renal circulation which facilitates renal circulation and vasodilation. Towards fluid and electrolyte homeostasis of the renal system, there is the production of the hemodynamic stimulus for ADH and thirst development which causes the vasodilation. The levels of the metals irons in the body constantly rise to fit the level of pregnancy. The amount of protein in the body is increased as a result of reduction in the carbonates and alkalosis in the body (Hall, 2015). The figure below shows the different changes in the renal system during pregnancy obtained from Helal et al (2012) Summary The body of the mother during pregnancy undergoes significant anatomical and physical changes to nurture and accommodate the development of the foetus (Blackburn, 2014). Some of the changes that have been discussed above include; the progressive increase in the plasma volume with drop in the platelets just below the upper limit. The pregnancy increases the iron requirement in the body three times than the normal individual. The body develops the cardiac, renal, water body balance, respiration and other structural changes to suit and best serve the development of the foetus. References list Abduljalil, K., Furness, P., Johnson, T.N., Rostami-Hodjegan, A. and Soltani, H., 2012. Anatomical, physiological, and metabolic changes with gestational age during normal pregnancy. Clinical pharmacokinetics, 51(6), pp.365-396. Blackburn, S., 2014. Maternal, fetal, & neonatal physiology. Elsevier Health Sciences. Böhm, J., Hoff, B., O’Gorman, C.M., Wolfers, S., Klix, V., Binger, D., Zadra, I., Kürnsteiner, H., Pöggeler, S., Dyer, P.S. and Kück, U., 2013. 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