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1.BREAST
1. Increase size of the breast
- This is due to increase level of oestrogen and
progesterone, which stimulate the growth of
milk ducts, and the expansion of fat tissue in
the breast. The lactiferous ducts and alveoli
develop and grow under the stimulation of
oestrogen and progesterone and prolactin.
2. Vascularity increases, some women may
experience tenderness and sensitivity.
3. the nipples become larger, erectile and deeply
pigmented.
4. Montgomery’s Tubercles
- small bumps on the areolar that contain glans
that secrete oily substances to keep the nipple
lubricated and protected, during pregnancy,
Montgomery’s tubercles may become more
1. prominent.
Chloasma (aka pregnancy mask)
- ⁃ From
Skin3-4 monthscharactered
condition of pregnancy, by colostrum
the
(thick, glossy, protein
development of brownrichorfluid
greythat is the first
milk produced
patches by face.
on the the mammary gland,
Colostrum is rich in nutrients and AB’s and
provide essential nutrition to the new-born) can
be expressed from the breasts, prolactin
stimulates the cells of alveoli to secrete milk.
Usually, the effect is blocked by the action of
progesterone and oestrogen however after
delivery the level of these hormones decrease 2.SKIN CHANGES
enabling prolactin to cause lactation to begin.
⁃ Suckling further stimulate oxytocin and
prolactin production, oxytocin causes
contraction of myoepithelial cells to cause
1. striae gravidarium (aka stretch marks)
⁃ found in
2A) Spider abdominal Anomalous
Angioma= wall below thedilation
umbilicus, of
more to do with genetics, some women can have
BV’s found beneath skin, if you put your finger
twins and not get stretch marks, and some can
on it, it would blanch,
get them in first trimester when foetus is small, a
womanErythema=
2B) palmer who has stretch marks has
Increase lessfingers to
BF to
stretchable collagen and has a higher
get rid of the heat, produced by the foetus, risk of which
lacerations in childbirth.
is transferred throughout the mother
2C) CHADWICK SIGN
- Bluish discolouration of the vagina and cervix
⁃ Caused by increase vascularity, which is due to
progesterone causing SM to relax, causing
vasodilation.
, 3.CARDIOVASCULAR CHANGES
3A. BLOOD PRSSURE
- Peripheral resistance decreases by 50%
(probably due to increase production of
vasodilator prostaglandin). This causes
relaxation of BV’s Causes a decrease in
Arterial BP, which causes increase HR
and SV, which causes increase CO. These
changes enhance uterine BF.
- BP (most noticeably diastolic) decreases
mid pregnancy by 10-20mmHg and
increases to non-pregnant level by term.
- Aortic compression may occur, causing
difference between brachial and femoral,
giving a pressure difference giving a
pressure difference of 10-15% from
supine to lateral position.
- femoral venous pressure increases and
can lead to VARICOSE VEINS and
haemorrhoids,
- Plasma volume increases by 50%
(normal 5L but can increase to 7.5L)
⁃ Should hear a systolic ejection murmur,
diastolic
2 murmur never normal in
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