Changes in Pregnancy

Changes in Pregnancy

1. METABOLIC AND SYSTEMIC CHANGES IN PREGNANCY

2. METABOLIC CHANGES GENERAL CHANGES: BMR increases by 30% To meet the needs of growing fetus.

3. PROTEIN METABOLISM Preg is a anabolic state. + ve nitrogenous balance. At term: Suppressed urea formation; B.urea falls to 15-20mg% AA: ACTIVELY transported to fetus across placenta.

4. CARBOHYDRATE METABOLISM

5. During MATERNAL FASTING: hypoglycemia , hypoinsulinemia , hyperlipidemia, hyperketonemia. OVERALL EFFECT : OGTT may show an abnormal pattern GF of glucose is increased to exceed tubular abs. threshold . Thus glucosuria is seen in 50% of normal preg females.

6. Fat metabolism Regulation by LEPTIN LIPID METABOLISM: HYPERLIPIDEMIA OF PREG IS NOT ATHEROGENIC. LPL activity is increased.

7. IRON METABOLISM Iron req for fetus and placenta : 5oomg Iron req for red cell increment : 500mg post partum loss: 180 mg lactation for 6 mn : 180 mg total req. : 1360mg 350 mg subtracted (saved as a result of amenorrhoea ) So actual extra demand : 1000mg

8. Total : 1000mg

9. SYSTEMIC CHANGES

10. RESPIRATORY SYSTEM

11. URINARY SYSTEM

12. Alimentary system

13. LIVER AND GALL BLADDER LIVER Fn are depressed. Only ALP is raised Mild cholestasis(d/t estrogen). GALL BLADDER

14. NERVOUS SYSTEM Estrogen and progesterone cause irritability, anxiety, depression, mental confusion and decreased concentration. (OR may be d/t psychological background) Fatigue and sleep deprivation can occur. Postpartum blues Carpal tunnel syndrome Compression of lat. Cut. Nv . Of thigh.

15. CALCIUM METABOLISM Inc demand ,sp. In last trimester for bone mineralization RDA :1-1.5mg Total maternal Ca is But S. ionized Ca is unchanged I,25 DH vit D3 abs. of Ca from gut & kidney CALCITONIN ; To protect maternal skeleton from osteoporosis Maternal phosphate is unchanged.

16. Skeletal system