Signs and Physiologic Changes of Pregnancy

Signs of Pregnancy

Presumptive Signs

• Definition: Symptoms that suggest pregnancy but have other possible causes.
• Examples:
  • Fatigue
  • Nausea
  • Amenorrhea (absence of menstruation)
  • Breast changes

Probable Signs

• Definition: Signs that make pregnancy probable but are not definitive.
• Examples:
  • Ballottement: Feels like fluid inside the uterus.
  • Positive pregnancy test: Indicates presence of HCG but can have other causes.
  • Chadwick, Goodell, Hegar's signs: Changes in cervix perceived by healthcare providers.

Positive Signs

• Definition: Definitive indicators of pregnancy.
• Examples:
  • Fetal heart sounds
  • Seeing the fetus on ultrasound
  • Healthcare provider feels fetal movement (not just the patient)
  • Mnemonic: If a baby can be heard, felt, or seen, pregnancy is positive.

Physiologic Changes in Pregnancy

Cardiovascular Changes

• Blood Volume: Increases by nearly 50%
• Consequences:
  • Edema due to extra fluid
  • Mild tachycardia
  • Dilutional drop in hemoglobin and hematocrit (considered anemic if <11 g/dL in 1st/3rd trimesters, <10.5 in 2nd trimester)

Musculoskeletal Changes

• Relaxin Hormone:
  • Relaxes ligaments for labor
  • Can cause clumsiness due to uncoordinated joints

Supine Hypotension Syndrome

• Cause: Lying on back compresses inferior vena cava
• Symptom: Hypotension due to reduced blood return to heart
• Solution: Avoid lying on back or use a pillow under one hip

Digestive Changes

• Common Issues:
  • Constipation
  • Nausea and vomiting

Integumentary Changes

• Chloasma: "Mask of pregnancy," facial discoloration
• Striae Gravidarum: Pregnancy-related stretch marks
• Linea Nigra: Vertical dark line on the abdomen

Closing

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