Chapter 3 - Maternal Physiology

Overview 39 Gestational Weight Gain 39 Cardiovascular System 39 Heart 39 Cardiac Output 39 Arterial Blood Pressure and Systemic Vascular Resistance 41 Venous Pressure 41 Central Hemodynamic Assessment 41 Normal Changes That Mimic Heart Disease 42 Effect of Labor and the Immediate Puerperium 42 Cardiac Rhythm 43 Hematologic Changes 43 Plasma Volume and Red Cell Mass 43 Iron Metabolism 44 Platelets 45 Leukocytes 45 Coagulation System 45 Respiratory System 46 Upper Respiratory Tract 46 Mechanical Changes 46 Lung Volume and Pulmonary Function 47 Gas Exchange 47 Sleep 48 Urinary System 49 Anatomic Changes 49 Renal Hemodynamics 49 Renal Tubular Function and Excretion of Nutrients 50 Body Water Metabolism 51 Osmoregulation 51 Salt Metabolism 51 Renin-Angiotensin-Aldosterone System 51 Atrial and Brain Natriuretic Peptide 52 Clinical Implications of Pregnancy-Related Renal and Urologic Changes 52 Alimentary Tract 52 Appetite 52 Mouth 52 Stomach 53 Intestines 53 Gallbladder 53 Liver 53 Nausea and Vomiting of Pregnancy 54 Endocrine Changes 54 Thyroid 54 Adrenals 55 Pituitary 56 Pancreas and Fuel Metabolism 56 Glucose 56 Proteins and Lipids 56 Skeleton 57 Calcium Metabolism 57 Skeletal and Postural Changes 58 Skin 58 Central Nervous System 59 Eyes 59 Breasts 59 Lower Reproductive Tract 59 Vagina 59 Cervix 59 Microbiome 59 Vaginal Microbiome 60 Gut Microbiome 60 Placental Microbiome 60 Summary 60