Physiology of Pregnancy
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Purpose of Review
The purpose of this review is to familiarize the trauma practitioner with the normal physiologic changes of pregnancy allowing them to recognize when a traumatic injury has caused a derangement to one of these physiologic systems. While nearly every physiologic system is changed during pregnancy, this review focuses on the changes which are clinically relevant to the trauma patient.
While there is scant new literature in this area, we review many of the landmark studies and essential text which have allowed practitioners to understand the complex physiology of the pregnant patient.
This article summarizes the physiologic changes in anatomy, the cardiovascular system, the respiratory system, the genitourinary system, the gastrointestinal system, the hematologic system, and the musculoskeletal system and highlights the relevant clinical findings which guide evaluation and management of the pregnant trauma patient.
KeywordsAnatomy of pregnancy Physiologic changes of pregnancy Changes in pregnancy Hemodynamics of pregnancy Obstetric
Compliance with Ethical Standards
Conflict of Interest
The authors declare no conflicts of interest relevant to this manuscript.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.• Clark SL, Cotton DB, Lee W, Bishop C, Hill T, Southwick J, et al. Central hemodynamic assessment of normal term pregnancy. Am J Obstet Gynecol. 1989;161(6 Pt 1):1439–42. This article describes the hemodynamic changes of pregnant patients who underwent rigorous central hemodynamic assessment and elucidates the significant derangements to the cardiovascular system during pregnancy. CrossRefPubMedGoogle Scholar
- 2.•Hegewald MJ, Crapo RO. Respiratory physiology in pregnancy. Clin Chest Med. 2011;32(1):1-13, vii. https://doi.org/10.1016/j.ccm.2010.11.001. The above article serves as a comprehensive review of the literature regarding the respiratory changes of pregnancy.
- 25.•• Mushambi MC, Kinsella SM, Popat M, Swales H, Ramaswamy KK, Winton AL, et al. Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia. 2015;70(11):1286–306. https://doi.org/10.1111/anae.13260. This article describes the first national obstetric guidelines for the safe management of the difficult airway in pregnant patients. CrossRefPubMedPubMedCentralGoogle Scholar
- 38.Assali NS. Biology of gestation. New York: Academic Press; 1968.Google Scholar
- 40.• Pomp ER, Lenselink AM, Rosendaal FR, Doggen CJ. Pregnancy the postpartum period and prothrombotic defects: risk of venous thrombosis in the MEGA study. J Thromb Haemost. 2008;6(4):632–7. https://doi.org/10.1111/j.1538-7836.2008.02921.x. This article reviews the evidence collected from a case-control study evaluating the risk of venous thrombosis during pregnancy and the post-partum state. CrossRefPubMedGoogle Scholar
- 46.Weight gain during pregnancy: reexamining the guidelines. Washington DC: National Academy of Sciences.; 2009.Google Scholar