00:01
Hello, welcome to a conversation
about pregnancy.
00:05
Today we're going to talk about the
physiological changes of pregnancy.
00:09
This lays the foundation for
everything we're going to talk about
in this course.
00:13
So spend some time in this lecture
and use it for a reference point.
00:17
If you ever feel like you're
struggling with any of the content.
00:20
Are you ready?
Here we go.
00:22
We're going to talk about
the reproductive system.
00:25
We're going to talk about
the cardiovascular system,
the hematologic system,
the endocrine system,
the renal system,
the gastrointestinal system,
the musculoskeletal system,
the respiratory system,
and finally,
the integumentry system.
00:43
So beginning with
reproductive system changes.
00:46
So these are the things that go on
in the reproductive system
that are going to change
as a result of pregnancy.
00:53
When we think about
changes in the breast,
the estrogen also causes
changes in the milk ducts.
00:59
So let's look at this in detail.
01:00
As we have an increase
in blood supply,
we're going to have growth and
proliferation of the milk ducts.
01:07
This is where the milk is
going to be produced later on,
so we have to start early.
01:12
Progesterone causes specifically the
development of the mammary lobes.
01:16
So remember, estrogen causes growth
and proliferation of the milk ducts,
and progesterone causes
development of the mammary lobes.
01:25
When we think about the areola,
that's the dark area
around the nipple.
01:29
This area is going
to become enlarged
and the pigment is going to change.
01:34
It's going to be much darker
than it is normally.
01:37
Sometimes this is a cause
for concern for clients.
01:40
Make sure they know
that this is expected.
01:42
We also may notice something
that looks like little pimples
around the nipple.
01:47
These are called the
tubercles of Montgomery.
01:49
The function of these tubercles
is to supply
the lubrication for the breast.
01:54
Remember, the function of the breast
is to feed the newborn.
01:57
So we want to make sure
that area doesn't get dry.
02:00
So the tubercles of Montgomery
will help with that process.
02:04
Also, in terms of
how the breasts look.
02:06
They're going to change.
So they may look more transparent.
02:10
They may have more vessels
that are visible superficially.
02:14
Again, these are things we want
to reassure the client about,
let them know
these are normal changes.
02:21
There may be stretch marks that
form on the breast as they enlarge.
02:24
And again, this may not be
the most fun, but it is normal.
02:30
This process of milk production
starts during the pregnancy.
02:34
So not just when the baby arrives.
02:36
We start the production of colostrum
during Lactogenesis I.
02:40
This happens during the pregnancy.
02:43
It's important that you know
that the lobes are formed,
that the alveoli cells
start to grow,
and we also have formation
of the milk ducts.
02:52
Fatty tissue will also help
to support breast function.
02:56
The areola, as we mentioned
previously, will become dark,
the nipple will become more
sensitive and often larger as well.
03:04
It's important that
you remind clients
that although cholesterol is
produced during pregnancy,
it's normal for it to leak out
before delivery.
03:14
Let them know that
and also let them know
they will not run out.
03:19
This is all a part of
Lactogenesis I.
03:22
Lactogenesis II,
we'll talk about in a later lecture
because that occurs after delivery.
03:28
Now, let's talk about the uterus.
03:30
Now, the uterus is primetime and we
talk about reproductive changes.
03:34
Under the influence of estrogen,
the cells proliferate
and the uterus grows.
03:38
Now, because estrogen is present,
whether the pregnancy
is in the uterus,
or as in the case of an ectopic
outside the uterus
no matter what the uterus
is going to grow and stretch.
03:49
So understanding
that the uterus grows
from the beginning, all the way
until the end of pregnancy
to create a home for the baby.
03:57
Let's talk about some other changes
that also happen.
04:00
Because of the increase
of blood flow to the uterus,
we have softening of the uterus.
04:07
So specifically when we speak
of the isthmus,
which is right above the cervix,
that area becomes soft,
and it has a name.
04:14
It's called Hegar's Sign.
04:16
So softening of the isthmus
is Hegar.
04:20
So high above the cervix
is how I remember.
04:23
Chadwicks is also
another sign of pregnancy.
04:27
But specifically,
what's going on is
all that extra blood flow
into the cervix
makes it take on
kind of a bluish color.
04:35
So if you place the speculum
into the vagina,
and you open up the blades,
and you see the cervix,
you may notice that it looks
a little cyanotic.
04:43
That seems bad,
but it's actually good.
04:45
Means we have great
blood flow to the cervix.
04:48
C for color,
C for chadwicks.
04:51
So, a Goodell's sign is when
we can feel how soft the cervix is
under the influence
of all those hormones,
as the cells proliferate
and blood flow comes in
the cervix is going to be softer.
Good all Goodell's.
05:08
Within the cervical canal, we have
the formation of a mucus plug,
also called operculum.
05:15
I actually just love saying that
operculum, operculum, operculum.
05:19
It makes me feel really smart.
05:21
But what it actually is
is a wad of mucus.
05:23
And when it comes out
later in pregnancy,
it looks like a wad of...
well mucus,
or it's not, which is not
really that nice looking.
05:31
But it is important
because functionally what it does
is to protect Cletus the fetus
is there inside
from all the bacteria they may form
inside the vagina.
05:40
That's the operculum or mucus plug.