Maternal Changes During Pregnancy

System Hormone/ Pattern Other

Parameter
Pituitary GH ∅∆
LH, FSH Low basal levels
ACTH ∅∆
TSH ∅∆
PRL ↑ until term
Placental hCG Peak 10wk then ↓ to lower plateau
hCS ↑ w/ placental weight Can lead to gestational
diabetes
Estrogens Estradiol ↑ until term
Estriol ↑ until term
Estrone ↑ until term
Esterol ↑ until term Almost all from placenta
Androgens Testosterone ↑ 10x pre-pregnancy level From maternal adrenal gland -
∆ed to estradiol
Thyroid tT4 ↑ 1st trimester then plateau
fT4 ∅∆
tT3 ↑ 1st trimester then plateau
fT3 ∅∆
TBG/CBG ↑ d/t estrogen
CV HR ↑ 20% gradually
BP ↓ 10% till wk 34, then back to d/t ↓ TPR
normal
SV ↑ to max at 19 wk then plateau
CO ↑ 20% rapidly, then 10% more by
wk 28
Peripheral Venous ↑ until term
Distention
Respiratory Rate ∅∆
Tidal Volume ↑ 30-40% Placenta and fetus req. ↑↑ O2
Expiratory Reserve ↓ gradually
Vital Capacity ∅∆
Minute Respiration ↑ 40% ↑ little beyond metabolic
demands (technically
hypervent. – CO2 ↓ a little)
Renal Flow ↑ 25-50% Must remove fetal waste
GFR ↑ early, then plateau
Weight Uterine ↑ from 60-70g → 0.9-1.2kg
Body ↑ avg. 25# Variable by individual
Blood Hematopoeisis ↑