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Lesson 5: Physiologic Changes During Pregnancy



Alterations in hormonal balance and mechanical stretching are responsible for several changes in the integumentary system. The following changes occur during pregnancy:

a. Linea Nigra. This is a dark line that runs from the umbilicus to the symphysis pubis and may extend as high as the sternum. It is a hormone- induced pigmentation. After delivery, the line begins to fade, though it may not ever completely disappear.

b. Mask of Pregnancy (Chloasma). This is the brownish hyper pigmentation of the skin over the face and forehead. It gives a bronze look, especially in dark-complexioned women. It begins about the 16th week of pregnancy and gradually increases, then it usually fades after delivery.

c. Striae Gravidarum (Stretch Marks). This may be due to the action of the adrenocorticosteroids. It reflects a separation within underlying connective tissue of the skin. This occurs over areas of maximal stretch--the abdomen, thighs, and breasts. It will usually fade after delivery although they never completely disappear.

d. Sweat Glands. Activity of the sweat glands throughout the body usually increases which causes the woman to perspire more profusely during pregnancy.


a. In early pregnancy, the breast may feel full or tingle, and increase in size as pregnancy progresses. The areola of the nipples darken and the diameter increases. The Montgomery's glands (the sebaceous glands of the areola) enlarge and tend to protrude. The surface vessels of the breast may become visible due to increased circulation and turns to a bluish tint to the breasts.

b. By the 16th week (2nd trimester) the breasts begin to produce colostrum. This is the precursor of breast milk. It is a thin, watery, yellowish secretion that thickens as pregnancy progresses. It is extremely high in protein.

c. Nursing implication: Inform the pregnant patient to wear a good, supporting bra.



5-1. Identify changes, which occur in the uterus, cervix, vagina, and ovaries during pregnancy.

5-2. Select changes of the skin and breast that occurs during pregnancy.

5-3. Identify changes, which occur in the circulatory system, respiratory system, urinary system, skeletal system, and gastrointestinal system during pregnancy.

5-4. Identify changes, which occur in the cardiac output during pregnancy.

5-5. Identify nursing indications for a patient who may have changes in her blood pressure during pregnancy.

5-6. Identify changes, which occur in the body temperature during pregnancy.

5-7. Identify nursing implications for the patient with gastrointestinal symptoms.

5-8. Identify changes in the endocrine system and placenta during pregnancy.

5-9. Identify changes in weight, which occur during pregnancy.




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