Alterations in physiology and anatomy during pregnancy Eng Kien Tan, MBChB (Hons, Manchester), MRCOG, Consultant a,*, Eng Loy Tan, MBBS (Singapore), M Med (O&G) (Singapore), MRCOG, Consultant

Pregnant women undergo profound anatomical and physiological
changes so that they can cope with the increased physical and
metabolic demands of their pregnancies. The cardiovascular, respiratory,
haematological, renal, gastrointestinal and endocrine
systems all undergo important physiological alterations and adaptations
needed to allow development of the fetus and to allow
the mother and fetus to survive the demands of childbirth. Such
alterations in anatomy and physiology may cause difficulties in
interpreting signs, symptoms, and biochemical investigations,
making the clinical assessment of a pregnant woman inevitably
confusing but challenging. Understanding these changes is
important for every practicing obstetrician, as the pathological
deviations from the normal physiological alterations may not be
clear-cut until an adverse outcome has resulted. Only with a sound
knowledge of the physiology and anatomy changes can the care of
an obstetric parturient be safely optimized for a better maternal
and fetal outcome.

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