Anatomical

changes in
Pregnancy

 The causes of these changes are:

1. To provide a suitable environment for
nutrition, growth and development.
2. To prepare the mother for the process
of parturition and subsequent support
of the new born baby.
All changes that occur in pregnancy
to achieve these objectives are
both visible and suitable

Changes in Reproductive organs

Uterus:
The uterus expands from a strictly
pelvic organ before 12 weeks to
become an abdominal organ for the
remainder of gestation.
the uterus increases in weight from 60
to 1000g (20 times its original weight).
In size, it changes from 6.5 to 32 cm.

 Its shape changes from elongated to oval

by the second month, to round by
midgestation, then back through oval to
elongated at term (the end of a normal
nine-month pregnancy).
Uterine expansion is caused by the growing
fetus and an increase in connective tissue
and in the size and number of blood
vessels supplying the uterus

Cervix
The portion of the uterus connecting
the body of the uterus and the vagina.
During pregnancy, the cervix is
closed. A mucus plug forms over the
cervix ,providing a protective barrier
between the vagina and the uterine
contents.

 During labour and delivery, the cervix

shortens and widens (or dilates).
A 10 cm opening is left between the
uterus and the vagina to allow for
passage of the fetus into the birth canal.
If the cervix begins dilating prematurely,
it is sometimes stitched together during
the second trimester, until the fetus in
mature. This procedure is known as a
cerclage.

Changes in Musculo-skeletal system

Ligaments
Placental production of the hormone relaxin
causes pelvic ligaments and the pubic symphysis
to relax, widen, and become more flexible.
This increased motility eases birth passage, but it
may also result in a waddling gait during
pregnancy.
Changes in joint laxity occurring during
pregnancy. By M Calguneri, H A Bird, V Wright
http://ard.bmj.com/content/41/2/126

Lumbar region
The expanding uterus causes an
progressive lumbar lordosis.
Lumbar lordosis leads to low back pain in 40 to
50 percent of all pregnant women.
Carlson HL, Carlson NL, Pasternak BA, Balderston
KD. Understanding and managing the back pain of pregnancy. Curr Womens
Health Rep 2003; 3:65.

Pregnancy and Back Pain . . . . By Kristen Schott, PT,

MPT
http://www.sportspti.com/research/articles/pregnancy-and-back-pain.aspx

Increased lordosis in pregnancy due to increased anterior load.

Center of Gravity
The increasing bulkiness of the abdomen
changes the woman's center of gravity
forward. This shift increases the stress on your
joints and causes your back to curve forward.
The change of the center of gravity location in
late pregnancy is temporary and two months
after delivery the center of gravity is located
as it was at the beginning of pregnancy.
Journal of Huan Kinetics. Volume 26, Issue -1, Pages 511, ISSN
(Online) 1899-7562, ISSN (Print) 1640-5544, DOI:
10.2478/v10078-010-0042-1, January 2011

Changes in Respiratory system

The diaphragm is progressively
elevated and compressed. Possibly
because of expansion and elevation
of the rib cage.
The lungs are compressed due to
growing uterus in later pregnancy
making it more difficult to breathe
deeply.

Postural changes:
During pregnancy, postural changes occurred.
These changes include
forward head,
rounded shoulders,
increased lumbar lordosis,
Center of gravity shift,
hyperextended knees, and
pronated feet.

 Muscular changes are also typical.

often noted alterations include
shortened hip flexors, lower back
musculature, and pectorals.
Abdominal muscles, neck, and upper
back muscle groups elongate.
Functional Changes in Back Muscle Activity
Correlate With Pain Intensity and Prediction of
Low Back Pain During Pregnancy
http://www.ncbi.nlm.nih.gov/pubmed/9779673

Changes in cutaneous
system

They are usually more marked below

the umbilicus, on the breasts and may
appear on the buttocks and thighs.
In some women they are not marked or
even don't appear during pregnancy.
Falling of hairs and brittleness of nails
may occur during pregnancy.

Pigmentation
It is due to suprarenal changes, it usually
begins to appear after the 4th month.
The pigmentation may appear anywhere
but the commonest sites are:
1. Linea nigra: which is a line of
pigmentation between the umbilicus and
the symphysis pubis.
2. Cloasma gravidarum or mask face
of pregnancy which is butterfly
pigmentation of the forehead, nose,

Linea

butterfly
pigmentation

Changes in weight
In normal pregnancy the average gain is
0.3 Kg/week up to 18 weeks,
0.45 Kg/week from 18-28 weeks and
a slight reduction with a rate of 0.36- 0.41
Kg/week until term.

Slight weight loss may occur in the last 2

weeks. The average weight gain for
primigravidae is 12.5 Kg. and is probably
about 0.9 Kg. less for multigravidae.

Weight gain is produced by:

Fetus ----------- ------3.63-3.88 Kg
Placenta -------------- 0.48-0.72 Kg
Amniotic fluid ------- 0.72-0.97 Kg
Uterus and breasts - 2.42-2.66 Kg
Blood and fluid ------ 1.94-3.99 Kg
Muscle and fat ------ 0.48-2.91 kg
Total=

9.70-14.55Kg

Anatomy
comparison

Milk Ducts

Lungs

Diaphragm

Stomach

Liver

Intestines

Placenta

Umbilical Cord

Uterus

Bladder

cervix

Vagina