Normal physiological changes during pregnancy Sample Clauses

Normal physiological changes during pregnancy. The majority of pregnant women are young and healthy and as a result have an uneventful pregnancy. When pregnant, many physiological changes and hormonal changes occur within the human body, some of which can mimic the signs and symptoms often seen in women with liver disease. These normal physiological changes associated with pregnancy need to be recognised and understood as no specific treatment or monitoring is required. Furthermore, a good understanding of what a normal pregnancy entails allows early detection and access to treatment in those who may develop liver disease and a consequence of pregnancy. (1) A rise in maternal heart rate and cardiac output along with a fall in blood pressure all occur in a normal pregnancy. (2) A physical examination of a pregnant women may show xxxxxx erythema and the presence of multiple spider naevi in up to 70%. (3) Spider naevi are angiomas which are found in the distribution of the superior xxxx xxxx thus commonly seen on the xxxx, xxxx, upper trunk and arms. They occur due to dilatation of the cutaneous arterioles driven by increased circulating oestrogen levels. Due to their pathophysiology they are common in pregnancy women, those on hormonal contraception and women with liver disease as the liver is responsible, in part, for metabolising oestrogen. Xxxxxx erythema is a mottled, red colouration mainly over the thenar and hypothenar eminences in the hands occurring secondary to cutaneous vasodilatation and a hyper dynamic circulation. It is a clinical sign that is (4) Despite this, blood flow to the liver remains relatively constant during pregnancy and it remains impalpable as it is displaced upwards into the thoracic cavity due to the expanding uterus. (5) The maternal alkaline phosphatase (ALP) can increase 2-4 times the upper limit of normal especially in the third trimester where ALP is produced both from the placenta and as a result of foetal bone development. The alpha fetoprotein (AFP) level increases in pregnancy as AFP is produced by the foetal liver. A marked increase however may reflect an underlying neural tube defect of the foetus. Other common biochemical and haematological tests including gamma-glytamyl transpepidase (GGY), aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, total protein levels, albumin, urea, haemoglobin levels and the prothrombin time remain unchanged or slightly reduced due to haemodilution as a consequence of increased circulating plasma volume that ...
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