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Maternal Medicine- Changes in Cardio Vascular System

Introduction During pregnancy, a woman’s body undergoes profound physiological and anatomical changes to support the growing fetus. These involve the cardiovascular, respiratory, renal, gastrointestinal, and hematological systems. 1. Cardiovascular Changes • ↑ Cardiac Output (30–50%) o Peaks by the third trimester. o Driven by estrogen → increased renal fluid reabsorption → ↑ plasma volume → ↑ preload → ↑ stroke volume → ↑ cardiac output. • ↑ Heart Rate o Mild increase, generally less than100 bpm. • ↓ Blood Pressure o Progesterone → vasodilation → ↓ systemic vascular resistance (~20%). o Leads to a 10–15 mmHg fall in BP in 1st trimester, normalizing by the 2nd trimester. • Uterine Compression Effects (≥ 20 weeks) o Compression of IVC (esp. in supine/right lateral position). o → ↓ Venous return, ↓ preload, and ↑ risk of supine hypotensive syndrome. o ↑ Risk of varicose veins & peripheral edema due to venous congestion. • Clinical Features o Palpitations, dizziness, syncope, exercise intolerance. o Peripheral edema, varicose veins. o Physiological (dilutional) anemia due to disproportionate ↑ plasma vs. RBC mass.