1. Anatomical changes in
Pregnancy
10th
Prepared by
Hazrat Bilal Malakandi
semester, DPT, IPM&R KMU
Peshawar

2. Group members
•
•
•
•
•
Hazrat Bilal
Heera Nawaz
Asmat Saeed
Bushra Bakht
Atif Nazir

3. • Pregnancy is the fertilization and development
of one or more offspring, known as an embryo
or fetus, in a woman's uterus.
• Pregnancy results in many anatomical changes
• Few of them are discussed shortly in next slides

4. Changes in Reproductive organs
I. 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.

5. • 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

8. 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.

9. • 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.

11. 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

12. 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

13. Increased lordosis in pregnancy due to
increased anterior load.

14. 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 5–11, ISSN (Online) 18997562, ISSN (Print) 1640-5544, DOI: 10.2478/v10078-010-0042-1, January 2011

16. 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.

17. 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.

18. • 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

20. 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.

21. 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, upper lip and the adjoining parts of the
checks.

22. Linea nigra
butterfly pigmentation

23. 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.

24. 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

25. Anatomy comparison

26. Milk Ducts

27. Lungs

28. Diaphragm

29. Stomach

30. Liver

31. Intestines

32. Placenta

33. Umbilical Cord

34. Uterus

35. Bladder

36. cervix

37. Vagina