Decrease in systemic vascular resistance.

Increase in cardiac output.

Increase in heart rate.

Increased cardiac workload can result in ventricular hypertrophy.

Benign systolic ejection murmur is common due to increased HR and blood volume; resolves after delivery.

Uterine compression of the inferior vena cava, leading to venous stasis and deep venous thrombosis.

Decrease in oncotic pressure leads to pedal edema.

Increase in plasma exceeds that of erythrocytes, leading to physiologic anemia aka “hemodilution” [1, 2].

There is relaxation of the rib cage allowing for a more horizontal position and upward displacement of the diaphragm.

Respiratory changes result in respiratory alkalosis, due to increase in minute ventilation.

Increase in oxygen consumption.

Rapid desaturation during periods of apnea.

Increase in glomerular filtration rate [1].

Increase in renal blood flow.

Increase in creatinine clearance.

Third trimester, bladder capacity reduction due to pressure from enlarged uterus. Hydroureter found in 90% of pregnancies [2]. See increased rate of UTI due to urinary stasis.

Decrease in lower esophageal sphincter tone.

Increase in gastric emptying time.

Increase in gastric pressure, can cause pyrosis (gastroesophageal reflux) complaint in 70% of pregnancies [1, 2].

Increase in bile secretion.

Increase in gallstone formation.

Hypoglycemia can result from insulin resistance and glucose utilization by the fetus, especially in times of fasting.

Chronic gingivitis.

1–5% patients develop pregnancy tumors (pyogenic granulomas) due to increased angiogenesis and local irritating factors such a plaque buildup. Normally self resolves [1, 3].

Decrease in salivary pH can lead to decreased mucosal desquamation and dental decay.

Melanosis of the skin and mucosa due to increase in estrogen and progesterone [1].

Preeclampsia is a pregnancy-induced condition due to abnormal placental implantation. It results in hypertension that occurs after 20 weeks of gestation or postpartum, accompanied by either proteinuria or other maternal organ dysfunction.

Form of severe preeclampsia characterized by seizures or coma without any other brain pathology.

Can be associated with respiratory failure, kidney failure, coagulopathy, stroke, and cardiac arrest.

Patient positioning into lateral decubitus position (reduce pressure vena cava), suctioning of secretions, and supplemental oxygen.

Administration of magnesium sulfate for seizure management.

Use antihypertensive medications to control blood pressure.

Emergent delivery of the fetus irrespective of gestational age.

Management as needed for other sequelae.

Syndrome characterized by hemolysis, elevated liver transaminases, and low platelet counts.

Occurs in conjunction with eclampsia or preeclampsia.

Patients may develop a subcapsular hepatic hematoma, which can rupture and lead to severe intra-abdominal bleeding and disseminated intravascular coagulation.

High maternal and perinatal morbidity/mortality rate.

Immediate delivery for pregnancies regardless of gestational age if mother is unstable.

If gestational age is less than 33 weeks and mother is stable, consider corticosteroids administration to allow for fetal maturation and improve platelet count. Delivery within 48 hours if maternal condition stabilized after steroid administration.

Elevated blood pressure during pregnancy not associated with proteinuria or any preexisting chronic hypertension. SBP ≥140 mm Hg and/or DBP ≥90 mm Hg (average of at least 2 measurements taken at least 15 minutes apart) [4].

May develop into preeclampsia if proteinuria develops.

May develop into chronic hypertension if it remains 3 months after delivery.

Treated with antihypertensive medication, concern for HELLP, preeclampsia, end organ damage, and risk of maternal stroke.

Women with severe hypertension with SBP 160 or DBP 110 mm Hg in pregnancy require urgent antihypertensive therapy because it is considered an obstetrical emergency [4].