1. Physiology of pregnancy

20. The function of amniotic fluid Protect maternal and fetal

21. Maternal changes during pregnancy The maternal system may produce a series of changes in order to adapt to the needing of fetal growth and development influenceed by placenta hormone and neuro-endocrine

22. Changes of reproductive system Uterus Body: become enlargement and soft from 7×5 ×3cm pre-pregnancy to 35×25 ×22cm at term Volume of uterus cavity: become enlargement from 5ml pre-pregnancy to 5000ml .at term

23. Weight: be increased from from 50g pre- pregnancy to 1000g at term Wall: become thickness and the thickist at mid- period from 1 cm pre-pregnancy to 2-2.5 cm at term Blood suply: blood flow increased significantly upto 500- 700ml/min ,increased 4-6 times and most of blood flow is transported to the placenta (80-85%)

24. Isthmus: be dialated and become soft from 1cm pre-pregnancy a portion of the uterus after 12 gestational weeks Cervix: be soft and coloration or stain secrete amount of mucus avoiding the uterus cavity suffer from infection

26. Changes of the circulation Heart border: become enlargement Heart rate: increased 10-15 beat per min at the late pregnancy Heart volume: increased 10% at the late pregnancy

27. Cardiac output Very important for fetal growth and development Incrased begain 10 weeks and upto the peak at 32 weeks 80ml/bp and keeps the level to the term pregancy

29. Changes of blood system Volume: increased (30-45% ) begain 6- 8 weeks and up to the peak at 32-34 weeks increased about 1500ml including plasma 1000ml and red cell 500ml

30. Changes of blood component Red cell: reticulocyte increased red cell decreased 3.6×1012(4.2×1012) Hb decreased 110g/L(130g/L) WBC: neutrophilic granulocyte increased lymphocyte mild increased no change in orther blood cells

31. Coagulation Hypercoagulability Factor ⅱⅴⅶ ⅷ Ⅸ ⅹ increased ESR increased significantly upto 100mm/h Plasma protein albumin decreased