Jump to ContentJump to Main Navigation
Oxford Textbook of Medicine$
Users without a subscription are not able to see the full content.
Oxford Textbook of Medicine (5 ed.)

Edited by David A. Warrell, Timothy M. Cox, John D. Firth

Online access to the Oxford Textbook of Medicine in low and middle income countries is available through the World Health Organization-led HINARI Access to Research in Health programme. 

Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

Access token activation

If you have an access token, please click here to activate it.

Sign up for an individual subscription to the Oxford Textbook of Medicine.

Publisher:
Oxford University Press
Print Publication Date:
May 2010
Print ISBN-13:
9780199204854
Published to Oxford Medicine:
May 2012
DOI:
10.1093/med/9780199204854.001.1

Subscriber Login

Forgotten your password?

Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Physiological changes of normal pregnancy

Chapter:
Physiological changes of normal pregnancy
Author(s):

David J. Williams

DOI:
10.1093/med/9780199204854.003.1401

Almost every maternal organ system makes a physiological adaptation to pregnancy that is required for optimal pregnancy outcome. An understanding of these adaptations brings insight into the aetiology and management of gestational syndromes, and also helps the clinician to advise women with pre-existing chronic illness about the risks and consequences of a pregnancy.

Physiological adaptations in pregnancy—these include (1) cardiovascular—cardiac output increases 50%; (2) respiratory—oxygen consumption increases 20%; and (3) renal—glomerular filtration rate increases 55%.

Biochemical and endocrine changes in pregnancy—gestational changes alter the normal ranges for many important metabolic and endocrine laboratory tests, including (1) serum creatinine, urea—both decreased; (2) cholesterol and triglycerides—both increased; (3) liver blood tests—alkaline phosphatase increased up to four fold; and (4) thyroid function tests—free thyroxine and tri-iodothyronine levels fall, thyroid-stimulating hormone (TSH) levels rise. Awareness of these changes is essential, both for recognition of disease in pregnancy and to prevent inappropriate pursuit of test results that are normal in pregnancy.

Long-term implications of pregnancy syndromes—conditions such as pre-eclampsia and gestational diabetes mellitus are abnormal responses to pregnancy that resolve after delivery, but herald similar complications, i.e. hypertension and diabetes mellitus, in later life.

Oxford Medicine requires a subscription or purchase to access the full text of books within the service. Public users can however freely search the site and view the abstracts and keywords for each book and chapter.

Please, subscribe or login to access full text content.

If you think you should have access to this title, please contact your librarian.

To troubleshoot, please check our FAQs , and if you can't find the answer there, please contact us.