RNSG 1412 (Ob/Pedi) - Exam 2, PPT & Learning Guide: Normal
Pregnancy|Uterine Enlargement, Hyperplasia, Hypertrophy, Fibrous
Tissue, Muscle Fiber Adaptation, Braxton Hicks Contractions, Fundal Height,
Lightening, Cervical Changes, Chadwick’s Sign, Goodell’s Sign, Mucus Plug,
Vaginal Vascularity, Glycogen Metabolism, Candida Risk, Ovarian
Progesterone Secretion, Placental Hormones, Breast Development,
Colostrum Production, Cardiovascular Adaptations, Blood Volume
Expansion, Cardiac Output, Hemodilution, Physiologic Anemia, Blood
Pressure Regulation, Supine Hypotension, Varicosities, Respiratory
Adaptations, Oxygen Consumption, Hyperventilation, Thoracic Cage
Changes, Tidal Volume Increase, Maternal-Fetal Oxygenation Exam
Questions Verified and Provided with Complete A+ Graded Rationales
Latest Updated 2026
Physiological Responses to Pregnancy - Uterus
Reproductive System-Uterus
§Enlargement from 10 ml to 5000 ml. (5L)
§Hyperplasia (more cells)
§Hypertrophy (enlarged cells)
§Fibrous tissue for elasticity
§Muscle fibers increase in length and width
§Uterine & placental blood flow reaches 1200 ml/min
Contractility
,has both horizontal & longitudnal muscles that make a strong basket weave.
§Braxton Hicks Contractions
Growth Pattern - uterus
§Predictable (EDD, EDB, EDC)
§Fundal heights (fig 13-1).
What is lightening?
the process during late pregnancy when the baby descends into the pelvis, preparing for birth. This
often occurs a few weeks before labor, especially for first-time mothers, though it can happen closer to
labor in subsequent pregnancies.
What is the fundal height at 20 weeks gestation? at the umbilicus (abt 22cm)
When does the uterus reach its highest level? abt 36 weeks, reaches sternum
Reproductive System (continued)- Cervix
§Chadwick’s sign – hyperemia caused by estrogen
(blood congestion… purple from cervix to vagina/labia)
§Goodell’s sign - softer than non-pregnant (earlobe)
,normally the cervix feels like the tip of your nose
§Mucus plug (fig 13-2), protection from ascending bacteria
What happens to the mucus plug during early labor?
usually comes out as the cervix softens and opens
Vagina and vulva
§Increase in vascularity - Chadwick's sign.
§Loosening of connective tissue – allowing distention
§Cells contain more glycogen – causes more discharge.
§Glycogen feeds Lactobacillus acidophilus – they make
lactic acid - acidic discharge – acidic pH - inhibits
bacteria
§Glycogen feeds Candida albicans – candidiasis (yeast
infections).
, Reproductive System - ovaries & breast
Ovaries
–Progesterone secretion (PRO gestation) from corpus luteum… then the placenta. Progesterone and
estrogen inhibit ovulation.
Breast
–Estrogen and progesterone promote mammary and lobal growth - increased size & darker color (fig 13-
3). May cause striae gravidarum
–Nipples more erect
When is colostrum first present?
typically beginning around the 12th-16th week
Cardiovascular System
•Slight cardiac enlargement
–Workload increased
–Location (more upwards and to the left)
–Systolic murmur in 95% of women
•Blood volume
Pregnancy|Uterine Enlargement, Hyperplasia, Hypertrophy, Fibrous
Tissue, Muscle Fiber Adaptation, Braxton Hicks Contractions, Fundal Height,
Lightening, Cervical Changes, Chadwick’s Sign, Goodell’s Sign, Mucus Plug,
Vaginal Vascularity, Glycogen Metabolism, Candida Risk, Ovarian
Progesterone Secretion, Placental Hormones, Breast Development,
Colostrum Production, Cardiovascular Adaptations, Blood Volume
Expansion, Cardiac Output, Hemodilution, Physiologic Anemia, Blood
Pressure Regulation, Supine Hypotension, Varicosities, Respiratory
Adaptations, Oxygen Consumption, Hyperventilation, Thoracic Cage
Changes, Tidal Volume Increase, Maternal-Fetal Oxygenation Exam
Questions Verified and Provided with Complete A+ Graded Rationales
Latest Updated 2026
Physiological Responses to Pregnancy - Uterus
Reproductive System-Uterus
§Enlargement from 10 ml to 5000 ml. (5L)
§Hyperplasia (more cells)
§Hypertrophy (enlarged cells)
§Fibrous tissue for elasticity
§Muscle fibers increase in length and width
§Uterine & placental blood flow reaches 1200 ml/min
Contractility
,has both horizontal & longitudnal muscles that make a strong basket weave.
§Braxton Hicks Contractions
Growth Pattern - uterus
§Predictable (EDD, EDB, EDC)
§Fundal heights (fig 13-1).
What is lightening?
the process during late pregnancy when the baby descends into the pelvis, preparing for birth. This
often occurs a few weeks before labor, especially for first-time mothers, though it can happen closer to
labor in subsequent pregnancies.
What is the fundal height at 20 weeks gestation? at the umbilicus (abt 22cm)
When does the uterus reach its highest level? abt 36 weeks, reaches sternum
Reproductive System (continued)- Cervix
§Chadwick’s sign – hyperemia caused by estrogen
(blood congestion… purple from cervix to vagina/labia)
§Goodell’s sign - softer than non-pregnant (earlobe)
,normally the cervix feels like the tip of your nose
§Mucus plug (fig 13-2), protection from ascending bacteria
What happens to the mucus plug during early labor?
usually comes out as the cervix softens and opens
Vagina and vulva
§Increase in vascularity - Chadwick's sign.
§Loosening of connective tissue – allowing distention
§Cells contain more glycogen – causes more discharge.
§Glycogen feeds Lactobacillus acidophilus – they make
lactic acid - acidic discharge – acidic pH - inhibits
bacteria
§Glycogen feeds Candida albicans – candidiasis (yeast
infections).
, Reproductive System - ovaries & breast
Ovaries
–Progesterone secretion (PRO gestation) from corpus luteum… then the placenta. Progesterone and
estrogen inhibit ovulation.
Breast
–Estrogen and progesterone promote mammary and lobal growth - increased size & darker color (fig 13-
3). May cause striae gravidarum
–Nipples more erect
When is colostrum first present?
typically beginning around the 12th-16th week
Cardiovascular System
•Slight cardiac enlargement
–Workload increased
–Location (more upwards and to the left)
–Systolic murmur in 95% of women
•Blood volume
