General Management Principles of the Pregnant Woman

Abstract

Pregnancy is a dynamic process that consists of profound physiological changes mediated by hormonal, mechanical, and circulatory pathways. Understanding of changes in physiology is essential for distinguishing abnormal and normal signs and symptoms in a pregnant patient. These physiological changes also have important pharmacotherapeutic considerations for a pregnant patient. Although there are limited data to guide decisions regarding medications and diagnostic procedures in pregnancy, a careful review of risks should be balanced with review of risk of withholding a medication or procedure. Interventional pulmonary procedures can be safely performed in pregnant women while keeping in mind the maternal anatomic and physiologic changes. Furthermore, management of a maternal cardiopulmonary arrest requires important modifications in patient positioning and intravenous access to ensure adequate efficacy of chest compressions, circulation, and airway management. This review will provide an overview of maternal physiologic changes with a focus on cardiopulmonary physiology, pharmacotherapeutic considerations, diagnostic and interventional pulmonary procedures during pregnancy, and cardiopulmonary resuscitation in pregnancy.

Identifying Symptom Clusters Among Pregnant Women During Early and Late Pregnancy

“…In addition, pregnant women are more likely to experience sharp emotional changes (e.g., the surprise and expectations of newborns' arrival or unpleasant emotions triggered due to transition between roles) and raise concerns about the foetal growth and development as well(Bergbom, Modh, Lundgren, & Lindwall, 2017, Taubman-Ben-Ari, Chasson, Horowitz, Azuri, & Davidi, 2021). In regard to late pregnancy, i.e., gestational age of more than 28 weeks, the functional load on the organs of women gradually approaches its maximum, consequently increasing the burden on the maternal body, and subsequently developing symptoms such as di culty in breathing and sleep disorders (Kaur & Miller, 2017, Mindell, Cook, & Nikolovski, 2015. In addition, as the due date approaches, women start getting concerned about the outcomes of the delivery and the baby's health (Bisetegn, Mihretie, & Muche, 2016), and some are even placed under pressure coming from family's acceptance of the newborn's gender (Zhou et al, 2020).…”