YBOA LP1

A HIGH-RISK PREGNANCY monitor the fetus to check for heart rate abnormalities
Is a pregnancy that involves increased health risk for using a cardiotocograph.
the pregnant, fetus, or both. a. Nursing Care: void before test; monitor fetal heart
rate for 30 minutes before test; monitor mother after
WHAT CAUSES HIGH-RISK PREGNANCY? test to observe for possible initiation of labor; evaluate
 Preexisting health condition, such as high blood response to procedure.
pressure, diabetes, or being HIV-positive. 7. Biophysical Profile (BPP) test measures the health of
 Pregnancy-related health conditions. the baby (fetus) during pregnancy. A BPP test may
 Lifestyle factors (including smoking, drug addiction, include a nonstress test with electronic fetal heart
alcohol abuse and exposure to certain toxin). monitoring and a fetal ultrasound. The BPP measures
 Age (being over 35 or under 17) increases the risk for your baby's heart rate, muscle tone, movement,
preeclampsia and gestational high blood pressure. breathing, and the amount of amniotic fluid around
 Overweight and obesity. Obesity increases the risk your baby.
for high blood pressure, preeclampsia, gestational a. Used for fetus that may have intrauterine
diabetes, stillbirth, neural tube defects, and caesarean compromise.
delivery. NICHD researchers have found that obesity b. Nursing Care: provide emotional support; evaluate
can raise infants' risk of heart problems at birth by response to procedure.
15%. 8. Maternal assessment of fetal activity: need to contact
 Multiple births. The risk of complications is higher in physician or nurse midwife when there are fewer than
women carrying more than one fetus (twins and 10 fetal movements in a 12-hour period, fewer than 3
higher-order multiples). Common complications fetal movements in an 8- hour period, or no fetal
include preeclampsia, premature labor, and preterm movements in the morning.
birth. More than one-half of all twins and as many as a. Used to determine vitality of fetus.
93% of triplets are born at less than 37 weeks' b. Nursing care: teach how to record and report
gestation. movements.
9. Fetal Scalp pH sampling: may be done during labor
IDENTIFYING AND/ OR MONITORING HIGH RISK when fetal heart patterns begin to indicate distress;
PREGNNANCY capillary blood samples are taken from fetal scalp in
1. Alpha-fetoprotein (AFP) enzyme blood test: elevated utero.
levels may identify the pregnant woman carrying a a. Results: if acidosis is present, immediate birth of
baby with neural tube defects (spina bifida and infant is indicated.
anencephaly) may also indicate twins. b. Nursing Care: cleanse vaginal area to avoid
2. Ultrasonography: Ultrasound (also called sonogram) is contamination during test.
a prenatal test offered to most pregnant women. It uses
sound waves to show a picture of your baby in the PREGANCY COMPLICATIONS
uterus (womb). Ultrasound helps your health care (PREEXISTING OR NEWLY ACQUIRED ILLNESS)
provider check on your baby's health and development. Pre-existing Maternal Medical Conditions:
a. Visualization during first 20 weeks of gestation is  Anemia - Hypertension
improved if bladder is full; a full bladder is not  Autoimmune disorder - Infectious diseases
necessary after 20 weeks’ gestation.  Blood clotting disorder - Kidney disease
b. Nursing Care: encourage fluids and refrain from  Mental health condition - Cancer
voiding before the test.  Neurological disorders - Diabetes
3. Chorionic villi sampling (CVS): supplies same data as  Epilepsy/ Seizure disorders - Nutrition issues
amniocentesis but can be done earlier and quicker  Gastrointestinal disorders - Obesity
results can be obtained.  Pulmonary conditions - Heart disease
a. Nursing Care: instruct to drink fluid so that the  Thyroid Disorders
bladder is full; after test monitor for uterine
contractions, vaginal discharge, and teach to observe A N E M I A is when blood has too few red blood cells. Having
for signs of infection. too few red blood cells makes it harder for the blood to carry
4. Amniocentesis: aspiration of the amniotic fluid used to oxygen or iron. This can affect how cells work in nerves and
detect sex, chromosomal or biochemical defects, fetal muscles. During pregnancy, the volume of blood increases. This
age, L/S ratio (2/1) ratio indicates lung maturity). means more iron and vitamins are needed to make more red
Increased bilirubin level associated with Rh Disease, blood cells. Not enough iron can cause anemia. It's not
and phosphatidy glycerol (PG) which appears in considered abnormal unless the red blood cell count falls too
amniotic fluid after thirty-fifth week, indicating fetal low.
lung maturity. Several types of anemia can develop during pregnancy. These
a. Test done after sonogram; usually after 15-18 weeks include:
gestation. Iron-deficiency Anemia- This type of anemia occurs when
b. Nursing Care: have client void; after test monitor for the body doesn’t have enough iron to produce adequate amount
uterine contractions, vaginal discharge; test for signs of of hemoglobin. That’s a protein in RBC. It carries oxygen from
infection; encourage rest. the lungs to the rest of the body. It is the most common cause
5. Nonstress Test (NST): usually done when a health care of anemia in pregnancy.
provider wants to check on the health of the fetus, such Folate-deficiency Anemia- Folate is the vitamin naturally in
as in a high-risk pregnancy or when the due date has certain food like green leafy vegetables. A type B vit, the body
passed. The test checks to see if the baby responds needs folate to produce new cells, including healthy red blood
normally to stimulation and is getting enough oxygen. cells. Folic acid helps cut the risk of having a baby with certain
a. Nursing Care: fasting is not necessary; observe the birth defects of the brain and spinal cord if it's taken before
fetal monitor; explain test to decrease anxiety; getting pregnant and in early pregnancy.
evaluate response to procedure. Vitamin B-12 Deficiency- when a pregnant woman doesn’t
Classification of results: get enough vit. B12 from their diet, their body can’t produce
Reactive: healthy red blood cells. Women who don’t eat enough meat,
Nonreactive: poultry, dairy products, and eggs have a greater risk of
Unsatisfactory: developing vitamin B12 deficiency. Strict vegans often need to
6. Contraction Stress Test (CST): performed near the end get vitamin B12 shots during pregnancy.
of pregnancy (34 weeks' gestation) to determine how
well the fetus will cope with the contractions of SYMPTOMPS OF ANEMIA
childbirth. The aim is to induce contractions and  Pale skin, lips, and lips -Feeling tired or weak
 Dizziness -SOB - Rapid heartbeat

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 Trouble concentrating - Stresses include decreased hemoglobin and increased
 Sensation of spinning (vertigo) or dizziness blood volume, stroke volume, and eventually heart
 Brittle fingernails, cheilosis (severely chapped lips), or rate. Cardiac output increases by 30 to 50%. These
a smooth, red, shiny tongue. changes become maximal between 28- and 34-weeks’
gestation.
- During labor, cardiac output increases about 20% with
RISK OF ANEMIA IN PREGNANCY each uterine contraction; other stresses include
Severe or untreated iron-deficiency anemia during straining during the 2nd stage of labor and the increase
pregnancy can increase your risk of having: in venous blood returning to the heart from the
 A preterm or LBW baby contracting uterus. Cardiovascular stresses do not
 A blood transfusion (if u lose significant amount return to prepregnancy levels until several weeks after
during delivery) delivery.
 PP Depression
 A baby with anemia FUNCTIONAL OR THERAPEUTIC CLASSIFICATION
 A child with developmental delays OF HEART DISEASE DURING PREGNANCY
Untreated folate deficiency: Class I: No limitation of physical activity; no
 Preterm or LBW baby symptoms of cardiac insufficiency.
Class II: Slight limitation of physical activity; may
 Baby with a serious defect of the spine or brain
experience excessive fatigue, palpitation, or dyspnea in last tri.
Untreated Vit. B12 deficiency:
Class III: Moderate to marked limitation of physical
 Can raise your risk of having a baby with neural tube activity; bed rest indicated during most of pregnancy.
defects. Class IV: Marked Limitation of physical activity;
Women are more likely to get iron-deficiency anemia in pregnancy should be avoided; indication for termination of
pregnancy if they: pregnancy.
 Have 2 pregnancies close together.
 Are pregnant with twins or more. ASSESSMENT
 Have vomiting often because of morning sickness. Prenatal period: VS, weight gain; dietary patterns;
 Are not getting enough iron from their diet and knowledge about self-care; signs of congestive heart failure;
prenatal vitamins. stress factors such as work, household duties.
 Had heavy periods before pregnancy. Intrapartal period: vital signs (heart rate will increase);
- respiratory changes (dyspnea, or coughing, or crackles); FHR
TREATMENT FOR ANEMIA patterns.
 Taking an iron supplement and/ or folic acid Postpartal period: signs of CHF or hemorrhage related
supplement in addition to your prenatal vitamins. to fluid shifts; intake and output.
 Blood test after a specific period.
 To treat vit. B12 deficiency, the doctor may NURSING DIAGNOSES
recommend a Vit. B12 supplement. Treatment for iron  Activity intolerance related to increased cardiac
deficiency anemia includes taking iron supplements. workload.
Some forms are time released. Others must be taken  Anxiety related to unknown course of pregnancy,
several times each day. Taking iron with a citrus juice, possible loss of fetus, and inability to perform role
such as orange, can help the body absorb it better. . responsibilities.
Taking antacids may make it harder for the body  Decreased cardiac output related to stress of pregnancy
and pathology associated with heart disease.
absorb iron. Iron supplements may cause nausea and
 Fear related to possible death.
cause stools to become dark greenish or black in color.
 Fluid volume excess related to fluid shifts resulting
They may also cause constipation. from a decrease in intra-abdominal pressure following
NURSING MANAGEMENT birth and/or a decrease in vascular space resulting from
 Provide client and family teaching. Discuss using iron cessation of need for fetal circulation and uterine blood
supplements and increasing dietary sources of iron as flow following birth.
indicated.  Risk for altered parenting related to increased
 Prepare for blood-typing and crossmatching, and for responsibility of caring for a neonate.
administering packed RBC during labor if the client o
has severe anemia. PLANNING/IMPLEMENTATION
 Provide support and management for clients with Prenatal period
hemoglobinopathies. In a client who has thalassemia  Teach importance of rest and avoidance of stress
or who carries the trait, provide support, especially if  Instruct regarding use of elastic stockings and periodic
the woman has just learned that she is a carrier. Also elevation of legs.
assess for signs of infection throughout the pregnancy.  Teach importance of continued medical supervision by
 In a pregnant client with sickle cell disease, assess iron cardiologist.
and folate stores, and reticulocyte counts; complete  Teach appropriate dietary intake: adequate calories to
screening for hemolysis; provide dietary counseling ensure appropriate, but not excessive, weight gain;
and folic acid supplements; and observe for signs of limited, not restricted, salt intake.
infection.  Administer medications as ordered; digitalis
 In a pregnant client with G-6-PD, provide iron and preparations, iron preparations, prophylactic antibiotics
folic acid supplementation and nutrition counseling, (penicillin), and anticoagulants (heparin).
and explain the need to avoid oxidizing drugs.  Monitor for signs of CHF, such as respiratory distress
and tachycardia; may be precipitated by severe anemia
HEARTDISEASE of pregnancy.
Origin: 90% rheumatic (incidence expected to decrease
as incidence of rheumatic fever decreases); 10% congenital Intrapartal period
lesions or syphilis.  Encourage mother to remain in semi-Fowler's or left
Normal hemodynamics of pregnancy that adversely lateral position.
affect the client with heart disease.  Provide continuous cardiac monitoring.
- Oxygen consumption increased 10%-20%; related to  Provide electronic fetal monitoring.
needs of growing fetus.  Assist mother to cope with discomfort; minimal
- Plasma level and blood volume increase; RBC remains analgesia and anesthesia are used.
the same (physiologic anemia).  Assist with forceps birth in second stage of labor to
avoid work of pushing.

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 Monitor for signs of CHF, such as respiratory distress miscarriage, and stillbirth in infants of women with
and tachycardia. uncontrolled diabetes.
Postpartal period: most critical time because of  Neonates at birth are at risk for hypoglycemia,
increased circulating blood volume after birth of placenta. respiratory distress syndrome, hypocalcemia, and
 Institute early ambulation schedule; apply elastic hyperbilirubinemia.
stockings.  More frequent prenatal visits should be done for
 Monitor for signs of CHF, such as respiratory distress women with diabetes for close monitoring of their
and tachycardia. condition and of the fetus.
 Monitor heart rate; accelerated heart rate of mother in
latter half of pregnancy puts extra workload on her
heart. HAZARDS OF DIABETES DURING PREGNANCY
 Provide for adequate rest; the increase in oxygen  Often there is a history of anomalies, still births, and
consumption with contractions during labor makes fetal deaths.
length of labor a significant factor.  Babies are excessively large, weighing 4000g
 Provide close supervision; sudden tachycardia during (MACROSOMIA)
birth or sudden bradycardia and normal increase in  Neonatal deaths occur as a result a hypoxia,
cardiac output following birth may cause cardiac hypoglycemia, congenital anomalies, and preterm
arrest. Administer prescribed prophylactic antibiotics labor.
to mother with history of rheumatic fever. Refer to  PIH and hydramnios are common.
various agencies for family aid, if necessary, on  Insulin therapy instituted.
discharge  Frequent hospitalization may be necessary during
prenatal period.
EVALUATION/OUTCOMES  Cesarean birth may be necessary.
 Delivers healthy infant.
 Maintains cardiac status within acceptable limits. ASSESSMENT
 Uses resources to obtain help in the home.  Length of time client has had diabetes mellitus.
 Dietary patterns.
DIABETESMELLITUS  Signs of infection.
 Vomiting during pregnancy, decreases carbohydrate  Blood glucose level.
intake with resulting acidosis and reduces need for  Understanding of disease in relation to pregnancy.
insulin.  Presence of support persons.
 Human placental lactogen decreases insulin response
in pregnant diabetics; maternal sparing of glucose, and NURSING DIAGNOSES
more oxidation of fats occurs to provide fetal  Fear related to health of newborn.
nourishment.  Fluid volume deficit related to osmotic diuresis.
 Elevated basal metabolic rate and decreases in carbon  Altered health maintenance related to lack of
dioxide combining power increases tendency toward knowledge of newly diagnosed DM or management of
acidosis. previously diagnosed DM during pregnancy.
 Normal lowered renal threshold for glucose can result  Altered nutrition: less than body requirements related
in glucosuria. to fetal growth and increased maternal metabolism.
 Muscular activity during labor depletes glycogen.  Risk for trauma related to large size of neonate.
 During puerperium insulin antagonists are removed.
It maybe: PLANNING/IMPLEMENTATION
PREGESTATIONAL- Type 1 or Type 2 Care of mother:
GESTATIONAL- Glucose intolerance first recognized during  Encourage preconception counseling and early medical
the pregnancy. and prenatal supervision.
In diabetes mellitus, the pancreas cannot produce  Teach and encourage adherence to dietary and insulin
adequate insulin to regulate glucose levels in the body. regimen.
 The problem in diabetes mellitus is controlling the  Teach signs and symptoms of hyperglycemia (acidosis)
balance between glucose and insulin levels to prevent and hypoglycemia.
hypoglycemia and hyperglycemia.  Teach serum glucose testing, insulin administration,
 Infants born to women with diabetes mellitus are five and record keeping.
times more likely to have heart anomalies.  Reinforce the need for various tests for fetal well-
 Type 1 diabetes occurs during childhood and the being.
pancreas could not produce adequate insulin for body  Prepare client for induction of labor or cesarean birth if
requirements. indicated.
 Type 2 diabetes occurs in older adults with gradual  Continue monitoring for fluid and electrolyte balance
failure of insulin production that occurs with aging. and ketoacidosis during intrapartal and postpartal
 As pregnancy progresses, women normally experience periods.
several changes in the glucose-insulin regulatory Care of neonate:
system.  Admit infant to neonatal intensive care unit if
 At about week 24, the pregnant woman with diabetes necessary.
must increase her insulin dosage as advised to prevent  Keep the infant warm because of poor temp control
hyperglycemia. mechanisms.
 Continued use of glucose by the fetus could lead to  Observe respiration.
hypoglycemia for the mother between meals.  Observe for signs of hypoglycemia and hypocalcemia,.
 An increase in the production of amniotic fluid occurs  Provide glucose water feeding to prevent acidosis.
because of hypoglycemia in the fetus that causes  Observe for congenital anomalies.
increased urine production.  Promote early mother-child interaction.
 A pregnant woman may develop hydramnios and could
be at risk for hemorrhage because of poor uterine EVALUATION
contractions.  Maintains serum glucose levels within acceptable
 Pregnancy-induced hypertension and infection could limits.
occur to a woman with poor glucose regulation.  Delivers a healthy newborn.
 Infants of mothers who have poorly controlled diabetes  Remains free from injury.
are large for gestational age.
 There are high incidences of congenital anomalies such
as caudal regression syndrome, spontaneous

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U R I N A R Y T R A C T I N F E C T I O N S (UTI) is an  Provide education on proper perineal hygiene and
infection of some part of the body's urinary system, which wiping from front to back.
includes :  Advise the woman to empty her bladder regularly, and
 Kidneys completely to prevent stasis urine, which can increase
 Ureters (tubes that carries urine from the kidneys to the the risk UTIs.
bladder)  Educate about symptoms that may indicate worsening
 Bladder infection or preterm labor and when to seek medical
 Urethra (a short tube that carries urine from your attention.
bladder to outside your body)
 Bacteria cause most UTIs. Anyone can get one, but MONITORING AND FOLLOW-UP:
they're most common in women, and they can be extra  Monitor the woman’s response to treatment by
concerning if pregnant. assessing for resolution of symptoms.
Changes of the urinary tract and immunologic changes  Arrange for follow—up urinalysis and culture and
of pregnancy predispose women to urinary tract infection. culture to ensure the infection has been effectively
Physiologic changes of the urinary tract include dilatation of the treated.
ureter and renal calyces; this occurs due to progesterone-related  Collaborate with other healthcare providers, such as
smooth muscle retardation and ureteral compression from the obstetrician or infectious disease specialists, as needed.
gravid uterus. UTI in pregnant women is primarily caused by
bacterial pathogens, most commonly E. coli. FETAL MONITORING
 Monitor fetal well-being thru regular prenatal with
ASSESSMENT including assessing a fetal movement, growth, and
 Perform a thorough assessment of the pregnant heart rate.
woman’s symptoms, including urinary frequency,  Educate the woman about the importance of fetal
urgency, dysuria, and any associated lower abdominal movement monitoring and when to seek medical
pain or flank pain. attention for changes in fetal activity.
 Monitor VS, including temp, as fever may indicate a
more severe infection. NURSING INTERVENTIONS
 Assess for any signs of preterm labor, such as uterine  Relieve pain. Antispasmodic agents may relieve
contractions, or vaginal bleeding, as UTIs can increase bladder irritability and analgesics and application of
the risk of preterm labor. heat help relieve pain and spasm.
 Urinalysis and culture.  Fluids. The nurse should encourage the patient to drink
liberal amounts of fluids to promote renal blood flow
URINALYSIS AND CULTURE: and to flush bacteria from the urinary tract.
 Obtain a midstream urine sample for urinalysis and  Voiding. Encourage frequent voiding every 2 to 3
culture to confirm the diagnosis of a UTI and identify hours to empty the bladder completely because this can
the causative organism. significantly lower urine bacterial counts, reduce
 Promptly start empirical antibiotic therapy based on urinary stasis, and prevent reinfection.
local antimicrobial susceptibility patterns and adjust  Irritants. Avoid urinary irritants such as coffee, tea,
treatment once culture results are available. colas, and alcohol.

SYMPTOMS EVALUATION
 An urgent need to urinate or urinating more often.  Experiences relief of pain.
 Trouble with urinating.  Explains UTI and their treatment.
 A burning sensation or cramps in the lower back or  Experiences no complications.
lower belly.
 A burning feeling when urinating INLUENZA
 Urine that looks cloudy or has an odor. Pregnant women are more susceptible to severe illness
 Blood in the urine, which can turn it red, bright pink, from influenza due to changes in their immune system, heart,
or cola-colored. and lungs during pregnancy. The influenza virus is typically
For kidney infection: transmitted thru resp droplets when an infected person coughs,
 Fever sneezes, or talks, and it can also spread by touching
 Nausea contaminated surfaces and then touching them.
 Vomiting NURSING MANAGEMENT
 Upper back pain, often on just one side  Conduct a thorough assessment of the pregnant
woman’s symptoms including fever, cough, sore throat,
DIAGNOSIS body aches, fatigues, and difficulty breathing.
 Urine test. A urine culture may also be checked. It  Monitoring VS, including temp, RR, and O2
shows what kind of bacteria are in the urine. Saturation.
 Assess for signs of dehydration, such as decreased
HYDRATION urine output, dry mouth, and increased thirst.
 Encourage adequate fluid intake to help flush out  Educate the pregnant woman about the importance of
bacteria from the urinary tract. rest and adequate hydration.
 Educate the woman about the importance of  Provide information on OTC medications that are safe
monitoring hydration, especially during pregnancy. to use.

ANTIBIOTIC THERAPY ASTHMA

 Administer antibiotics as prescribed by the healthcare Hormonal changes
provider.  Fluctuations in hormone levels, particularly increased
 Ensure the woman understands the importance of levels of estrogen and progesterone.
completing full course of antibiotics to prevent Increased blood volumes
recurrent infections and antibiotic resistance.  Pregnancy leads to an increase in blood volume, which
Antibiotics for 3 to 7 days or as doctor recommendation. can result in changes in lung function and resp
Many common antibiotics -- amoxicillin, physiology. This may contribute to a feeling to
erythromycin, and penicillin, for example -- are considered breathlessness and women asthma symptoms in some
safe for pregnant women. women.
Changes in immune function
EDUCATION

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 Changes in immune function may influence the body’s NURSING MANAGEMENT
response to asthma triggers and inflammation in the  Conduct a thorough assessment of the pregnant
airways. woman’s spinal curvature.
NURSING MANAGEMENT  Assess the woman’s symptoms, including back pain,
 Conduct a thorough assessment of the pregnant muscle weakness and difficulty breathing, which may
woman’s asthma history, including previous be exacerbated the pregnancy.
exacerbations, current medications, and triggers.  Provide education to the pregnant woman to the
 Assess the severity and frequency of asthma pregnant woman about the potential impact of scoliosis
symptoms, such as coughing, wheezing, SOB, and on pregnancy and childbirth, including increased back
chest tightness. pain and difficulty with labor and delivery.
 Evaluate the woman’s lung function using spirometry  Recommend non-pharmacological pain management
if available. strategies.
 Provide education about asthma management during  Assess the woman’s need for assistive devices, such as
pregnancy including the importance of medication back braces or maternity support belts, to provide
adherence, trigger avoidance, and recognizing signs of additional support to the spine and alleviate discomfort
worsening asthma. during pregnancy.
 Monitoring the pregnant woman’s asthma symptoms  Collaborate with the healthcare tram, including
and lung function regularly, especially during prenatal obstetricians and anesthesiologists to develop a labor
visits. and delivery pain that takes into account the woman’s
 Identify and educate the woman about common asthma scoliosis and any associated spinal issues.
triggers, such as allergens, tobacco smoke, air
pollution, and respiratory.

TUBERCULOSIS
Caused by Mycobacterium tuberculosis. Symptoms of
active TB disease include loss of appetite, weight loss, fever,
night sweats, chills, and weakness. Pulmonary TB symptoms
also include cough, chest pain, and hemoptysis. The clinical
presentation reflects the organ system that is involved in
disease.

NURSING MANAGEMENT
 Conduct a thorough assessment of the pregnant
woman’s TB history, including previous treatment,
drug resistance, and symptoms.
 Assess the severity of TB symptoms, such as cough,
fever, night sweats, weight loss, and fatigue.
 Monitor the woman’s response to treatment through
regular clinical assessments.
 Collaborate with the healthcare team to develop an
individualized treatment plan based on the woman’s
TB diagnosis, drug susceptibility testing, and
pregnancy status.
 Assess the woman’s nutritional status and provide
guidance on monitoring a balanced diet to support
maternal and fetal health during TB treatment.

GASTROINTESTINALDISORDERS
 Elevated levels of progesterone may lead to alterations
in gastrointestinal motility which could contribute to
nausea, vomiting, and/or GERD.
 Pregnancy-induced diarrhea may be due to elevated
levels prostaglandins.

NURSING MANAGEMENTS
 Conduct a thorough assessment of the pregnant
woman’s symptoms including heartburn, regurgitation,
and difficulty swallowing.
 Assess the severity and frequency of symptoms and
their impact on the woman’s quality of life.
 Provide education about lifestyle medications to reduce
GERD symptoms, such as avoiding trigger foods.
 Encourage the woman to maintain a healthy weight
during pregnancy to reduce pressure on the stomach
and lower esophageal sphincter.
 Collaborate with the healthcare provider to prescribe
medications that are safe for use during pregnancy and
pregnancy and provide relief from GERD symptom.

M U S C U LO S K E LE TALD I S O R D E R S
 The enlarging uterus alters body’s center of gravity and
applies mechanical stress on the body.
SCOLIOSIS
 Refers to an abnormal curvature of the spine, and its
management during pregnancy requires special
considerations due to the changes in the body’s
biomechanics and the potential impact on both the
matter and the developing fetus.

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