Systemic and Central Nervous System Changes During Pregnancy

The impact of pregnancy on the neuroendocrine system is profound. Although the vast majority of these changes are hormonally mediated, some organ systems are also affected by the anatomic alterations caused by the enlarging uterus or the physiologic increase in maternal blood volume. The endocrine, metabolic, psychological, and sociocultural changes associated with pregnancy and parturition represent a coordinated and cooperative set of homeostatic responses that facilitate maternal and fetal health. These changes are signaled by the placental secretion of hormones, but they can alter in abundance, interact with one another, and exert wide effects on maternal tissues during pregnancy. Normal pregnancy represents an enormous challenge, and complications of pregnancy are common. It is critically important for the clinician to understand these changes when caring for pregnant women, as many physical examination findings, laboratory values, and imaging findings that would be viewed as abnormal and of great concern outside of pregnancy can be normal and reassuring in pregnant women.