• Eng Kien Tan and Eng Loy Tan.
• Department of Obstetrics & Gynaecology, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore 119228, Singapore. Electronic address: dr.ektan@gmail.com.
• Best Pract Res Clin Obstet Gynaecol. 2013 Dec 1; 27 (6): 791-802.

AbstractPregnant women undergo profound anatomical and physiological changes so that they can cope with the increased physical and metabolic demands of their pregnancies. The cardiovascular, respiratory, haematological, renal, gastrointestinal and endocrine systems all undergo important physiological alterations and adaptations needed to allow development of the fetus and to allow the mother and fetus to survive the demands of childbirth. Such alterations in anatomy and physiology may cause difficulties in interpreting signs, symptoms, and biochemical investigations, making the clinical assessment of a pregnant woman inevitably confusing but challenging. Understanding these changes is important for every practicing obstetrician, as the pathological deviations from the normal physiological alterations may not be clear-cut until an adverse outcome has resulted. Only with a sound knowledge of the physiology and anatomy changes can the care of an obstetric parturient be safely optimized for a better maternal and fetal outcome.Copyright © 2013 Elsevier Ltd. All rights reserved.

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