ORGANIC AND FUNCTIONAL CHANGES IN OTHER THAN THE DUCTIVE ORGANS.
There is no system in woman that is not modified by pregnancy. We will study each one in succession.
Digestive Apparatus.
Compression phenomena here predominate. The growth of the uterus crowds the intestines and stomach, diminishing their freedom of motion, so that we often witness, at the end of pregnancy, the reappearance of vomiting, which is dependent entirely upon pressure on the stomach. The intestines may escape compression by occupying space at the side of the uterus; but the rectum, being behind it, is always compressed, and this is exaggerated by the constipation which is habitual in pregnancy. Hence masses of faeces collect, and so bulge the vaginal wall that inexpert observers have mistaken such a tumor for the festal head. Similar com pression on the rectal veins induces hemorrhoids.
Tarnier has described the liver as fatty, but, as this can only be proved at the autopsy of patients dying of puerperal fever, many think that this is a pathological, rather than a physiological phenomenon.
The experiments of de Sinety on animals seem to prove the reverse, however. The fat accumulates in the centre of the lobule, and is scanty or absent at the periphery. Now, in pathological cases, the disposition of fat is just the reverse.
From the beginning of pregnancy, the digestive functions are altered. They are (Pajot) increased, diminished, perverted or perturbed. We will study these later. Although constipation is the rule, in many cases pro fuse diarrhoea alternates with it. Like vomiting, the diarrhoea may become pathological and uncontrollable.
Pregnant women increase in weight.
The experiments of Hecker and Gassner (of Munich) conclusively prove this. The latter states that the increase shows itself in the last three months, being 34 to 54- pounds for each month, except when the fcetns dies. Gassner attributes it not only to the growth of the ovum and the uterus, but to a universal increase in the organism, the result of greater activity in the functions of assimilation.
Circulatory Apparatus.
The quantity and quality of the blood are changed, as well as the heart and vessels.
The former of these changes have been investigated by Spiegelberg, Gecheidlen and Nasse.
The first two of these authors, experimenting on animals, arrived at the following conclusions: 1st. The blood-mass increases during pregnancy, but only after the fourth month.
2d. The amount of htemaglobin depends on the animal's nourish ment.
3d. Increase in watery constituents, if it exist, is insignificant.
Andral and Gavarret were the first to investigate the composition of the blood; and their results have been confirmed by Becquerel, Rodier, Regnault and Nasse.
They prove that the pregnant female is not plethoric, antemic or chlo rotic. The latter condition is ascribed to her by Cazeaux; but the blood during gestation is peculiar; there is increase in water and diminution in red corpuscles, iron and albumin. For the first six months the fibrin diminishes; for the remaining three it increases.
The following tables, one from Becquerel and Rodier, and the other from Regnault, give a resume of the blood condition in pregnant women: We must notice, also, the cardiac and vascular changes. Larcher was the first (1857) to describe cardiac hypertrophy in pregnancy. The left ventricle is the only part involved in this process. Ducrest has confirmed this: he examined 100 hearts of women who died in childbirth, and found the walls thicker by of an inch. Blot found the heart about 900 grains heavier.
Jacquemier heard a murmur in 25 per cent. of 257 cases he examined.
The arteries and veins undergo changes in pregnancy, that manifest themselves by a frequency and hardness of the pulse, and compression of the veins inducing varices, oedema and hemorrhoidal tumors.