pregnancy physiology

physiological changes during pregnancy clinical overview cardiovascular respiratory renal guidelines

diagram physiological changes during pregnancy cardiovascular respiratory renal systems

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mkdir -p "/tmp/workspace/pregnancy-physiology-ppt/src" "/tmp/workspace/pregnancy-physiology-ppt/output" && python - <<'PY' from pathlib import Path p=Path('/tmp/workspace/pregnancy-physiology-ppt/src/create_presentation.py') p.write_text(r'''from pptx import Presentation from pptx.util import Inches, Pt from pptx.dml.color import RGBColor from pptx.enum.shapes import MSO_SHAPE from pptx.enum.text import PP_ALIGN, MSO_ANCHOR from pptx.enum.dml import MSO_THEME_COLOR OUT='/tmp/workspace/pregnancy-physiology-ppt/output/Physiological_Changes_in_Pregnancy.pptx' prs=Presentation() prs.slide_width=Inches(13.333); prs.slide_height=Inches(7.5) blank=prs.slide_layouts[6] NAVY=RGBColor(20,43,70); TEAL=RGBColor(18,132,143); AQUA=RGBColor(84,197,191) CORAL=RGBColor(232,112,94); GOLD=RGBColor(236,179,68); INK=RGBColor(36,48,61) MUTED=RGBColor(94,109,122); PALE=RGBColor(241,247,247); WHITE=RGBColor(255,255,255) LIGHT=RGBColor(223,235,236); RED=RGBColor(180,62,57) def bg(slide, color=WHITE): sh=slide.background.fill; sh.solid(); sh.fore_color.rgb=color def rect(slide,x,y,w,h,fill, radius=False, line=None): sh=slide.shapes.add_shape(MSO_SHAPE.ROUNDED_RECTANGLE if radius else MSO_SHAPE.RECTANGLE, Inches(x), Inches(y), Inches(w), Inches(h)) sh.fill.solid(); sh.fill.fore_color.rgb=fill sh.line.color.rgb = fill if line is None else line if radius: sh.adjustments[0]=0.12 return sh def text(slide,x,y,w,h,s,size=18,color=INK,bold=False,align=None, font='Aptos', valign=None): tb=slide.shapes.add_textbox(Inches(x),Inches(y), Inches(w), Inches(h)); tf=tb.text_frame tf.clear(); tf.word_wrap=True; tf.margin_left=tf.margin_right=Inches(.04); tf.margin_top=tf.margin_bottom=Inches(.02) p=tf.paragraphs[0]; p.text=s if align: p.alignment=align if valign: tf.vertical_anchor=valign for r in p.runs: r.font.name=font; r.font.size=Pt(size); r.font.bold=bold; r.font.color.rgb=color return tb def title(slide, n, heading, sub=None): text(slide,.55,.30,.45,.28,f'{n:02d}',11,TEAL,True,align=PP_ALIGN.CENTER) rect(slide,.55,.59,.42,.035,TEAL) text(slide,1.12,.23,11.5,.48,heading,27,NAVY,True) if sub: text(slide,1.14,.73,11.2,.35,sub,11,MUTED) rect(slide,.55,7.13,12.2,.02,LIGHT) text(slide,.57,7.18,8,.18,'Physiological changes in pregnancy',8,MUTED) text(slide,11.55,7.18,1.1,.18,str(n),8,MUTED,align=PP_ALIGN.RIGHT) def bullet_list(slide,x,y,w,items,size=16,color=INK,accent=TEAL,gap=.48): for i,item in enumerate(items): cy=y+i*gap sh=slide.shapes.add_shape(MSO_SHAPE.OVAL, Inches(x), Inches(cy+.08), Inches(.12), Inches(.12)); sh.fill.solid();sh.fill.fore_color.rgb=accent;sh.line.color.rgb=accent text(slide,x+.22,cy,w-.22,.38,item,size,color) def metric(slide,x,y,w,h,num,label,accent=TEAL): rect(slide,x,y,w,h,PALE,True) rect(slide,x,y,.08,h,accent) text(slide,x+.25,y+.20,w-.35,.42,num,24,accent,True) text(slide,x+.25,y+.71,w-.35,.35,label,10,MUTED) def card(slide,x,y,w,h,head,body,accent=TEAL): rect(slide,x,y,w,h,PALE,True) rect(slide,x,y,w,.08,accent) text(slide,x+.22,y+.22,w-.44,.3,head,14,NAVY,True) text(slide,x+.22,y+.68,w-.44,h-.8,body,12,INK) def icon_circle(slide,x,y,letter,color): sh=slide.shapes.add_shape(MSO_SHAPE.OVAL, Inches(x),Inches(y), Inches(.48), Inches(.48));sh.fill.solid();sh.fill.fore_color.rgb=color;sh.line.color.rgb=color text(slide,x,y+.07,.48,.25,letter,14,WHITE,True,align=PP_ALIGN.CENTER) # 1 title s=prs.slides.add_slide(blank);bg(s,NAVY) # abstract maternal-fetal motif for x,y,r,c in [(10.6,.8,1.6,TEAL),(11.5,1.7,.65,AQUA),(9.9,4.9,1.0,CORAL),(10.85,5.55,.38,GOLD)]: sh=s.shapes.add_shape(MSO_SHAPE.OVAL,Inches(x),Inches(y),Inches(r),Inches(r));sh.fill.solid();sh.fill.fore_color.rgb=c;sh.fill.transparency=12;sh.line.color.rgb=c rect(s,.7,1.18,.08,4.65,TEAL) text(s,1.1,1.48,8.6,.5,'MATERNAL ADAPTATION',13,AQUA,True) text(s,1.08,2.02,8.7,1.4,'Physiological\nChanges in Pregnancy',36,WHITE,True) text(s,1.1,3.70,7.8,.7,'An organ-system approach to normal maternal adaptation, clinical interpretation, and red flags.',17,RGBColor(216,234,236)) text(s,1.1,5.72,4,.3,'Teaching presentation',11,AQUA,True) text(s,1.1,6.12,6,.3,'For medical and nursing learners',12,WHITE) #2 overview s=prs.slides.add_slide(blank);bg(s);title(s,2,'Why physiology changes in pregnancy','The objective is to meet fetal demands while preserving maternal homeostasis.') text(s,.72,1.28,3.1,.35,'The central drivers',15,NAVY,True) card(s,.72,1.78,3.75,1.25,'Hormonal milieu','Progesterone, estrogen, relaxin and placental hormones change vascular tone, ventilation and metabolism.',TEAL) card(s,.72,3.22,3.75,1.25,'Mechanical effects','The enlarging uterus elevates the diaphragm and compresses venous and urinary structures.',CORAL) card(s,.72,4.66,3.75,1.25,'Fetoplacental demand','Higher oxygen, nutrient and perfusion requirements reshape maternal circulation and metabolism.',GOLD) text(s,5.1,1.28,6.6,.35,'Timeline of adaptation',15,NAVY,True) for x,lab,desc,c in [(5.15,'1st trimester','Vasodilation and rising cardiac output begin early.',TEAL),(7.55,'2nd trimester','Peak fall in systemic vascular resistance and blood pressure.',AQUA),(9.95,'3rd trimester','Mechanical effects and oxygen demand are most prominent.',CORAL)]: icon_circle(s,x,2.0,lab[0],c); text(s,x,2.62,1.9,.25,lab,13,NAVY,True); text(s,x,3.06,1.9,.8,desc,11,INK) rect(s,5.25,4.58,6.5,.1,LIGHT) for x,c in [(5.3,TEAL),(7.7,AQUA),(10.1,CORAL)]: rect(s,x,4.42,1.35,.42,c,True) text(s,5.15,5.34,6.55,.44,'Most changes regress after delivery, but the immediate postpartum period includes major fluid shifts.',13,RED,True) #3 high yield s=prs.slides.add_slide(blank);bg(s);title(s,3,'High-yield changes at a glance','Approximate maximum changes in normal singleton pregnancy. Interpret in clinical context.') metrics=[('↑ 40%','Cardiac output',TEAL),('↑ 50%','GFR',AQUA),('↑ 50%','Minute ventilation',CORAL),('↓ 20%','Functional residual capacity',GOLD),('↓ 15%','PaCO₂ and HCO₃⁻',TEAL),('↑ 30-250%','Selected clotting factors',CORAL)] for i,(n,l,c) in enumerate(metrics): metric(s,.8+(i%3)*4.08,1.48+(i//3)*1.65,3.5,1.25,n,l,c) rect(s,.8,5.32,11.7,.94,NAVY,True) text(s,1.08,5.53,11.1,.42,'Clinical anchor: normal pregnancy is hypervolemic, mildly tachycardic, hyperventilatory, hypercoagulable and associated with lower serum creatinine.',15,WHITE,True,align=PP_ALIGN.CENTER) text(s,.85,6.48,11.5,.25,'Source: Morgan and Mikhail’s Clinical Anesthesiology, 7e, p. 1572.',9,MUTED) #4 CV s=prs.slides.add_slide(blank);bg(s);title(s,4,'Cardiovascular adaptation','A high-flow, low-resistance circulation supports uteroplacental perfusion.') metric(s,.7,1.35,2.55,1.12,'↑ 35-55%','Blood / plasma volume',TEAL) metric(s,3.48,1.35,2.55,1.12,'↑ 40%','Cardiac output',TEAL) metric(s,6.26,1.35,2.55,1.12,'↑ 20%','Heart rate',TEAL) metric(s,9.04,1.35,2.55,1.12,'↓ 15%','Diastolic BP',CORAL) card(s,.72,3.02,3.75,2.32,'Mechanisms','• Systemic vasodilation lowers SVR\n• Expanded plasma volume raises preload\n• Stroke volume and heart rate raise cardiac output',TEAL) card(s,4.78,3.02,3.75,2.32,'Expected findings','• Soft ejection systolic flow murmur\n• Bounding pulse\n• Physiological dependent edema may occur',AQUA) card(s,8.84,3.02,3.75,2.32,'Position matters','Supine uterus can compress the IVC, reducing venous return and causing hypotension. Use left lateral tilt when symptomatic.',CORAL) text(s,.78,5.78,11.6,.52,'Red flags: persistent hypertension, syncope, chest pain, dyspnea at rest, pulmonary edema or a diastolic murmur are not presumed physiological.',14,RED,True) #5 resp s=prs.slides.add_slide(blank);bg(s);title(s,5,'Respiratory adaptation','Progesterone-driven hyperventilation meets higher oxygen requirements.') metric(s,.75,1.32,2.7,1.15,'↑ up to 50%','Minute ventilation',CORAL) metric(s,3.72,1.32,2.7,1.15,'↑ 20-50%','Oxygen consumption',CORAL) metric(s,6.69,1.32,2.7,1.15,'↓ to 28-32','PaCO₂ (mm Hg)',TEAL) metric(s,9.66,1.32,2.7,1.15,'↓ up to 20%','FRC at term',GOLD) card(s,.78,3.02,3.75,2.18,'Acid-base pattern','Primary respiratory alkalosis is compensated by renal bicarbonate loss. Thus, a PaCO₂ near 40 mm Hg can be concerning in late pregnancy.',TEAL) card(s,4.79,3.02,3.75,2.18,'Anatomical adaptation','Diaphragm elevates as uterus enlarges. Chest AP diameter increases, while vital capacity is largely maintained.',AQUA) card(s,8.8,3.02,3.75,2.18,'Clinical consequence','Reduced FRC plus higher O₂ use means faster desaturation during apnea. Supine position can worsen atelectasis at term.',CORAL) text(s,.83,5.74,11.4,.3,'Common but assessable: mild exertional breathlessness. Concerning: cyanosis, hypoxemia, wheeze, fever, pleuritic pain or sudden dyspnea.',13,RED,True) #6 renal s=prs.slides.add_slide(blank);bg(s);title(s,6,'Renal and urinary adaptation','Renal vasodilation and higher perfusion alter laboratory interpretation and urinary anatomy.') metric(s,.75,1.28,2.7,1.15,'↑ up to 80%','Renal plasma flow',AQUA) metric(s,3.72,1.28,2.7,1.15,'↑ 40-50%','GFR by 2nd trimester',TEAL) metric(s,6.69,1.28,2.7,1.15,'↓','Serum creatinine',CORAL) metric(s,9.66,1.28,2.7,1.15,'↑','Urinary glucose / protein excretion',GOLD) card(s,.78,3.02,3.75,2.18,'Fluid & solutes','Lower serum osmolality and mild gestational hyponatremia result from altered water and electrolyte handling.',TEAL) card(s,4.79,3.02,3.75,2.18,'Collecting system','Progesterone plus uterine compression cause dilated renal pelvis, calyces and ureters, commonly greater on the right.',AQUA) card(s,8.8,3.02,3.75,2.18,'Clinical interpretation','A creatinine that looks “normal” outside pregnancy can be abnormal in pregnancy. Dilation promotes urinary stasis and infection risk.',CORAL) text(s,.83,5.74,11.4,.3,'Assess proteinuria, hypertension, rising creatinine, dysuria, fever or flank pain rather than attributing them to pregnancy alone.',13,RED,True) #7 blood s=prs.slides.add_slide(blank);bg(s);title(s,7,'Hematologic adaptation','Volume expansion exceeds red-cell expansion, while coagulation shifts toward hemostasis.') # balance diagram rect(s,.8,1.44,5.15,3.95,PALE,True); text(s,1.1,1.73,4.55,.3,'Physiological anemia',18,NAVY,True) text(s,1.18,2.29,4.2,.42,'Plasma volume expands disproportionately more than RBC mass.',14,INK) rect(s,1.18,3.08,3.9,.34,AQUA,True); text(s,1.32,3.12,3.3,.2,'PLASMA VOLUME ↑↑',11,NAVY,True,align=PP_ALIGN.CENTER) rect(s,1.18,3.64,2.55,.34,TEAL,True); text(s,1.26,3.68,2.3,.2,'RBC MASS ↑',11,WHITE,True,align=PP_ALIGN.CENTER) text(s,1.18,4.34,4.25,.5,'Result: hemoglobin and hematocrit fall despite increased total RBC mass.',13,INK) card(s,6.45,1.44,2.75,3.95,'Hypercoagulability','↑ Factors VIII, IX and X\n↑ Fibrinogen\nRelative fall in fibrinolysis\n\nPurpose: reduce blood loss at delivery.',CORAL) card(s,9.53,1.44,2.75,3.95,'Platelets & WBC','Mild fall in platelets may occur. Leukocytosis, especially around labor, may be physiological but must be interpreted with symptoms.',GOLD) text(s,.84,5.87,11.4,.35,'Clinical implication: pregnancy and puerperium increase venous thromboembolism risk. Evaluate significant anemia or thrombocytopenia rather than assuming a normal variant.',13,RED,True) #8 GI s=prs.slides.add_slide(blank);bg(s);title(s,8,'Gastrointestinal, hepatic and skin changes','Hormonal smooth-muscle relaxation and mechanical pressure explain many common symptoms.') items=[('GI motility','Progesterone reduces smooth-muscle tone: reflux, delayed gastric emptying and constipation are common.',TEAL),('Gallbladder','Reduced emptying and altered bile composition contribute to biliary stasis and gallstone tendency.',GOLD),('Liver tests','Alkaline phosphatase rises from placental production. Albumin falls by hemodilution. Marked AST/ALT elevation is not physiological.',CORAL),('Skin','Hyperpigmentation, linea nigra, melasma, striae and spider angiomas may occur.',AQUA)] for i,(h,b,c) in enumerate(items): x=.82+(i%2)*6.05;y=1.43+(i//2)*2.25;card(s,x,y,5.58,1.78,h,b,c) text(s,.85,6.18,11.5,.35,'Do not dismiss severe vomiting, jaundice, pruritus without rash, upper abdominal pain, GI bleeding or persistent weight loss as routine pregnancy symptoms.',13,RED,True) #9 endocrine metabolism s=prs.slides.add_slide(blank);bg(s);title(s,9,'Endocrine and metabolic adaptation','Pregnancy supports fetal nutrient delivery, creating a progressively insulin-resistant state.') card(s,.78,1.34,3.72,3.55,'Carbohydrate metabolism','Early pregnancy: increased insulin sensitivity and glycogen storage.\n\nLater pregnancy: placental hormones create insulin resistance, so maternal glucose is spared for the fetus.',TEAL) card(s,4.82,1.34,3.72,3.55,'Lipids & protein','Maternal triglycerides and cholesterol rise, especially late in gestation. Protein requirements increase. Fasting physiology favors lipolysis and ketone formation.',GOLD) card(s,8.86,1.34,3.72,3.55,'Endocrine axes','Total T4 and T3 rise because binding proteins rise. Total cortisol rises. The thyroid is stimulated transiently by hCG early in pregnancy.',CORAL) text(s,.86,5.43,11.4,.62,'Clinical interpretation: screening identifies gestational diabetes. Use pregnancy-specific reference ranges for thyroid and other laboratory tests where available.',14,NAVY,True,align=PP_ALIGN.CENTER) #10 MSK neuro s=prs.slides.add_slide(blank);bg(s);title(s,10,'Musculoskeletal, neurologic and sensory adaptation','Body mechanics and tissue laxity change as pregnancy progresses.') card(s,.78,1.42,3.72,1.68,'Posture & gait','Shifted center of gravity produces lumbar lordosis and altered gait. Back and pelvic girdle pain are common.',TEAL) card(s,4.82,1.42,3.72,1.68,'Ligaments & nerves','Relaxin-related laxity may contribute to pelvic discomfort. Edema can worsen carpal tunnel symptoms.',AQUA) card(s,8.86,1.42,3.72,1.68,'Sleep & CNS','Sleep disruption and fatigue are frequent. Reduced anesthetic requirements are relevant for anesthetic practice.',CORAL) card(s,.78,3.56,3.72,1.68,'Eyes','Corneal thickness and curvature may change slightly. Contact-lens tolerance may decrease.',GOLD) card(s,4.82,3.56,3.72,1.68,'Breasts','Enlargement, tenderness and colostrum production reflect estrogen, progesterone and prolactin effects.',TEAL) card(s,8.86,3.56,3.72,1.68,'Safety check','New focal neurologic deficit, severe headache, visual symptoms, seizures or sudden swelling require urgent assessment.',RED) #11 red flags s=prs.slides.add_slide(blank);bg(s);title(s,11,'Normal adaptation versus pathology','Physiology provides context, not permission to overlook danger signs.') headers=[('Often physiological','Assess promptly','Escalate urgently')] for x,h,c in [(.78,'Often physiological',TEAL),(4.82,'Assess promptly',GOLD),(8.86,'Escalate urgently',RED)]: rect(s,x,1.35,3.65,.52,c,True);text(s,x,1.48,3.65,.2,h,14,WHITE,True,align=PP_ALIGN.CENTER) bullet_list(s,.95,2.15,3.25,['Mild exertional dyspnea','Dependent ankle edema','Soft systolic flow murmur','Urinary frequency','Mild reflux / constipation'],14,INK,TEAL,.54) bullet_list(s,4.99,2.15,3.25,['Persistent BP elevation','Anemia or platelet decline','Raised creatinine for pregnancy','Dysuria, fever, flank pain','Abnormal liver enzymes'],14,INK,GOLD,.54) bullet_list(s,9.03,2.15,3.25,['Dyspnea at rest or hypoxemia','Chest pain, syncope, hemoptysis','Severe headache / visual change','Vaginal bleeding or seizures','Pulmonary edema signs'],14,INK,RED,.54) rect(s,.8,5.75,11.65,.7,NAVY,True);text(s,1.04,5.96,11.1,.25,'Assess gestational age, trajectory, vital signs and symptoms together. When uncertain, investigate rather than label a change physiological.',14,WHITE,True,align=PP_ALIGN.CENTER) #12 sources s=prs.slides.add_slide(blank);bg(s,NAVY) text(s,.72,.65,11.6,.45,'Key takeaways & sources',30,WHITE,True) rect(s,.72,1.32,1.1,.08,TEAL) text(s,.76,1.66,5.55,.3,'Takeaways',17,AQUA,True) bullet_list(s,.78,2.12,5.55,['Adaptations are coordinated across every organ system.','Normal pregnancy is high-output, low-resistance and hypercoagulable.','Use pregnancy-specific lab interpretation and symptom context.','Recognize red flags early, especially cardiorespiratory and hypertensive symptoms.'],15,WHITE,AQUA,.72) text(s,6.63,1.66,5.8,.3,'Selected sources',17,AQUA,True) refs=['Morgan and Mikhail’s Clinical Anesthesiology, 7e, pp. 1572-1574.','Comprehensive Clinical Nephrology, 7e, Kidney Physiology in Normal Pregnancy, pp. 1348-1349.','Wiles K, Brown MA. Kidney physiology and complications in normal pregnancy.','Physiological changes in pregnancy. PMC4928162.','Natural Physiological Changes During Pregnancy. PMC10964813.'] for i,r in enumerate(refs): text(s,6.67,2.15+i*.66,5.65,.48,r,12,WHITE) text(s,.75,6.72,11.5,.23,'Educational use only. Values are approximate and vary with gestation, baseline health and pregnancy characteristics.',10,RGBColor(205,224,227),align=PP_ALIGN.CENTER) # notes style default prs.core_properties.title='Physiological Changes in Pregnancy' prs.core_properties.subject='Maternal physiological adaptation' prs.core_properties.author='Orris' prs.save(OUT) print(OUT) ''') PY python "/tmp/workspace/pregnancy-physiology-ppt/src/create_presentation.py"

python - <<'PY' from pptx import Presentation from pathlib import Path p=Path('/tmp/workspace/pregnancy-physiology-ppt/output/Physiological_Changes_in_Pregnancy.pptx') prs=Presentation(str(p)) print('exists',p.exists(),'bytes',p.stat().st_size,'slides',len(prs.slides)) for i,sl in enumerate(prs.slides,1): txt=' | '.join(sh.text.replace('\n',' / ') for sh in sl.shapes if getattr(sh,'has_text_frame',False) and sh.text.strip()) print(i, txt[:190]) PY