Introduction

An understanding of the normal adaptive mechanisms in pregnancy is vital to enable accurate diagnosis, and to allow appropriate management of the critically ill obstetric patient. These remarkable changes begin soon after conception and continue with advancing gestation. Certain physical signs (e.g. resting sinus tachycardia, an ejection systolic murmur, or a third heart sound) considered abnormal in the non-pregnant woman may be normal findings in pregnancy. Conversely, what appears normal may be abnormal; some pathological conditions (e.g. pre-eclampsia) arising during pregnancy are, at least in part, a result of failure to adapt adequately to the pregnant state. Therefore a comprehensive understanding of the fundamental changes occurring within the different systems of the body during normal and abnormal pregnancy is required.

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