Common symptoms during pregnancy

The profound anatomical and physiological changes that occur in the mother as adaptation to normal pregnancy can result in a number of symptoms and signs that overlap with those associated with disease outside of pregnancy. These include palpitations, peripheral oedema, dyspnoea, and pruritus. Underlying cardiovascular and respiratory changes include increased cardiac output, heart rate, tidal volume and minute ventilation, and fall in blood pressure. Adaptations in other organ systems include increased glomerular filtration rate, reduced gastrointestinal motility, and hyperpigmentation.Most of the symptoms and signs are benign, but clinicians need to be aware of those which warrant further investigation and may be associated with disease. These would include dyspnoea associated with more worrying features such as chest pain or haemoptysis, or hyperpigmentation which is generalized rather than localized.In women with pre-existing disease, awareness of the normal adaptation to pregnancy is crucial in tailoring management, as symptoms may worsen or improve depending on the system involved. The stress of pregnancy may also result in previously sub-clinical disease presenting for the first time.