CVS change in pregnancy -

Ans. is 'b' i.e., Slight left axis deviation in ECG Cardiovascular systemo Anatomical changes heart is pushed upwards & outward. Apex beat is shifted in 4th intercostals space. A systolic murmur can be heard in apical or pulmonary area. Mammary' murmur is a continuous hissing murmur audible over tricuspid area in left 2nd & 3rd intercostals space. ECG shows left axis deviation. S3 and rarely S4 can be heard.o Cardiac output starts to increase from 5th week of pregnancy, reaches its peak 40-50% at about 30-34 weeks. It is lowest in sitting or supine position & highest is the right or left lateral or knee chest position. CO further increases by 50% during labour and immediately following delivery. CO returns to pre labour values by one hour following delivery and to the pre-pregnant level by another 4 weeks,o Blood pressure systemic vascular resistance (SVR) decreases. Maternal BP is decreased,o Venous pressure femoral venous pressure is raised,o Supine hypotension syndrome (postural hypotension)o Regional distribution of blood flow uterine blood flow is increased from 50 ml per minute in non-pregnant state to 750ml near term. Pulmonary blood flow is increased by 2500 ml /minrenal blood flow increases by 400ml/min. The blood flow through skin and mucous membrane increases by 500ml/min.