Systemic changes in the active phase of labor

This table shows the systemic changes that occur during the active phase of labor.

System	Change
Cardiovascular	Increased blood pressure Increased cardiac output Supine hypotension
Respiratory	Increased oxygen consumption Increased rate Possible hyperventilation leading to respiratory alkalosis, hypoxia, and hypercapnia (if breathing isn’t controlled)
Neurologic	Increased pain threshold and sedation caused by endogenous endorphins Anesthetized perineal tissues caused by constant intense pressure on nerve endings
GI	Dehydration Decreased motility Slow absorption of solid food Nausea Diarrhea
Musculoskeletal	Diaphoresis Fatigue Backache Joint pain Leg cramps
Endocrine	Decreased progesterone level Increased estrogen level Increased prostaglandin level Increased oxytocin level Increased metabolism Decreased blood glucose
Renal	Difficulty voiding Proteinuria (1+ normal)

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