CLINICIAN’S CORNERCLINICAL REVIEW Manifestations of Chronic Disease During Pregnancy

MANYPHYSIOLOGICCHANGESoccur in pregnancy, be-ginning early in gesta-tion. These changes al-low themother to tolerate the genetically incompatible fetoplacental unit, adapt her physiologic makeup to nourish and support itsdevelopment, andprepareher for the hazards of delivery. As a conse-quence, these complex adaptations ren-der her insulin-resistant, thrombo-philic, relatively immunosuppressed, and hypervolemic. Healthy young women generally cope well with these physi-ologic changes,withpregnancyproceed-ing uneventfully to term. However, physiologic changes can interactwith an inherited or acquired predisposition t