A nurse's handbook of obstetrics . uterus increases in size to makeroom for the growing foetus. It becomes more vascular andthe thickened, growing mucous membrane becomes the de-cidua of pregnancy. At the end of four months it has risenout of the pelvis. Its muscular walls become much stronger andmore active, and the abdomen must enlarge to accommodate thegrowing uterus. The mechanical effect of this distention of the abdominalwall causes, in the later months of pregnancy, the formationof certain reddish or bluish streaks in the skin covering thesides of the belly and the anterior and outer as
A nurse's handbook of obstetrics . uterus increases in size to makeroom for the growing foetus. It becomes more vascular andthe thickened, growing mucous membrane becomes the de-cidua of pregnancy. At the end of four months it has risenout of the pelvis. Its muscular walls become much stronger andmore active, and the abdomen must enlarge to accommodate thegrowing uterus. The mechanical effect of this distention of the abdominalwall causes, in the later months of pregnancy, the formationof certain reddish or bluish streaks in the skin covering thesides of the belly and the anterior and outer aspects of thethighs. These streaks are known as stria? gravidarum orlinea albicantes, and are due to the stretching, rupture, andatrophy of the deep connective tissue of the skin. They growlighter after labor has taken place, and finally take on the 67 68 A NURSES HANDBOOK OF OBSTETRICS. silvery whiteness of cicatricial tissue. In subsequent preg-nancies new reddish or bluish lines may be found mingled withold silvery white Fig. 30.—Striae gravidarum, or Linese albicantes, showing also abdominal pigmenta-tion especially marked around navel, and protrusion of umbilicus. Multigravida atterm. Twins. The number, size, and distribution of stria; gravidarum varyexceedingly in different women, and patients are occasionallyseen in whom there are no such markings whatever, even afterrepeated pregnancies. As the striae are due solely to the stretching of the cutis,they are not peculiar to pregnancy, but may be found in otherconditions which cause great abdominal distention, such asdropsy and the presence of large tumors of rapid growth. PHYSIOLOGY OF PREGNANCY. 69 Coincident with the uterine and abdominal enlargement theumbilicus is pushed upward until, at about the seventh month, itsdepression is completely obliterated and it forms merely a dark-ened area in the smooth and tense abdominal wall. Later it israised above the surrounding integument and projects to aboutthe size of
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