Normal changes during pregnancy that affect the heart and peripheral vasculature include

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Largely the result of an increase in plasma,blood volume increases by 30% to 50% (more with multiple births),thus increasing the cardiac output.Heart rate increases by 10 to 20 beats per minute.Systolic pressure is not significantly different throughout pregnancy,but diastolic pressure may lower by 5 mm Hg in the second trimester,then rise to first trimester levels after midpregnancy.Supine hypotension,resulting from the weight of the uterus on the inferior vena cava,is common.

Normal Changes During Pregnancy That Affect the Heart and Peripheral