Regarding physiologic changes in pregnancy, which description reflects the change in total body water reported by Dr. Fabry?

• A. Decrease in total body water
• B. No change in total body water
• C. Increase in total body water from 5 L to 6-8 L, with edema in extremities
• D. Decrease in extracellular fluid

Answer: (C)

During pregnancy the body expands its fluid compartments to support the growing fetus, leading to an overall increase in total body water. Hormonal and hemodynamic changes promote sodium and water retention and a substantial rise in plasma volume, so total body water increases—often described as moving from about 5 L to roughly 6–8 L—with edema in the extremities due to higher extracellular fluid and venous pooling. Dr. Fabry’s description reflects this adaptation: a rise in total body water with edema. Choices that propose a decrease or no change don’t fit the known physiologic changes in pregnancy, and a decrease in extracellular fluid wouldn’t account for the edema observed.