Pregnancy is associated with profound anatomical, physiological, biochemical and endocrine changes that affect multiple organs and systems. Red blood cell (RBC) volume falls during the first 8 weeks of pregnancy, increasing back to non-pregnant levels by 16 weeks and then rising to 30 percentage above non-pregnant levels by term. Marked physiological changes of cardiovascular system, respiratory system, renal system, and gastrointestinal system are significantly observed. During pregnancy the skin undergoes a number of changes, mainly thought to be due to hormonal changes. The additional demand for folate during pregnancy leads to a rapid fall in red cell folate and to a high incidence of megaloblastic anaemia in those women taking anticonvulsant drugs for control of epilepsy. For appendicectomy the type of incision depends on the gestation and the location of the appendix. The routine use of urinalysis for monitoring of glycaemic control during pregnancy is unreliable.