08.2 Maternal Adaptations in Pregnancy

Question 1

What happens to the mother’s blood pressure in pregnancy?

Answer 1

Decreases then returns to normal in T3

Question 2

What happens to TPR and CO in pregnancy?

Answer 2

TPR decreases

CO increases

Question 3

What happens to GFR in pregnancy?

Answer 3

Increases

Question 4

What happens to serum urea and creatine in pregnancy?

Answer 4

Decreases

Question 5

Why would pylenophritis be more common in pregnant women?

Answer 5

Hydroureter increases the likelihood as the ureters become dilated

Question 6

What happens to the diaphragm in pregnancy?

Answer 6

Displaced upwards as uterus enlarges

The AP diameter of the thorax increases

Question 7

What happens to ventilation rate in pregnancy?

Answer 7

Increases

Question 8

What happens to the acid base balance due to the hyperventilation that occurs in pregnancy?

Answer 8

Respiratory alkalosis that is then compensated for by excreting HCO3-

Question 9

What specifics happen in terms of metabolism in pregnancy?

Answer 9

Insulin resistance (blood glucose increases a lot after eating)
T3+T4 raised

Question 10

What happens to the GI system during pregnancy?

Answer 10

Appendix moves to the upper right quadrant

Smooth muscle relaxation = constipation, biliary stasis, pancreatitis

Question 11

In pregnancy the mother’s blood is prothrombotic, can you give warfarin to reduce the chance of DVT?

Answer 11

No as warfarin crosses the placenta and is teratogenic

Question 12

What causes anaemia in pregnant women?

Answer 12

Plasma volume increasing and RBC mass not increasing by enough

Question 13

What happens to the immune system in pregnancy?

Answer 13

Locally suppressed as the foetus is technically an allograft

This means the mother is susceptible to infection