16 - Repro - Pregnancy 2 Flashcards

1
Q

What change occurs to the maternal blood volume during pregnancy? Why?

A

Blood volume increases ~ 50%

  • To supply growing foetus
  • To supply overactive kidneys
  • In anticipation of ~500 ml blood loss @ birth
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2
Q

What change occurs to the maternal cardiac output during pregnancy? Why does this occur?

A

Increases ~ 40%

  • Due to increase in blood volume = increased stroke volume
  • Slight increase in heart rate
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3
Q

What is the average heart rate of the mother during pregnancy?

A

~ 80-90 bpm

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4
Q

What changes to the maternal heart may you notice on auscultation/palpation?

A
  • Hypertrophied
  • Upwards displacement
  • Flow murmurs
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5
Q

What change occurs to maternal GFR during pregnancy, and how does this affect creatinine clearance?

A
  • Increased GFR

- Increased creatinine clearance

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6
Q

What causes pregnant women to be at increased risk of developing hydroureter and UTI’s?

A
  • Gravid uterus may compress ureter’s against pelvic brim

- Progesterone causes relaxation of smooth muscle in walls of ureters and bladder, causing urinary stasis

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7
Q

What affect does progesterone have on the maternal respiratory system? Why does it do this?

A

Progesterone drives hyperventilation:

  • Increases excretion of CO2
  • Maintains CO2 gradient from foetus to mother
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8
Q

Why are pregnant women at risk of developing respiratory alkalosis?

A

Progesterone causes hyperventilation

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9
Q

What change occurs to the maternal O2 consumption during pregnancy?

A

Increases ~ 15%

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10
Q

What change occurs to the maternal tidal volume during pregnancy? How does this not affect the vital capacity?

A

Increases ~ 40 %

  • Doesn’t affect vital capacity as the functional residual capacity decreases during pregnancy
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11
Q

What change occurs to the maternal respiratory rate during pregnancy?

A

No change

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12
Q

What change occurs to the amount of insulin released into the maternal bloodstream after a meal, particularly in early pregnancy? Why does this occur?

A

Increased insulin release
= Increased uptake of glucose into body cells
= More energy stored in body, to be used by foetus in later stages of pregnancy

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13
Q

Why do levels of free fatty acids, ketones and triglycerides rise in the maternal serum as pregnancy progesses?

A
  • hPL increases maternal resistance to insulin, allowing increased glucose availability to foetus
  • This forces mother to switch to gluconeogenesis and lipolysis, to generate alternative fuels for her body cells
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14
Q

Why do levels of Calcitriol rise in the mother during pregnancy?

A
  • Increase Ca2+ absorption from the gut

- Used for foetal growth and bone development

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15
Q

What change occurs to the appendix during pregnancy?

A

Moves up towards RUQ due to displacement by the uterus

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16
Q

Why is venous engorgement and distention associated with late pregnancy? What problems may this cause?

A
  • Gravid uterus compresses IVC
  • Progesterone causes venodilation
  • Oedema
  • Haemorrhoids
  • Varicose veins
17
Q

Why are pregnant women said to be in a ‘hypercoagulable state’?

A
  • Increased fibrinogen and clotting factors
  • Decreased fibrinolysis
  • Stasis (IVC compression + venodilation)
18
Q

Why do pregnant women suffer physiological dilutional anaemia?

A
  • Plasma volume increases ~ 50%
  • Red blood cell number increases ~ 20/30%

= Diluted blood

19
Q

List some foetal problems associated with gestational diabetes:

A
  • Macrosomia
  • Shoulder dystocia
  • Brain damage due to reflex hypoglycaemia
  • Prematurity
  • Newborn respiratory disorders
  • Cardiac defects
  • Neural tube defects
  • Polycythemia
20
Q

What are some problem associated with maternal anaemia?

A
  • Foetal growth retardation
  • Maternal mortality
  • Stillbirth
21
Q

What is the Barker hypothesis?

A

Decreased foetal growth may lead to chronic adult conditions such as DMII, CVD, hypertension etc.