2 Pregnancy Induced Changes Flashcards
Changes of the uterus shape ?
The shape is spherical but changes to cylindrical after 22 weeks , it starts growing towards the sternum as well.
Changes of the uterus size ( fundal height) ?
12 weeks : Above the symphysis pubis.
20 weeks At the umbilicus.
36 weeks at the xiphoid process.
36-40 weeks decrease of 4cm due to fetal head engagement.
Myometrial cell changes ? Braxton hicks ?
Hypertrophy and hyperplasia , myometrial cells increase in size and number.
Braxton hicks contractions usually could happen around 20 weeks or in third trimester , irregular , painless , uterus practicing for labor , triggered by dehydration , activity , a fully bladder
What about the changes of the cervix ?
Chadwick sign : 4th week increased blood flow bluish.
Goodells sign : Softening of cervix due to increased vascularization
Cervical ripening , occurs late in pregnancy , with collagen breakdown and increased water content to prep for labor
Changes in the vagina ?
Chadwick sign , vaginal secretions (acidic) to prevent infections , thickening of mucosa ( estrogen) , loosening of ligaments ,vaginal walls more elastic.
Changes in the ovaries ?
Ovarian follicles most undergo atresia , suppressed ovulation due to hcg and progesterone , ovaries increase in size , corpus luteum produces progesterone
Changes in mammary gland ?
Enlarged , pigmented areola , striae gravidarum ( stretch marks )
Colostrum , increased blood flow , enlarged areola to protect nipples during breastfeeding
Extragenital changes :
Skin
Hyperpigmentation , chloasma gravidarum ( darker patches on cheek)
linea nigra ( dark line crossing thru umbilicus ) , striae gravidarum
Extragenital changes :
Skeletal system
Relaxin hormone released from corpus luteum or placenta later , softens and loosens ligaments in pelvic area.
increased blood supply to bone marrow increase rbc production , calcium withdrawal from bones.
posture : proud gait ( forward leaning stance )
Extragenital changes :
digestive system
progesterone reduces smooth muscle tone , delaying peristalsis and causing bloating.
Bile stagnation (inter hepatic cholestasis ) increases risk for gall stones caused by high estrogen levels was it slows down bile movement also uterus pressure on gall bladder/ liver
Respiratory changes and cardiovascular
enlarged thoracic cage increases lung capacity.
blood vol increase by 50% causes physiological anemia , <100g/l hb , HR increase by 10-15bpm.
Weight gain 12kg
Why not to have excessive vitamin A?
Can be toxic
What causes linea nigra ?
The melanocyte-stimulating hormone created by the placenta causes melanin to rise during pregnancy.
What is physiological anema ?
Physiologic anemia occurs in pregnancy because plasma volume increases more quickly than red cell mass leading to lower heamoglobin levels
Hygiene during pregnancy
regular bathing to maintain hygiene and prevent infection especially in genital areas , avoid hot baths
