2.5.2 Maternal Physiology

Question 1

What happens to coagulation factors during pregnancy?

Answer 1

Most all of the factors are increasingly produced

Question 2

Is she in labor?

Answer 2

Left: No

Right: Yes

Question 3

What happens to the urinary system during pregnancy?

Answer 3

Increase and GFR and renal plasma flow by 50%

Question 4

How does the blood flow to the uterus change during pregnancy?

Answer 4

Total CO2 increases from 2 to 17%

Question 5

What is preferred over warfarin during pregnancy?

Answer 5

Heparin

Question 6

What are the two different ways the uterus changes in size during pregnancy?

Answer 6

70g to 1100g

10mL to 5000mL

Question 7

Summarize the effects of pregnancy on the mother

Answer 7

Question 8

What pregnancy complications are obese mothers at risk for?

Answer 8

Question 9

What are some of the maternal cardiac changes?

Answer 9

Question 10

What type of state is pregnancy?

Answer 10

“Hypercoaguable” state

Question 11

What effect does volume expansion have on plasma osmolality?

Answer 11

Decreased osmolality (reducing oncotic forces)

Question 12

What’s your impression? Plan? Interpretation?

Answer 12

Question 13

What is preeclampsia?

Answer 13

Disorder of gestation characterized by HTN and proteinuria (5-10% of gestations)

Question 14

How might the BP change during pregnancy?

Answer 14

Systolic: stable

Diastolic: decrease by 10 mm Hg

Question 15

Contractions which do not lead directly to the dilation of the cervix

Answer 15

Braxton Hicks Contractions aka False Labor

Question 16

What are some of the comparable symptoms of pregnancy and heart dz?

Answer 16

Question 17

If a woman is in her reproductive years and not on any form of contraception, what is a good idea for that patient?

Answer 17

Take a prenatal vitamin

Question 18

What are three purposes of physiologic anemia in pregnancy?

Answer 18

Question 19

What effects will pregnancy have on asthmatic patients?

Answer 19

Question 20

How does lung function change during pregnancy?

Answer 20

Diaphragm can rise 4cm. Reducing TLC, VC should be unaltered

Question 21

What is a pontential source/etiology of pre-eclampsia?

Answer 21

Deficient uroplacental perfusion is a feature due to deficient trophoblast modeling of decidual arteries at the implantation site

Question 22

Name conditon: gums soften and become hyperemic

Answer 22

Epulis

Question 23

What happens hematologically during pregnancy?

Answer 23

Blood volume increase 45%

But the amount of RBCs only increases 33%

(Physiologic Anemia during Hypervolemia)

Question 24

What are the two forces inducing the hypertrophy of the myometrium?

Answer 24

Estrogen (<12 wks)

Expanding force of pregnancy (>12 wks)

Question 25

What are some characteristics of braxton hicks contractions?

Answer 25

Less rhythmic or predictable, less intense, spontaneously resolve

Question 26

What is the iron requirements in a pregnant woman?

Answer 26

1000 mg

Question 27

What happens to fibrinogen during pregnancy? Free S protein?

Answer 27

Fibrinogen - increases

Free S Protein - decreases

Question 28

What happens to the pituitary gland during pregnancy?

Answer 28

Enlarges 135%, Prolactin increases from 15 to 150 ng/mL

Question 29

How does glucose metabolism change during pregnancy?

Answer 29

There are greater spikes of glucose, but the glucose is utilized/resolved quickly

Question 30

How does CO change over the course of pregnancy and labor?

Answer 30

Question 31

What are some of the indicated mechanisms and consequences of pre-eclampsia?

Answer 31

Question 32

How does the myometrium change during pregnancy?

Answer 32

Marked hypertrophy with limited production of new myocytes

Question 33

What are the three components of virchow’s triad?

Answer 33

Vascular wall injury, hypercoaguable state, circulatory stasis

Question 34

How does HCG production change over the course of pregnancy?

Answer 34