2.5.2 Maternal Physiology Flashcards
What happens to coagulation factors during pregnancy?
Most all of the factors are increasingly produced
Is she in labor?
Left: No
Right: Yes
What happens to the urinary system during pregnancy?
Increase and GFR and renal plasma flow by 50%
How does the blood flow to the uterus change during pregnancy?
Total CO2 increases from 2 to 17%
What is preferred over warfarin during pregnancy?
Heparin
What are the two different ways the uterus changes in size during pregnancy?
70g to 1100g
10mL to 5000mL
Summarize the effects of pregnancy on the mother
What pregnancy complications are obese mothers at risk for?
What are some of the maternal cardiac changes?
What type of state is pregnancy?
“Hypercoaguable” state
What effect does volume expansion have on plasma osmolality?
Decreased osmolality (reducing oncotic forces)
What’s your impression? Plan? Interpretation?
What is preeclampsia?
Disorder of gestation characterized by HTN and proteinuria (5-10% of gestations)
How might the BP change during pregnancy?
Systolic: stable
Diastolic: decrease by 10 mm Hg
Contractions which do not lead directly to the dilation of the cervix
Braxton Hicks Contractions aka False Labor
What are some of the comparable symptoms of pregnancy and heart dz?
If a woman is in her reproductive years and not on any form of contraception, what is a good idea for that patient?
Take a prenatal vitamin
What are three purposes of physiologic anemia in pregnancy?
What effects will pregnancy have on asthmatic patients?
How does lung function change during pregnancy?
Diaphragm can rise 4cm. Reducing TLC, VC should be unaltered
What is a pontential source/etiology of pre-eclampsia?
Deficient uroplacental perfusion is a feature due to deficient trophoblast modeling of decidual arteries at the implantation site
Name conditon: gums soften and become hyperemic
Epulis
What happens hematologically during pregnancy?
Blood volume increase 45%
But the amount of RBCs only increases 33%
(Physiologic Anemia during Hypervolemia)
What are the two forces inducing the hypertrophy of the myometrium?
Estrogen (<12 wks)
Expanding force of pregnancy (>12 wks)
What are some characteristics of braxton hicks contractions?
Less rhythmic or predictable, less intense, spontaneously resolve
What is the iron requirements in a pregnant woman?
1000 mg
What happens to fibrinogen during pregnancy? Free S protein?
Fibrinogen - increases
Free S Protein - decreases
What happens to the pituitary gland during pregnancy?
Enlarges 135%, Prolactin increases from 15 to 150 ng/mL
How does glucose metabolism change during pregnancy?
There are greater spikes of glucose, but the glucose is utilized/resolved quickly
How does CO change over the course of pregnancy and labor?
What are some of the indicated mechanisms and consequences of pre-eclampsia?
How does the myometrium change during pregnancy?
Marked hypertrophy with limited production of new myocytes
What are the three components of virchow’s triad?
Vascular wall injury, hypercoaguable state, circulatory stasis
How does HCG production change over the course of pregnancy?
