3. Pregnancy: Maternal Adaptations Flashcards
List 8 factors that influence adaptation to pregnancy
Age Parity Previous experience (obstetric) Body build ; BMI Preexisting disease Socio-economic factors Ethnic, geographic, climactic variables No. and size of conceptus
List two general effects of pregnancy on the mother
Gain in body water Weight gain (lordosis: backache, cramps, nerve compression)
What is the approximate weight gain of the mother in pregnancy
7kg
What effect does pregnancy have on Cardiac Output
Raised Cardiac Output by 1.5l/min by 10 weeks
What is the effect of pregnancy on pulse rate
Pulse rate raised by 15bpm
What is the effect of Pregnancy on pulse pressure
Raised pulse pressure
What is the effect of Pregnancy on Peripheral Resistance
Fall in Peripheral resistance (vasodilation)
What is the effect of Pregnancy on the position of the heart
Heart pushed upwards and rotates forwards
What is the effect of Pregnancy on the size of the heart
Heart enlargement
What is the effect of pregnancy on diastolic blood pressure
Diastolic pressure falls by 10-15mmhg by 2nd Trimester
There is a 50% increase in flow to which organs during pregnancy
Uterus
Kidney
Skin
How does pregnancy affect the chest shape of the mother
Flaring of the ribs
Diaphragm raised
What is the effect of Pregnancy on maternal pCO2
pCO2 lowered
What is the effect of Pregnancy on maternal ventilation
Raised maternal ventilation
What is the effect of Pregnancy on vital capacity and tidal volume
Tidal volume increases by 200ml (normal 500ml)
Vital capacity increases by 200ml (normal 3000-5000ml)
What is the effect of Pregnancy on red cell mass
Red cell mass increases by 20%
What is the effect of Pregnancy on plasma volume
Plasma volume Increases by 50%
What is the effect of Pregnancy on red cell volume
Red cell volume rises
What is the effect of Pregnancy on platelets
Platelets decreased
What is the effect of Pregnancy on clotting factors and fibrinogen
Raised clotting factors and fibrinogen
What are the changes seen in the uterus in pregnancy
- Increase in size and weight of the uterus (10x) ; hyperplasia and hypertrophy
What changes in the Myometrial syncytium are seen in pregnancy
More gap junctions and oxytocin receptors
What changes are seen in the cervix in pregnancy
Less collagen as term approaches
What changes are seen in the vagina during pregnancy
More glycogen in cells
What is the effect of Pregnancy on Glomerular Filtration Rate
50% increase
List five effects of pregnancy on the Kidney and Urinary Tract
50% increase in GFR
Increased urine production
Extrinsic Bladder compression
Frequency of micturition, nocturia, stress incontinence
What changes are seen in the mouth during pregnancy
Taste change
Ptyalism
Pica
What effect does pregnancy have in the stomach
Reflux, hyperacidity, reduced emptying
What effect does pregnancy have on the intestine
Better fluid absorption
~ constipation
What effect does pregnancy have on the liver and gall bladder
Cholestasis
List 7 changes seen in the skin seen in pregnancy
Increased skin pigmentation Facial chloasma Striae Vasodilation Spider nevi Postnatal shedding of hair and nails Pregnancy prurigo (itchy skin papules)
How is glucose transferred to the fetus
Facilitated diffusion through placenta in membrane vesicles
Does insulin cross the placenta
Nope
True or false
Fetal hyperinsulinemia promotes transfer of glucose
True
What is the effect of maternal hyperglycemia on the fetus
May exaggerate fetal insulin response leading to fetopathy
What is the normal weight and length of a 16 week fetus
100gms
14-17 cm long
What is the normal weight of a 24 week fetus
600 gms
Fat deposition starts at which week in the fetus
24 weeks
What is the normal weight and length of a 28 week fetus
1050gms
37cm long
What is the normal weight and length of a 32 week fetus
1700gms
42 cm long
What is the normal weight and length of a 36 week fetus
2500 gms
47cm long
What is the normal weight and length of a 40 week fetus
3200-3500gms
50cm long
When does the fetus start its own production of insulin
12 weeks
True or False
Thyroid Stimulating Hormone TSH, crosses the placenta
False
In fetal circulation, what percentage of cardiac output goes to umbilical arteries
60%
When does Fetal circulation start
5weeks
When does fetal erythropoeisis start
By 6 weeks
Which Haemoglobin is dominant in fetal blood by 8 weeks
HbF
What is the main source of Amniotic Fluid
Fetal Urinary Tract
What is the result of obstruction to the Fetal Urinary Tract
Oligohydramnios