6.2b Cardiovascular System

Question 1

Physiological Changes

Answer 1

• First few days plasma volume decreases from diuresis
  COPING WITH BLOOD LOSS
• Elimination of placental circulation
• Loss of placental endocrine function (vasodilation)
• Mobilization of extravascular water stored during pregnancy

Question 2

Cardiac Output

Answer 2

• Pulse, Stroke volume, CO, increase during pregnancy
• After birth, blood loss reduces plasma volume but does not reduce CO
• Due to compensation from 500 mL of blood coming from uteroplacental blood into mothers circulation
• There is also a rapid decrease in uterine flow
• Mobilization of extracellular fluid

Question 3

VS

Answer 3

• HR increased after birth and can last an hour
• Puerperal (after birth) bradycardia common reduces 40-50 bpm
• 5% increase in BP first few days
• Weeks-Months for BP to return to normal
• 140/90 or greater on 2 occasions is gestational hypertension or preeclampsia
• Fever is common in first 24 hours
• Fever during first 10 days may indicate infection
• RR is normal almost immediately after birth

Question 4

Varicosities

Answer 4

• Varices (legs) and hemorrhoids (anus) are common.

Question 5

Blood Components

Answer 5

• Normal blood loss hematocrit drops moderately for 3-4 days then increases. Normal by 8 weeks
• WBC rise which may obscure diagnosis of infection
• Hypercoagulability increases risk for thromboembolism (especially after c-section)