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Semester 4- Reproduction > 8.2 Maternal Problems in Pregnancy > Flashcards

8.2 Maternal Problems in Pregnancy Flashcards

1
Q

Why does blood volume increase in pregnancy?

A

Compensate for blood loss in pregnancy

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2
Q

In the CVS, which things increase in function?

A

Cardiac output
Stroke volume
Heart rate
Pre-load

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3
Q

In the CVS, which things decrease in function?

A

Systemic vascular resistance

After-load

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4
Q

Describe the changes in blood pressure throughout a pregnancy

A

Trimester 1 and 2- decreases

Trimester 3- goes back to normal

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5
Q

Why is systemic peripheral resistance reduced in T1 and 2?

A

Progesterone causes vasodilation

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6
Q

Why does blood pressure return to normal (increase from hypotension) in trimester 3?

A

Pressure on aorta and IVC from uterus

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7
Q

What happens in pre-eclampsia with regard to the endothelium of the vessel walls and the plasma?

A

Plasma is contracted

Endothelium is contracted

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8
Q

In pregnancy what happens to GFR?

A

Increases

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9
Q

Why does the functional renal reserve decrease in pregnancy?

A

Progesterone dilates the efferent and afferent arterioles meaning it is hard to increase the GFR through vasodilation. Less capacity to compensate for a drop in GFR

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10
Q

What happens to the levels of urea and creatinine in pregnancy?

A

Decrease

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11
Q

What is a hydroureter?

A

Dilation of the ureter or obstruction causes urinary stasis

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12
Q

What happens to the vital capacity in pregnancy?

A

Does not change

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13
Q

What happens to the tidal volume in pregnancy?

A

Increases

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14
Q

What happens to the functional residual volume in pregnancy?

A

Decreases

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15
Q

Why does physiological hyperventilation occur in pregnancy?

A

Breathe more O2 to remove excess CO2 from the fetus.

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16
Q

How is physiological hyperventilation compensated for by the body in pregnancy?

A

Increased renal bicarbomnate excretion.

Body will struggle to cope with compensating for metabolic acidosis

17
Q

Why does physiological dyspnoea occur in pregnancy?

A

Progesterone-driven hyperventilation means the patient can feel themselves breathing more deeply

18
Q

What happens to maternal insulin resistance levels in pregnancy?

A

Increase so the mother switches to gluconeogenesis. Glucose is passed through the placenta to the fetus

19
Q

What hormone increases the mother’s resistance to insulin?

A

hPL (human placental lactogen)

20
Q

What is gestational diabetes?

A

Insulin resistance increases too much so mother develops hyperglycaemia

21
Q

What affect on the fetus does gestational diabetes have?

A

Macrosomia (large fetus)

22
Q

Describe the changes in fat metabolism throughout pregnancy

A

T1- increase in fat stores

T2- increase in lipolysis and plasma free fatty acids

23
Q

Why are fat stores important for the mother in late pregnancy?

A

Mother uses fat stores as energy supply. Fat cannot cross the placenta so fetus does not take away energy

24
Q

What is the mother at risk of in T2 when using fatty acids as an energy source?

A

Ketoacidosis

25
Q

What happens to levels of T3 and T4 in pregnancy?

A

Increased

Free T4 remains the same due to equal increase in thyroid binding globulin

26
Q

What GI complications can arise in pregnancy?

A

Complications due to stasis:
Gall stones
Constipation
Pancreatitis

27
Q

How does the composition of the mother’s blood change in pregnancy?

A

Increased fibrinogen
Increased clotting factors
Reduced fibrinolysis

28
Q

What is thromboembolic disease?

A

Excess clotting factors cause inappropriate clots in vessels

29
Q

Why can warfarin not be used to thin the blood in pregnancy?

A

Teratogen in pregnancy

30
Q

Why can physiological anaemia occur in pregnancy?

A

Plasma volume increases and RBC mass increases but not as much resulting in a dilation of RBCs in plasma.
May also develop an iron or folate deficiency

31
Q

How is the maternal body adapted to not reject the fetus?

A

Local immune system at materno-fetal interface is reduced

32
Q

What is thyroiditis?

A

Antibodies against the thyroid can be transferred to the fetus

Semester 4- Reproduction (17 decks)

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