a and p changes during pregnancy Flashcards
why are their physiological changes during pregnancy
Supports growth of developing fetus
Helps to sustain the pregnancy
Supports preparation for labour and birth
what is the function of HCG
produced by placenta after implantation , supports function of corpus luteum in early pregnancy
prolactin
main hormone used for breast milk contributes to the enlargement of the mammary glands
progesterone
helps establish the placenta stimulates growth of blood vessels and inhibits contractions of the uterus so it grows as the uterus does
oestrogen
help uterus grow maintains its lining and helps fetal organ development also helps with secretion of prolactin
relaxin
inhibits uterine contraction to prevent premature birth relaxes blood vessels increasing blood flow to the placenta
oxytocin
stimulates contractions , triggers production of prostaglandins
Describe the role of Relaxin in pregnancy, its effects on the body, and the related symptoms and changes a woman may experience during the first trimester.
Relaxin is produced primarily by the corpus luteum gravidiatis in the first trimester of pregnancy.
It is responsible for the softening of ligaments, especially those in the pelvic region, to facilitate childbirth.
Along with progesterone, relaxin contributes to uterine quiescence, ensuring the uterus remains calm and relaxed during pregnancy.
Relaxin is associated with several pregnancy-related symptoms, including:
Pelvic girdle pain and lower back pain due to the softening of ligaments and the growing baby.
Postural changes as the body grows; the abdomen changes from flat or concave (dished) to a convex (bulging) shape, increasing the curve of the back.
The changes in posture, along with looser ligaments, make the woman more prone to sprains and strains.
Explain the changes in uterine blood flow, cardiac output, and uterine growth during pregnancy, and the factors driving these changes.
Uterine blood flow progressively increases during pregnancy:
It is 50 ml/min at 10 weeks (10/40), and rises to 450-700 ml/min at 40 weeks (full term).
Enlarged vessels in the uterus can be heard on auscultation, producing a ‘soufflé’ sound due to increased blood flow.
The uterine demand on cardiac output also increases dramatically:
2% of cardiac output before pregnancy, rising to 20% by term, to meet the increased metabolic needs of the growing uterus.
Uterine growth occurs through two key processes:
Myometrial cell hyperplasia (increase in the number of muscle fibers) and hypertrophy (increase in the length and thickness of muscle fibers).
The growth is primarily driven by oestrogen and various growth factors.
Uterine growth occurs regardless of the site of implantation, including in cases of ectopic pregnancy.
As pregnancy progresses, distension (expansion from the pressure within) promotes further growth of the uterus.
what are Braxton hicks
xton Hicks;
Contractions prior to labour
Usually painless
Measurable from first trimester
Do not dilate cervix
Increase the blood circulation to the uterus and placenta
Usually more at night, less in the afternoon
Contractions of circular muscles are less frequent than longitudinal
Fetus pregnancy
Uterus
what happens to the cervix in pregnancy
ncreases in mass and width as pregnancy progresses
Remains approx. 2.5cm long throughout pregnancy
Blood supply increases, resulting in lilac colouration and softer texture
The epithelium in less robust and prone to bleeding with contact - e.g. coitus
Collagen fibre bundles become less-tightly bound
what happens to the mucosa in pregnancy
Mucosa proliferate and become more complex
Mucosa secrete thickened mucous
Mucous forms ‘plug’ - operculum
Operculum protects uterus from ascending infection
Cervix
what happens to the blood flow in the vulva and vagina
Results in softer vaginal tissue
Lilac colouration (Chadwick sign)
Pulsing of uterine arteries palpable in lateral fornices (historically Osiander sign)
Increased sensitivity - sometimes with increased sexual arousal
what happens to vaginal discharge in pregnancy
ncreased vaginal discharge - leucorrhoea;
Due to increased blood flow and increased cervical mucous
Low pH (acidic) - due to effect of oestrogen
Thick, white and inoffensive odour
what is Candida albicans
thrush
what happens to breast in pregnancy
reasts gradually increase in size as pregnancy progresses
Early pregnancy
Increased vascularisation - possible marble appearance
Breasts may feel full or tingle
Nipples
Areolar pigmentation increases - due to increased oestrogen and
progesterone
Montgomery tubercles enlarge and protrude
Nipples become more erect
what happens to the heart in pregnancy
Shift upwards and to left
Increased demand on heart
Increased cardiac output - influenced by posture
Increases in size - approx. 12%
Thickness of left ventricular wall increases by 28%
Atria increase in size due to increased venous return
Increased resting heart rate - by approx. 15bpm
Heart sounds alter
Up to 92% pregnant women/people develop innocent systolic murmur
what way does the heart shift
upwards and to the left
why does atria increase in size
due to increased venous return
what happen to the cardiovascular system in pregnancy
Haemodilution (Blood Dilution):
During pregnancy, blood volume increases by about 50% in the third trimester to meet the growing needs of the fetus.
This causes haemodilution, meaning the blood becomes less thick (lower viscosity), and the amount of circulating hemoglobin decreases.
Blood Pressure:
Oestrogen makes the walls of blood vessels more flexible by reducing collagen, which lowers resistance to blood flow.
Progesterone helps to relax the smooth muscle in blood vessels, allowing for easier blood flow.
Generally, blood pressure doesn’t change dramatically in a healthy pregnancy:
Systolic blood pressure (the top number) remains about the same.
Diastolic blood pressure (the bottom number) may be lower in the first two trimesters but returns to pre-pregnancy levels by the third trimester.
what happens to the capillaries in pregnancy
increase permeability
what happens to the veins in pregnancy
vasodilation increase Venus return
what are vairocosities
Varicosities
Experienced by up to 40% pregnant women/people
Abnormally dilated veins
Can occur due to oedema
Legs (also can occur on vulva and anus)
More likely if family history
Important to exclude VTE!
what happens to respiratory system
more oxygen consumption
what are the structural changes in the respiratory system
Respiratory volume reduced due to expanding uterine volume
Diaphragm displaced upwards by 4cm
Diameter of chest increases by 15cm to maintain volume of thoracic cavity
Lung capacity decreases by 5%
what does progesterone do to the respiratory system
decreases airway resistance
what complaint do women have with renal system
Increased urinary frequency
Urine leakage
Nocturia
Urinary Tract Infection (UTI)
how much can the bladder hold when pregnant
can hold up to 1L of urine
gastrointestinal changes
vomitting , reflux , constipation
why does reflux and constipation happen
Pressure of growing uterus
Displacement of organs
Prolonged gastric emptying
Decreased oesophageal sphincter tone
man suffering from crohns disease, male anatomy, inflamed large intestine, Sigmoid Colon, human digestive system parts, 3d render
Dental cartoon character 105 (bleeding when brush the tooth)
Gastrointestinal
Constipation;
Reduced gut motility
Iron supplementation
Altered diet
Slowed transit time - increased water absorption
cravings and aversion
Some dietary changes can be deliberate
Senses (taste and smell) may be enhanced
Change of senses reflect hCG levels
Sensitivity of many taste buds become decreased
Common cravings include fruit and strong flavoured foods
Common aversions include tea, coffee, meat, fried foods
Often dietary changes from cravings increase energy and calcium intake
what is pica
Extreme, persistent craving for non-nutritious substances
Examples include coal, soil, ice, soap, toothpaste and pencil shavings
Usually does not affect health
melasma
Irregular blotchy pigmentation,
Usually bilateral and symmetrical
Sometimes shape of butterfly - ‘mask of pregnancy’
45% - 75% pregnant women/people
striae gravidarium
stretch marks
sleep in pregnancy
disturbances Disturbances include;
Nocturia
Dyspnoea and nasal congestion
Reflux
Muscle aches, cramping and restless legs
Emotions - stress and anxiety
