Antepartum (Physiological changes in Pregnancy) Flashcards
What does increased vascularity of the vagina and other pelvic viscera result in?
This leads to edema and increased sensitivity (this increased sensitivity may result in increased sexual interest during the 2dn trimester)
What happens to the PH in the vagina during pregnancy?
It lowers to a range of 3.5 - 6.0
What is the third trimester?
28 weeks through 40 completed weeks
What is commonly measured to estimate the duration of a pregnancy?
The Fundus
What are the 3 factors that decrease blood flow to the uterus?
1.) Low arterial pressure
2.) Contractions of the uterus
3.) Supine position
What is the shape of the uterus in the second trimester?
As the muscular walls strengthen and become more elastic, the uterus becomes “spherical or globular”
What happens at 28 weeks with Braxton Hicks? What elivates them?
They become more definite and are alleviated with walking or exercise
What hormone increases blood flow to the uterus?
Estrogen
What happens to our circulation and coagulation “system” during pregnacy?
Pregnancy is considered a hypercoagulable state in which patients are at at a 5 - 6 times increased risk for thromboembolic disease/
(Circulation time decreases slightly by week 32 but returns to near normal by term)
What is the first trimester?
First day of LMP through 12 completed weeks
What do Montgomery Tubercles do?
They are bumps on that develop on the areolas that secrete substances to lubricate and provide anti-infective agents to protect breasts during breastfeeding
What neuro symptoms occur during pregnancy? (7)
1.) Compression of pelvic nerves may cause leg sensations to change
2.) Edema involving peripheral nerves may lead to carpal tunnel syndrome during last trimester
3.) Stooped shoulder may compress nerves in arm leading to hand numbness
4.) Tension headaches
5.) Light-headedness and syncope may happen in 1st trimester
6.) Hypocalcemia may lead to muscle cramps
7.) Corneal thickening and decreased intraocular pressure can occur but resolves shortly after pregnancy
What do Braxton Hicks Contraction facilitate?
They facilitate uterine blood flow through the intervillous spaces of the placenta and promote oxygen delivery to the fetus
What can ultrasound measure? What at risk conditions is it especially used for?
Ultrasound can measure the bloodflow and is used for pregnancies at risk due to:
1.) HTN
2.) Intrauterine growth restriction
3.) DM
4.) Multiple gestation
When/how is renal function most efficient during pregnancy? When is it least efficient? Why?
Renal function most efficient when Pt lays on side or is in a lateral recumbent position and is least effective when the patient assumes a supine position
A side-lying position increases renal perfusion, which increases urine output and decreases edema.
What are the 3 categories of changes in pregnancy?
Presumptive – subjective changes reported by Pt
Probable – objective changes assed by an examiner. When combined with presumptive, they strongly suggest pregnancy
Positive – signs assessed by examiner can only be attributed to presence of fetus
What happens to blood flow to the kidneys if a pregnant patient is lying in a supine position.
If patient is lying supine, the heavy uterus compresses the vena cava and aorta, which reduces cardiac output. As a result blood flow to the kindeys is reduced so that it may go to the brain and heart.
At 3 months gestation what is the Fundus starting to put pressure on? What does it cause?
The finds starts to put pressure on the bladder causing increased urinary frequency
What happens to the GI system during pregnancy? (10 of them)
1.) Morning sickness (70-80% experience) - NVP can occur which typically goes away after first trimester
2.) By end of second semester appetitive increases in response to increasing metabolic needs
3.) Patients may have changes in their taste lading to cravings - this can lead to “pica”
4.) Gums may swell and bleed
5.) Excessive salivation (ptyalism)
6.) Pyrosis (heartburn)
7.) Consitpation (this can be caused by the increase in water absorption from the colon or diet, ecxersise, etc)
8.) Decerase in gut biodome diversity
9.) Develpoemnt of gllstones
10.) Inta-abdominal discomfort (from shifting of internal organs)
What happens/occurs to the breasts during pregnancy? (5 things)
1.) Fulness and heightened sensitivity due to estrogen and progesterone increases (this sensitivity could be mild tingling to sharp pain)
2.) Pigmented nipples and areolas
3.) Pronounced Montgomery Tubercles (bumps on areolas)
4.) Visible veins
5.) Enlargement of breast from mammary glands in 3rd trimester (results in tissue becoming softer and looser)
What is the increase in total body water during pregnancy? WHat must the body due to “componsate” for this increase?
6.5 - 8.5L - To stay balanced the body must maintain more sodium
During pregnancy, what does the microbiome prevent?
Microbiome prevents ascending bacterial infections (However, during pregnancy the patient is more vulnerable to yeast infections
What happens to RBC count, Hemoglobin and hematocrit count, and WBC during pregnancy?
RBC ↑17%
Hemoglobin and hematocrit decrease
WBC increase 2nd and 3rd trimester
What happens to the respiratory system during pregnancy?
1.) Increase of 20-40% in O2 consumption
2.) Diaphragm is pushed up thus the ribcage also expands
3.) Tidal volume increased 40% but Resp rate stays the same (or might slightly increase)
