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Apex 11 Obstetrics > Cardiovascular Physiological Changes During Pregnancy > Flashcards

Cardiovascular Physiological Changes During Pregnancy Flashcards

1
Q

Cardiac output increases by ___________ during pregnancy

A

40 %

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2
Q

The uterus receives _______ of the cardiac output

A

10%

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3
Q

How does uterine contraction affect cardiac output

A

Uterine contraction causes autotransfusion resulting in increased preload

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4
Q

Heart rate increases by ______ during pregnancy

A

15 %

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5
Q

Stroke volume increases by ________

A

30 %

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6
Q

How is CO affected during the various stages of labor

A
  • 1st stage: 20% increase
  • 2nd stage: 50% increase
  • 3rd stage: 80% increase
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7
Q

CO returns to pre labor values in _______ hours

A

24-48 hrs

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8
Q

CO returns to pre-pregnancy values within?

A

Approximately 2 weeks

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9
Q

How does a twin pregnancy affect cardiac output

A

It increases CO above a single fetus pregnancy

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10
Q

How is MAP affected in pregnancy

A

no change

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11
Q

How is SBP affected in pregnancy

A

No change

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12
Q

How is DBP affected

A

DBP decreases by 15%

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13
Q

MAP remains unchanged in spite of Increased cardiac output because?

A

^Blood volume + Decreased SVR = Net even effect on MAP

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14
Q

How is SVR affected

A

15% decrease

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15
Q

How is PVR affected

A

30 % decrease

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16
Q

Why is vascular resistance decreased

A
  1. Progesterone causes Increased nitric oxide causing vasodilation.
  2. Progesterone causes decreased response to angiotensin and NE
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17
Q

What is the effect of pregnancy on filling pressures (CVP and PAOP)

A

No change, however uterine contractions causes autotransfusion and can increase filling pressures.

18
Q

How does pregnancy affect the cardiac axis?

A

Left deviation: Heart is pushed up and left

19
Q

Identify the three major actions of progesterone

A
  1. Increases RAAS activity => ^blood volume => Increased cardiac output
  2. Vascular relaxation => Decreased SVR and PVR => Increased blood flow
  3. ^Minute ventilation Vt>RR => Decreased PaCO2 => Kidney elimination of HCO3 to preserve pH
20
Q

syndrome of supine hypotension is also called?

A

Aortocaval compression

21
Q

Aortocaval compression causes compression of?

A

Both the aorta and the vena cava

22
Q

Aortocaval compression results in what effects?

A
  1. Decrease venous return to the heart as well as arterial flow to the uterus and lower extremities.
  2. Decreased CO compromises fetal perfusion and can lead to maternal loss of consciousness
22
Q

Aortocaval compression results in what effects?

A
  1. Decrease venous return to the heart as well as arterial flow to the uterus and lower extremities.
  2. Decreased CO compromises fetal perfusion and can lead to maternal loss of consciousness
23
Q

Aortocaval compression is prevented by? This should be perform at what stage of pregnancy?

A

Prevented by 15 degrees left uterine displacement.

Should be performed on anyone that is in their second or 3rd trimester.

24
Q

Intravascular volume increases by?

A

35%

25
Q

Plasma volume increases by?

A

45%

26
Q

Erythrocyte volume increases by?

A

20%

27
Q

Increased intravascular volume prepares the mother for ______ and creates _______

A

Hemorrhage

Dilutional anemia

28
Q

Pregnancy creates a hypercoagulable state, which clotting factors increase?

A

1, 8, 9, 10, 12

29
Q

DVT is _____ times higher in pregnant women

A

6 times

30
Q

Which anticoagulants are decreased by pregnancy

A

antithrombin

Protein S

31
Q

How does pregnancy affect protein C

A

No change, there is a resistance to activated protein C

32
Q

_______ counteracts the state of coagulability

A

Increased fibrin breakdown

33
Q

How is factor 11 and 13 affected

A

Decreased factor 11 and 13 reduces fibrin plymerization

34
Q

PT decreases up to ____________

A

20% normal range (9.6-12.9)

35
Q

PTT decreases up to?

A

20% (normal range 24.7-35 seconds)

36
Q

Platelet count is ____________

A

Unchanged or decreased to 10% due to hemodilution

37
Q

The most common cause of thrombocytopenia during pregnancy is?

A

gestational thrombocytopenia

38
Q

The most common cause of thrombocytopenia in pregnancy is?

A

Gestational thrombocytopenia, it does not increase the rate of complications

39
Q

Other etiologies of thrombocytopenia include?

A

Hypertensive disorder of pregnancy

Idiopathic thrombocytopenia

Apex 11 Obstetrics (6 decks)

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