Changes to anatomy and physiology in pregnancy including TOG - exercise in Pregnancy

Question 1

How much does cardiac output increase by?

Answer 1

30-50%

Question 2

How much does plasma volume increase by?

Answer 2

45-50%

Question 3

RBC volume increases by…?

Answer 3

20-30%

Question 4

Rate of blood flow to the uterus at term?

Answer 4

500-800ml/min

Ie 10% cardiac output

Question 5

Which clotting factors increase in pregnancy?

Answer 5

Fibrinogen, VII, VIII, IX, X, thrombin

vWF

Question 6

Which anticoagulants decrease in pregnancy?

Answer 6

Lower levels of functional Protein S
Complement C4b
Increased plasminogen activator inhibitor type 1

Question 7

Which clotting factors remain the same in pregnancy?

Answer 7

Protein C and Antithrombin III

Question 8

How much does cardiac output increase by in pregnancy?

Answer 8

50%

Question 9

How much does stroke volume increase by in pregnancy?

Answer 9

30% (10% by end of T1)

Question 10

How much does heart rate increase by in pregnancy?

Answer 10

15%

15-20bpm

Question 11

How much does systemic vascular resistance fall by?

Answer 11

15%

Question 12

How much does minute volume increase by in pregnancy?

Answer 12

50%

Question 13

How much does tidal volume increase by in pregnancy?

Answer 13

40%

Question 14

How much does respiratory rate increase by in pregnancy?

Answer 14

10%

Question 15

What happens to functional residual capacity, end respiratory volume and residual volume?

Answer 15

All decrease by 20%

Question 16

What happens to O2 consumption?

Answer 16

Increases by 20%

Question 17

How much does basal metabolic rate increase by in pregnancy?

Answer 17

15-20%

Question 18

What is the average normal weight gain for pregnancy?

Answer 18

11-12kg

Question 19

How much does GFR increase by up to 16/40?

Answer 19

150%

Question 20

What causes the decrease in peripheral vascular resistance and increase in plasma volume?

Answer 20

Activation of renin-angiotensis system

Mild reduction of plasma atrial natriuretic peptide

Question 21

At what gestation does blood volume plateau?

Answer 21

32/40

Question 22

Why is there an increase in cardiac output and at what gestation does it plateau?

Answer 22

Increase in stroke volume, then increase in heart rate

Plateaus at 25/40

Question 23

By how much does cardiac output increase with each contraction and how much volume returns to the circulation in this time?

Answer 23

50%

300-400ml blood transfers back to circulation

Question 24

How much uterine blood returns to the maternal circulation during the 3rd stage of labour?

Answer 24

500ml

Question 25

At how many weeks is there a return to pre-pregnancy cardiac output, blood volume and peripheral resistance?

Answer 25

4-12 weeks

Natriuresis and diuresis within 48 hours

Question 26

How long postpartum is it before clotting factors return back to normal?

Answer 26

8/52 - hence increased risk VTE PP

Question 27

What % of pregnant women exercise at the recommended level?

Answer 27

15%

Question 28

How much does MAP alter in pregnancy?

Answer 28

Decreases by 5-10mmHg by mid T2 then back to pre-pregnancy levels (development of uteroplacental circulation)

Question 29

By how much does nutritional requirement change in pregnancy?

Answer 29

Extra 300 kcal end of T1