effect of pregnancy on maternal physiology

Question 1

when is the uterus palpable

Answer 1

13 weeks

Question 2

what point does the uterus reach at term

Answer 2

xiphoid process

Question 3

how does the back change during pregnancy

Answer 3

increased lumbar lodosis causing backache

Question 4

what is relaxin

Answer 4

a hormone produced during pregnancy which causes softening of ligaments leading to pelvic pain

Question 5

how much weight gain can be expected during pregnancy

Answer 5

12.5 kg

Question 6

why might pregnant people have varicose veins

Answer 6

pressure on the IVC impeding venous return

Question 7

what is physiological anaemia of pregnancy

Answer 7

increased plasma volume meaning that red cell, haematocrit and hb all decrease

Question 8

how else does the blood change during pregnancy

Answer 8

increase WBC

increase clotting factors leading to thromboembolism risk

Question 9

what are the features of uteroplacental circulation

Answer 9

high volume low resistance
increased peripheral vasodilation
reduced total peripheral resistance triggers RAAS
increased blood volume

Question 10

how does cardiac output change

Answer 10

increases by 40%

increase in heart rate and stroke volume

Question 11

where does blood flow increase to

Answer 11

uterus, breast and skin

Question 12

why might a pregnant person faint when lying down

Answer 12

IVC obstruction

Question 13

when does blood pressure normally fall

Answer 13

second trimester by approx 10 mmHg

Question 14

what are the features of preeclampsia

Answer 14

increase in BP, Proteinuria, oedema

Question 15

what are the problems with preeclampsia

Answer 15

poor placental diffusion
hypertension in mother
renal arteriolar endothelial damage causing glomerular damage
low birth weight

Question 16

what are the features of eclampsia

Answer 16

extreme hypertension 180/120 
increased intracranial pressure 
seizures
comas
cerebral haemorrhage 
20% maternal mortality

Question 17

how can eclampsia be treated

Answer 17

magnesium sulphate
antihypertensives
rapid delivery
fluid balance

Question 18

how does ventilation change

Answer 18

increased CO2 sensitivity

increased tidal volume

Question 19

what are the renal effects

Answer 19

increased GFR
increased urea production
decreased plasma urea, creatinine and uric acid
urgency and frequency due to bladder compression
increased risk of UTI
urinary incontence

Question 20

by how much does body water increase by

Answer 20

6-8 L

decreased osmolarity due to increased kidney function

Question 21

why does kidney function increase

Answer 21

increased cardiac output

Question 22

what is morning sickness related to

Answer 22

HCG levels

worse in multiparity

Question 23

why might pregnancy cause constipation

Answer 23

pressure of uterus on rectum and lower colon

decreased motility due to progesterone effect on smooth muscle

Question 24

why might pregnancy cause heartburn

Answer 24

relaxation of the lower oesophageal sphincter
pressure of the uterus
worse lying down

Question 25

how much do calorie requirements increase by

Answer 25

200-300 calories per day

Question 26

when does foetal growth rate increase most by

Answer 26

30-36 weeks

Question 27

when is the mother more succeptable to insulin

Answer 27

early pregnancy

Question 28

why do maternal glucose levels rise in later pregnancy

Answer 28

reduced insulin sensitivity increased lipolysis increased triglycerides increased protein requirement

Question 29

what are the risk factors for gestational diabetes

Answer 29

race obesity family history predictor of future type two diabetes

Question 30

what is gestational diabetes a risk factor for

Answer 30

macrosomia and complication

Question 31

what is folic acid needed for

Answer 31

neural tube fusion

Question 32

what extra vitamins might be needed

Answer 32

folic acid b12 vit D high levels of vit A may lead to abnormalities

Question 33

why is calcium needed

Answer 33

skeleton | maternal gut absorption increases, urinary loss decreases

Question 34

why is zinc needed

Answer 34

protein synthesis, nucleic acid synthesis insult activity increased dietary need

Question 35

where is HCG secreted from

Answer 35

placenta

Question 36

what other hormones are released during pregnancy

Answer 36

``` growth hormone decreased FSH and LH Increased prolactin increased PTH increase in size of pituritary increased size of thyroid ```

Question 37

why will a mother experience amenorrhoea post nataly

Answer 37

if she is breast feeding | may be associated with menopausal symptoms

Question 38

when are most changes reversed by

Answer 38

Six weeks

Question 39

s

Answer 39

s