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MD3002 post MSA > effect of pregnancy on maternal physiology > Flashcards

effect of pregnancy on maternal physiology Flashcards

1
Q

when is the uterus palpable

A

13 weeks

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2
Q

what point does the uterus reach at term

A

xiphoid process

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3
Q

how does the back change during pregnancy

A

increased lumbar lodosis causing backache

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4
Q

what is relaxin

A

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

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5
Q

how much weight gain can be expected during pregnancy

A

12.5 kg

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6
Q

why might pregnant people have varicose veins

A

pressure on the IVC impeding venous return

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7
Q

what is physiological anaemia of pregnancy

A

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

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8
Q

how else does the blood change during pregnancy

A

increase WBC

increase clotting factors leading to thromboembolism risk

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9
Q

what are the features of uteroplacental circulation

A

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

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10
Q

how does cardiac output change

A

increases by 40%

increase in heart rate and stroke volume

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11
Q

where does blood flow increase to

A

uterus, breast and skin

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12
Q

why might a pregnant person faint when lying down

A

IVC obstruction

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13
Q

when does blood pressure normally fall

A

second trimester by approx 10 mmHg

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14
Q

what are the features of preeclampsia

A

increase in BP, Proteinuria, oedema

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15
Q

what are the problems with preeclampsia

A

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

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16
Q

what are the features of eclampsia

A 
extreme hypertension 180/120 
increased intracranial pressure 
seizures
comas
cerebral haemorrhage 
20% maternal mortality
17
Q

how can eclampsia be treated

A

magnesium sulphate
antihypertensives
rapid delivery
fluid balance

18
Q

how does ventilation change

A

increased CO2 sensitivity

increased tidal volume

19
Q

what are the renal effects

A

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

20
Q

by how much does body water increase by

A

6-8 L

decreased osmolarity due to increased kidney function

21
Q

why does kidney function increase

A

increased cardiac output

22
Q

what is morning sickness related to

A

HCG levels

worse in multiparity

23
Q

why might pregnancy cause constipation

A

pressure of uterus on rectum and lower colon

decreased motility due to progesterone effect on smooth muscle

24
Q

why might pregnancy cause heartburn

A

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

25
Q

how much do calorie requirements increase by

A

200-300 calories per day

26
Q

when does foetal growth rate increase most by

A

30-36 weeks

27
Q

when is the mother more succeptable to insulin

A

early pregnancy

28
Q

why do maternal glucose levels rise in later pregnancy

A

reduced insulin sensitivity
increased lipolysis
increased triglycerides
increased protein requirement

29
Q

what are the risk factors for gestational diabetes

A

race
obesity
family history

predictor of future type two diabetes

30
Q

what is gestational diabetes a risk factor for

A

macrosomia and complication

31
Q

what is folic acid needed for

A

neural tube fusion

32
Q

what extra vitamins might be needed

A

folic acid
b12
vit D

high levels of vit A may lead to abnormalities

33
Q

why is calcium needed

A

skeleton

maternal gut absorption increases, urinary loss decreases

34
Q

why is zinc needed

A

protein synthesis, nucleic acid synthesis
insult activity
increased dietary need

35
Q

where is HCG secreted from

A

placenta

36
Q

what other hormones are released during pregnancy

A 
growth hormone
decreased FSH and LH
Increased prolactin 
increased PTH
increase in size of pituritary 
increased size of thyroid
37
Q

why will a mother experience amenorrhoea post nataly

A

if she is breast feeding

may be associated with menopausal symptoms

38
Q

when are most changes reversed by

A

Six weeks

39
Q

s

A

s

MD3002 post MSA (66 decks)

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