effect of pregnancy on maternal physiology Flashcards
when is the uterus palpable
13 weeks
what point does the uterus reach at term
xiphoid process
how does the back change during pregnancy
increased lumbar lodosis causing backache
what is relaxin
a hormone produced during pregnancy which causes softening of ligaments leading to pelvic pain
how much weight gain can be expected during pregnancy
12.5 kg
why might pregnant people have varicose veins
pressure on the IVC impeding venous return
what is physiological anaemia of pregnancy
increased plasma volume meaning that red cell, haematocrit and hb all decrease
how else does the blood change during pregnancy
increase WBC
increase clotting factors leading to thromboembolism risk
what are the features of uteroplacental circulation
high volume low resistance
increased peripheral vasodilation
reduced total peripheral resistance triggers RAAS
increased blood volume
how does cardiac output change
increases by 40%
increase in heart rate and stroke volume
where does blood flow increase to
uterus, breast and skin
why might a pregnant person faint when lying down
IVC obstruction
when does blood pressure normally fall
second trimester by approx 10 mmHg
what are the features of preeclampsia
increase in BP, Proteinuria, oedema
what are the problems with preeclampsia
poor placental diffusion
hypertension in mother
renal arteriolar endothelial damage causing glomerular damage
low birth weight
what are the features of eclampsia
extreme hypertension 180/120 increased intracranial pressure seizures comas cerebral haemorrhage 20% maternal mortality
how can eclampsia be treated
magnesium sulphate
antihypertensives
rapid delivery
fluid balance
how does ventilation change
increased CO2 sensitivity
increased tidal volume
what are the renal effects
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
by how much does body water increase by
6-8 L
decreased osmolarity due to increased kidney function
why does kidney function increase
increased cardiac output
what is morning sickness related to
HCG levels
worse in multiparity
why might pregnancy cause constipation
pressure of uterus on rectum and lower colon
decreased motility due to progesterone effect on smooth muscle
why might pregnancy cause heartburn
relaxation of the lower oesophageal sphincter
pressure of the uterus
worse lying down
how much do calorie requirements increase by
200-300 calories per day
when does foetal growth rate increase most by
30-36 weeks
when is the mother more succeptable to insulin
early pregnancy
why do maternal glucose levels rise in later pregnancy
reduced insulin sensitivity
increased lipolysis
increased triglycerides
increased protein requirement
what are the risk factors for gestational diabetes
race
obesity
family history
predictor of future type two diabetes
what is gestational diabetes a risk factor for
macrosomia and complication
what is folic acid needed for
neural tube fusion
what extra vitamins might be needed
folic acid
b12
vit D
high levels of vit A may lead to abnormalities
why is calcium needed
skeleton
maternal gut absorption increases, urinary loss decreases
why is zinc needed
protein synthesis, nucleic acid synthesis
insult activity
increased dietary need
where is HCG secreted from
placenta
what other hormones are released during pregnancy
growth hormone decreased FSH and LH Increased prolactin increased PTH increase in size of pituritary increased size of thyroid
why will a mother experience amenorrhoea post nataly
if she is breast feeding
may be associated with menopausal symptoms
when are most changes reversed by
Six weeks
s
s
