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MD3002 WEEK 10 - K > Effect of Pregnancy on Maternal Physiology > Flashcards

Effect of Pregnancy on Maternal Physiology Flashcards

1
Q

Which hormone causes softening of the sacral ligaments?

A

Relaxin

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2
Q

Why do pregnancy women get backache?

A

Centre of gravity changes developing an accentuated lumbar lordosis

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3
Q

Why may pregnant women get varicose veins?

A

Pressure on IVC will impede venous return from the lower limbs and may impair function of valves

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4
Q

What is physiological anaemia of pregnancy?

A

Haematopoiesis increases but increased plasma volume means that red cell count, haematocrit and haemoglobin are all reduced

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5
Q

Why are pregnant women at risk for thromboembolism?

A

Platlets more reactive and increase in clotting factors

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6
Q

What are the characteristics of uteroplacental circulation?

A

High volume, low resistance

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7
Q

Why is uteroplacental low resistance?

A

Spiral arteries and arterioles lose capacity to vasoconstrict

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8
Q

What happens to blood volume in pregnancy?

A

Reduced TPR triggers RAAS increasing blood volume

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9
Q

What factors contribute to vasodilation in pregnancy resulting in low blood pressure?

A

Pregnancy hormones suppressing pressor (AT II) agents such as angiotensin
Oestrogen increased VEGF and NO production in endothelial cells
Endothelial cells release prostaclycin

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10
Q

What happens to CO during pregnancy?

A

Increased by 30-50% during weeks 6-28

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11
Q

Why may pregnant women faint when lying flat?

A

Uterus obstructs IVC decreasing venous return

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12
Q

What happens to BP in pregnancy?

A

Normally falls in second trimester

Systolic falls 5-10mmHg and diastolic 10-15mmHg

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13
Q

What changes occur to the respiratory system during pregnancy?

A

Progesterone increases sensitivity of central CO2 receptors
Increases tidal volume by 4%
Ventilation rate stays the same

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14
Q

Why does renal function increase in pregnancy?

A

Kidneys need to deal with foetal urea

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15
Q

What changes in Us & Es occur during pregnancy?

A

Urea, creatinine and uric acid decrease

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16
Q

What happens to GFR during pregnancy?

A

Increases due to increased cardiac output

17
Q

Why are pregnant women prone to UTI?

A

Compression of bladder causes ureters to dilate

18
Q

How much does total body water increase by in pregnancy?

A

6-8L

19
Q

Why does blood osmolality fall in pregnancy?

A

Decreases urea and creatinine due to increased GFR

20
Q

What is morning sickness related to?

A

hCG levels

21
Q

Why do pregnant women get constipated?

A

Pressure of uterus on rectum and lower colon

Progesterone relaxes smooth muscle decreasing motility

22
Q

Why do pregnancy women get gastric reflux?

A

Pressure of uterus causes relaxation of lower oesophageal sphincter

23
Q

Why do pregnant women gain weight?

A

Breast tissue
Foetus
Placenta and amniotic fluid
Fat and extracellular fluid

24
Q

What metabolic changes occur during early pregnancy?

A

3kg fat laid down to provide energy during final trimester
Maternal tissue more sensitive to insulin
Increased protein synthesis

25
Q

What metabolic changes occur during late pregnancy?

A

Relative insulin resistance
Increased lipolysis to provide energy for mother - increase in TAGs
Increased requirement for protein

26
Q

What is folic acid required for?

A

Neural tube fusion

27
Q

Why should pregnant women not have too much vitamin A?

A

Can cause foetal abnormalities

28
Q

Why do calcium levels increase in pregnancy?

A

Maternal gut absorption increases (vit D3)
Urinary loss decrease (PTH)
Increase in calcium released from bone
Active transport across placenta to calcify skeleton of foetus

29
Q

Why is zinc important in pregnancy?

A

Required for metabolic processes e.g. protein synthesis, insulin synthesis

30
Q

When should iron be given to pregnancy women?

A

If iron deficiency anaemia is present

31
Q

What hormones does the mother secrete?

A

Growth hormone
Prolactin
PTH
Decreased FSH and LH

32
Q

What is a suggested cause of pre-eclampsia?

A

Failure of the second wave of trophoblast invasion that normally impairs the spiral arteries ability to constrict

33
Q

What are the symptoms of pre-eclampsia?

A

Hypertension
Proteinuria
Oedema

34
Q

Why does pre-eclampsia cause oedema and proteinuria?

A

Renal arteriolar endothelial damage from high blood pressure cause proteinuria and oedema

35
Q

When does pre-eclampsia begin?

A

20 weeks

36
Q

What is a complication of pre-eclampsia?

A

Foetal growth restriction due to reduced perfusion of placenta

37
Q

What is eclampsia?

A

Extreme hypertension which increases intracranial pressure leading to seizures, cerebral haemorrhage and coma

38
Q

What interventions are present for eclampsia?

A

Magnesium sulphate
Antihypertensives
Rapid delivery
Careful fluid balance

39
Q

What is gestational diabetes associated with?

A

Foetal macrosomia - big baby with increased insulin resistance and high glucose

MD3002 WEEK 10 - K (9 decks)

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