Exam 3 - Maternal Adaptations of Pregnancy Flashcards
How long is the human gestation period?
266 days (38 weeks) since ovulation
- 10 lunar months, 9 calendar months
Musculoligamentous changes to the woman during pregnancy
- Lordosis and accentuated lumbosacral spinal curve
- Change in posture from center of gravity
- Kyphosis
- Altered gait
- Pubis symphysis widens
- Pelvis tilts anteriorly
- Separation of rectus abdominis due to pressure from enlarged uterus –> diastasis recti
Integumentary changes to pregnant women
Estrogen and progesterone + melanocyte stimulating hormone induces melanocytes to deposit pigments in skin
What causes striae gravidarum during pregnancy?
From thinning of elastin fibers and collagen in connective tissue
- Stretching and softening in epidermal junction under skin
Nail changes to pregnant women
- Transverse grooving
- Softening
- Increased brittleness
Hair changes to pregnant women
- Increase in number of hairs in growth phase
- Decrease in number of hairs in resting phase
- Longer and thicker hair
Will reverse postpartum - hair loss 2-4 months after delivery
Cardiovascular changes in pregnant women
- HR increases in first month and peaks at 32 weeks
- Ventricular muscle mass increases
- Heart displaced upward, forward, to left
Can murmurs be heard during pregnancy?
Systolic murmur heard between 12-20 weeks
- S1, S2 split can happen and/or S3
- Murmurs louder than 2 out of 6, or any diastolic murmur, requires eval
Does blood volume increase during pregnancy?
Increases as early as 6 weeks and peaks at 32 weeks
- Due to increased plasma volume and red cell mass (RBC volume)
- Hemodilution –> decrease in hemoglobin
Why is there an increase in blood volume during pregnancy?
- Maintains adequate blood flow to uterus, fetus, maternal tissues
- Maintains BP and regulates temperature
- Prepares for blood loss during delivery
What cardiovascular changes occur during the second and third trimester of pregnancy?
- Hemoglobin and hematocrit levels drop in late pregnancy
- Due to fetal uptake which maternal reserves cannot replace
- Iron absorption improved in pregnancy but not enough to account for difference so mothers reserves are depleted
How does blood pressure change during pregnancy?
Decreases from pre-pregnancy levels and reaches low in second trimester –> returns to baseline in third trimester
- Can decrease in left lateral position
- Due to hormonal effects of vasodilation and decreased SVR
True/false: Pregnancy is considered a hypercoagulable state
True - increased clotting factors, decreased fibrinolysis, decreased anticoagulant activity
- Protective changes to prevent hemorrhage at birth
- Increases risk for VTE and coagulopathies during pregnancy and immediate postpartum period
Is there increased leukocyte production in pregnancy?
Yes, may rise to 6,000-17,000 in third trimester without infection
- Normal: 4,000-12,000
What are the anatomic changes to the respiratory organs during pregnancy?
- Diaphragm rises from upward uterine pressure
- Lung chamber expands AP diameter to compensate and improve lung capacity
Allows for sufficient gas exchange to meet maternal and fetal metabolic needs