Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GGE > Gametes - Maternal Physiology > Flashcards

Gametes - Maternal Physiology Flashcards

1
Q

insulin during pregnancy

A

mothers becomes less sensitive to insulin

Brought about by hCS (also known as Human Placental Lactogen, hPL)

FAs for her own metabolism and glucose spared for baby

Too much insensitivity - gestational diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

weight gain expected during pregnancy for each BMI category

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

underweight BMI (< 18.5) weight gain

A

28-40 pounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

normal weight BMI (18.5-24.9) weight gain

A

25-35 pounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

overweight BMI (25-29.9) weight gain

A

15-25 pounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

obese BMI > or = 30

A

11-20 pounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are obesity and excessive weight gain in pregnancy associated with

A

gestational diabetes

macrosomia - large baby

pre-eclampsia

caesarean section

post-operative complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

AA essential during pregnancy

A

leucine

(IGF-1 and IGF-2 also)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

distribution of weight during pregnancy

A

6kg - maternal tissues

5kg - foetal tissues

7kg - water

3kg - fat

1kg - protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how is weight gain distributed throughout pregnancy

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

water content at term

A

foetus + placenta + amniotic fluid = 3.5L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

where is this increase in total body water seen

A

increase in volume of blood, plasma, RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when does the increase in TBW start

when does it reach max vol

what is it caused by

A

increases from week 6/8

max vol@ 32 weeks - 45% increase

→ oestrogen action on renin/angiotensin/aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

pregnancy is a condition of

A

Chronic Volume Overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

if you’re not pregnant but experience fluid overload, how does your body respond

A

(ADH stops you getting rid of fluid) → ADH is inhibited

AMP promotes water loss → AMP is increased

⇒ Pressure Diuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

haemotological changes in pregnancy - RBCs

A

RBC production is increased by 33% - possibly hormonally mediated

this increases the O2-carrying capacity of blood

the increase in plasma is greater and faster than RBC, so there is no increase in viscosity of blood

⇒ Hb conc falls from 14 g/dL → 12 g/dL

⇒ Dilution Anaemia (Hb and Hct decrease)

[true anaemia = Hb < 12 g/dL, Hct < 32%]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Haemotological changes in pregnancy - leukocytes

WBC count in each trimester and labour

explain the change in WBC count

A

bone marrow is hyperplastic

peripheral WBC rises progressively during pregnancy

1st trimester - 9500/mm3

2nd and 3rd trimester - 10,500/mm3

labour - 20-30,000/mm3

rise is due to PMNs - polymorphonuclei (eosinophils, basophils etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

haematological changes in pregnancy - platelets

A

platelets progressively decline but remain within normal range

likely due to increased destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what cells regulate the localised immunity in the uterine environment

A

T regulatory cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Haematological changes in pregnancy - coagulation

increase in levels of…

no change in…

decline in levels of…

A
  • increased levels of coagulation factors (more likely to develop embolism) - decreases blood loss at delivery

fibrinogen (Factor I)

Factors VII → X

  • no change in prothrombin (Factor II), Factor V and Factor XII
  • decline in platelet count, Factor XI and XIII

bleeding time and clotting time are unchanged in normal pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pregnancy is a

A

hyper-coaguable state

22
Q

COAGULATION

increased levels of

A

fibrinogen - Factor I

Factor VII

Factor X

23
Q

COAGULATION

no change in

A

prothrombin - Factor II

Factor V

Factor XII

24
Q

COAGULATION

decline in

A

platelet count

Factor XI

Factor XIII

bleeding and clotting time are unchanged in normal pregnancy

25
Q

clinical implications of the haematological changes in pregnancy

A
  1. increased circulatory need of the enlarging uterus and the foeto/placental unit (increase of 45%)
  2. fills of the ever-increasing venous reservoir
  3. protects the parturient (woman in labour, about to give birth) from the bleeding at the time of delivery
  4. parturients become hypercoaguable as the gestation progresses
26
Q

how long does it take for blood volume to return to normal

A

8 weeks

27
Q

CV changes in pregnancy

A
  1. increased metabolic demands
  2. expansion of vascular channels
  3. increase in steroid hormone
28
Q

CO =

A

HR x stroke volume

29
Q

change in maternal CO

A

30-40% increase

30
Q

CO during pregnancy

A

6-7L/min (to allow for O2 delivery to foetus)

CO remains maximal until delivery/labour

31
Q

what causes this increase in CO

how long is this increase in CO maintained for

A

increase in CO ⇒ increase in SBP

fluid and vol increased ⇒ increased CO

oestrogen and progesterone

maintained until 4 days post-partum

32
Q

what does CO in pregnancy depend on

A

varies depending on the uterine size + maternal position

33
Q

haemodynamic parameters during pregnancy

A
34
Q

why does CO increase

A

it facilitates maternal and foetal exchanges of respiratory gases, nutrients and metabolites

it reduces the impact of maternal blood loss at delivery

35
Q

how does pulse (HR) change during pregnancy

A

1st trimester - resting pulse increases by 8 beats/min

by term, increased by 15-20 BPM

36
Q

how does BP change during pregnancy

systolic vs diastolic

A

systemic BP overall decreased

  • systolic BP changes little (even though there’s an increase in CO)
  • diastolic reduced by 5-10 mmHg
  • Venous pressure in upper body unchanged, venous pressure in the lower body increased

⇒ BP affected by position of mother

37
Q

what dynamic factor contributes to diastolic BP

A

peripheral resistance

vessels dilate to ensure you have the blood supply to support the foetus

38
Q

basis for the haemodynamic changes of pregnancy

A

increased O2 demand → increased CO

  • vasodilation at placenta and increased vascularisation

increased blood flow to foeto-placental unit

decreased systemic vascular resistance (SVR)

  • diastolic BP decreases
39
Q

overview of CVS changes during pregnancy

A
40
Q

anatomical and changes of the heart in pregnancy

A

apex displaced upwards and to the left

heart size is increased by 12%

left axis deviation of 15% (approx) - linked with hypertrophy of ventricle - indicative of heart failure

diaphragm moves upwards by 4cm

41
Q

ECG changes during pregnancy

A

benign dysrhythmia

reversal of ST, T and Q waves

left axis deviation

42
Q

changes in heart sounds in pregnancy

A

split 1st heart sound - early closure of mitral valve

intensity of 2nd sound may become louder

systolic functional murmurs may develop due to tricuspid regurgitation

43
Q

peripheral vasodilation during pregnancy

A

increased blood flow to the skin - especially hands and feet - lead to a feeling of warmth

increased congestion of nasal mucosa leading to nasal congestion (because of peripheral vasoD)

epistaxis is common (increased risk of nose bleeds)

44
Q

supine hypotension is caused by

A

compression of inferior vena cava

decreased venous return

decreased cardiac output

lowered BP

45
Q

movement of diaphragm during pregnancy

A

at term diaphragm can be elevated up to 4cm

resp system may be compromised - (70% contribution by diaphragm)

diaphragm movement reduces thoracic cavity vol

mobility reduced

respiration becomes mainly thoracic

widened subcostal angle, increasing transverse diameter of the chest

46
Q

tidal vol during pregnancy

A

increased by 30-40%

47
Q

respiration rate during pregnancy

what is it influenced by

A

increased by 15% at term

influenced by progesterone

48
Q

minute ventilation during pregnancy

formula

A

increased at term by 50%

minute ventilation = resp rate x tidal vol

respiration reserve decreases because of anatomical movement upwards

49
Q

effect of elevation of diaphragm on:

  1. total lung vol
  2. residual vol
  3. FRC - functional residual capacity
  4. FEV1 or FEV1:forced vital capacity
A
  1. total lung vol decreases by 5%
  2. residual vol decreases by 20%
  3. FRC decreases by 20%
  4. no change in FEV1 or the ratio of FEV1 to forced vital capacity
50
Q

risk of compressed lungs

A

more susceptible to noxious gases

51
Q

change in minute ventilation and its subsequent impact on O2 consumption

PA and Pa levels

arterial pH

A

minute vol increases by 30-40% by late pregnancy

O2 consumption increases only 15-30%

⇒ higher PAO2 (alveolar) and PaO2 (arterial)

⇒ fall in PACO2 (what drives respiration) and PaCO2

arterial pH remains unchanged

increased bicarbonate excretion via kidneys

52
Q

what causes dyspnea during pregnancy

A

late 1st or early 2nd trimester

likely due to:

  • reduced PaCO2 levels
  • awareness of increased tidal vol of pregnancy

GGE (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions