HUMANS- Pregnancy

Question 1

Compare the 3 trimesters of pregnancy?

Answer 1

1st trimester (1-12 weeks)- Development and differentiation of the embryo which becomes a foetus at 10-14 weeks.

(highest rate of misscarriage here)

2nd trimester- 12-28 weeks- further differentation (e.g. development of hearing/sight)

3rd trimester- This is just growth to have enough fat stores and muscle for the trauma of birth.

Question 2

Why do we see the physical changes in pregnancy?

Answer 2

The body puts on weight and a baby bump develops due to the increase in fluid and tissue size.

Question 3

What hormonal changes are seen during pregnancy?

Answer 3

Increased oestrogen and progesteron levels which cause:

• Increased renin increasing salt and water retetention.
• The plasma volume is increased by 45% but the increased water dilutes it (causing Hb to fall and resulting in pregnancy aenaemia)

This can also reduce insulin sensitivity. (can have pregnancy induced diabetes)

Question 4

What are the haematological changes seen through pregnanacy.

Answer 4

Increased production of RC/WC and platelets

There is a 20% increase in RC mass.

There is an increase in platelet consumption.

Question 5

What are the cardiovascular changes in pregnancy?

Answer 5

Increased heart rate (heart is pumping a greater blood volume around the body)

There is relaxation of the vascular smooth muscles (reducing peripheral resistance)

Question 6

What are the coagulatory changes in the mother during pregnancy?

Answer 6

Increased clotting factor production

Increased fibrinolysis

Increased system sensitisation.

Question 7

What is the placenta?

Answer 7

The organ that connects the foetus to the mother and joins to the umbilical chord.

This interlinking mesh of blood vessels prevents maternal and foetal blood mixing but allows nutrients to diffuse between.

Question 8

Discuss the stages of labour.

Answer 8

1st and 2nd stage are for delivery of the baby

3rd stage is delivery of the placenta.

Question 9

How does pregnancy affect dental care ?

Answer 9

• Dental care is free for pregnant women.
• Any drugs given to the mother will also affect the baby.
• Pregnancy gingivitis
• Pregnant women have a greater risk of periodontitis.
• We have to treat the patient laterally (if in supine position the baby will compress the vena cava & aorta)