Lecture 17 - Exercise during pregnancy Flashcards
define pregnancy
physiological process in which a fertilized egg implants and grows within a woman’s uterus, leading to the development of an embryo, and later, a fetus
how many trimesters in pregnancy? how many months? how many weeks?
- what are the mother’s symptoms at each trimester?
TRIMESTER 1
- months 1-3
- weeks 1-12
- fatigue, swollen breasts, indigestion, weight changes, constipation, nausea
- morning sickness only in T1
TRIMESTER 2
- months 4-6
- weeks 12-27 ish
- rapid weight gain bc fetus grows, swelling of hands and feet, darkened skin around belly button
TRIMESTER 3
- months 7-9
- weeks 27 ish to 40
- heartburn, shortness of breath, swelling, insomnia, leakage from breasts, frequent urination
describe what happens to fetus ish during trimester 1 to 3
TRIMESTER 1:
- placenta forms (at around 10 days after conception)
- all major organs BEGIN to develop (finish developing in T3)
- heart fully developed at the end of T1
TRIMESTER 2:
- vocal cords
- skin thickens + fat development
- movement
- responsive to stimuli like light
TRIMESTER 3:
- lung surfactant –> to have surface tension for gas exchange
- reserves for body fat
- nervous system + organs develop to mature status
what is the placenta?
- developed when?
- where?
- 2 functions ish
placenta = temporary vital organ –> fetal lifeline while in uterus
- develops during T1
- attaches to uterine wall through umbilical cord
- means of communication btw fetus and mom (nutrient, gas, waste exchange) + responsible for ALL hormone production after 1st trimester
what are 3 main hormones produced by the placenta + functions
+ when do they peak?
hCG
- 1st hormone produced during pregnancy –> helps detect pregnancy –> peaks at the beginning (T1) and decreases after
- thickens uterine lining so embryon can implant
PROGESTERONE:
- makes sure that you don’t menstruate
OESTROGEN
- allows for uterus to grow along with fetus growth
both P and E gradually increase throughout T2 and T3 ish and peak right before delivery
umbilical cord is made of which blood vessels?
- which major organ is not well developed until T3 in fetus, how to bypass that?
- 2 umbilical arteries –> bring deox blood from fetus to placenta
- 1 umbilical vein: bring oxygenated blood from placenta/mom to fetus heart
- lungs are not well developed! SO umbilical vein brings blood to the foramen ovale (in fetus heart) –> makes blood from R ventricle directly go to L atrium and ventricule and bypass lungs
what is transferred through the placenta?
- what can placenta store?
- from fetal side: CO2, waste and antibodies (?) –> go to maternal side
- from maternal side: O2, nutrients, glucose (and antibodies) –> to fetus side
- placenta can store glucose as glycogen! but that glycogen can only be used by fetus
what happens to plasma volume and RBC during T1, T2 and T3? why?
PLASMA VOLUME
- T1: increase 10-15%
- T2: increase
- T3: increase 40-50% (from pre-pregnancy levels)
- fetal growth –> needs more nutrients and O2, all delivered through plasma + mom’s organs also has increased demand
RBC:
- increase in all 3 trimesters. increased by 25% by T3
- increase bc need to carry more oxygen to fetus and mom’s organs
what happens to CO, SV and HR during T1, T2 and T3? why?
HR
- increase in all 3 trimesters. increase by 10-30bpm by T3
- huge variability btw women though –> due to how pregnancy develops + genetics + pre-pregnancy levels
SV:
- increase 8% in T1 –> what drives increase in CO
- increase in T2, not as drastic
- plateaus in T3
CO:
- increase 8% in T1 (bc of SV)
- increase by 30-40% by T2
- plateau! in T3
- bc fetus is super big, uterus compresses on inferior vena cava so less blood returns to heart, so SV stabilizes and CO too
what happens to vascular resistance during T1, T2 and T3? why?
T1: decrease –> bc vessels dilate so more O2 and nutrients to fetus
T2: decrease 19-30%
T3: increase!
*T3 increase –> not sure why/still researched –> maybe bc body is preparing for labor –> keep blood in heart to minimize blood loss
what happens to BP during T1, T2, T3? why?
T1: decrease
T2: decrease (lowest point)
T3: increase! bc VR increases! –> small vessels = higher blood pressure
how does the oxyhemoglobin curve shift for women during pregnancy + for the fetus?
WOMAN:
- curve shifted to the right! –> decreased affinity to O2 so that O2 can go to fetus!
- shift to the R can also be caused by increased H+, 2-3BPG and temp (ie in muscles: Hg has less affinity to O2 so O2 can go in muscle)
FETUS
- curve shifted to the left –> increased affinity to O2 so fetus keeps O2 is has
- shift to L also caused by decreased H+, 2,3-BPG, temps
- ie lungs: bring O2 to cells, need high affinity
what happens to diaphragm, chest wall compliance and rib cage during pregnancy?
- pregnancy –> uterus gets really big –> organs all get pushed up –> puts pressure on diaphragm so diaphragm and lungs can’t move as much
- diaphragm shifts upwards 5cm
- chest wall compliance decreases (bc less space to move)
- rib cage expands! to accommodate for diaphragm that moved up
what happens during pregnancy to:
- ERV and FRC
- IRV
- VC
- VT
- breath frequency
- TLC
- ERV and FRC: both decrease! bc diaphragm pushed up = can’t push as much air out –> FRV decreased by 20%
- IRV: also decreases bc of diaphragm
- VC: stays same! bc VT increases and IRV decreases
- VT: increases by 40% bc body knows diaphragm changed so compensates to get more O2 for fetus
- breath frequency: stays same bc VT is same
- TLC: decreases by 5%
which hormone is released when high blood glucose? what does it do? vs low blood glucose?
HIGH:
- insulin from beta cells is released! –> decrease blood glucose
- anabolic! uses glu to store as glycogen
LOW:
- glucagon (alpha cells) –> increase blood glucose
- catabolic: break down glycogen
