Brainscape's Knowledge GenomeTM

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


See full index

Reproduction Week 3 > Lecture 34:Physiology of Pregnancy Delivery > Flashcards

Lecture 34:Physiology of Pregnancy Delivery Flashcards

1
Q

What are changes in lungs during pregnancy?

A

Increased diaphragmatic excursion
Heart is bigger
Lungs are wider and diaphragm is higher

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

What are the mechanical changes in respiration during pregnancy?

A
  1. chest circumference expands
  2. subcostal angle increases
  3. transverse diameter increases 2 cm
  4. dyspnea (shortness of breath)
  5. more predisposed to URT infections
  6. hyperemia and edema induced by estrogen
  7. total lung volume is reduced
  8. tidal volume is greater
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does total lung volume decrease in pregnancy?

A

Drives the gradient at the level of the placenta

Leads to hyperventiliation which decreases PCO2 and increases O2

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

What is the association between epistaxis and pregnancy?

A

Pregnancy leads to more epistaxis and nasal stuffiness

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

How does a pregnant woman’s heart change?

A

Stroke Volume and cardiac output INCREASES
Murmur in diastole is NOT NORMAL
While a murmur in systole is normal
Heart is bigger
If someone gets tired too easily, then pregnancy might need to be carried term faster

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

How does the blood distribution change?

A
  1. fetus gets 17% of cardiac output (uterus = 10x more)
    • 2% goes to breasts
  2. reduction of CO to splanchnic bed and skeletal muscle
  3. kidney, skin and brain blood flow does notc change
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does total body water volume change in a pregnant woman?

A

Increase by 2 L (6.5 to 8.5L)
Water retention (less osmality)
Pregnancy is a condition of chronic volume overload

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

What happens when a woman is supine?

A

Fetus could compress IVC when lying down

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

What does progesterone do to vascular resistance?

A

Drops peripheral vascular resistance
Nadir of BP is at 24 weeks
Drop in vascular resitstance helps CV accommodate increased blood volume

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

What are the blood changes in pregnancy?

A
  1. blood volume increases
  2. maximum volume at 32 weeks (45% increase)
  3. red blood cell mass increases
  4. hypercoagulable state (DVT)
  5. increase in factors I, 7, 8, 9 and 10
    • but bleeding and clotting should not change in pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the dilutional effect during pregnancy?

A

The effect in whch plasma volume increases by more than the RBC volume increases
This leads to anemia of pregnancy
Need to look out for iron deficiency and HBopathies

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

What are the renal changes in pregnancy?

A
  1. renal hypertrophy
  2. dilation of renal pelves/calyces
  3. dilation of ureters
  4. drop in creatinine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which liver is more affected by renal changes?

A

Right liver due to mechanical effects of enlarging uterus

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

What does progesterone do to the kidney? Significance?

A

Leads to dilated ureters and renal pelves

Pregnant women are more likely to have kidney infections (pyelonephritis) and kidney stones (nephrolithiasis)

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

What is pyelonephritis?

A

Ascending UTI that reaches pyelum or pelvis of kidney

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

What is nephrolithiasis?

A

Kidney stones

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

How does progesterone affect GI system (or pregnancy affects GI)?

A
  1. decreases emptying time of stomach
  2. decreased GE junction
    • so more ACID REFLUX
  3. decreased bowel and colonic motility
  4. constipation
  5. increased portal venous pressure (hemorrhoids)
  6. slow gallbladder emptying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why is there nausea and vomiting in pregnancy?

A

Women vomit/nausea 4-16 weeks
Due to hCG
Supportive care with ginger, vit B6, unisome, antiemtics

19
Q

What is gravida?

A

Woman who is or has been pregnant regardless of outcome

20
Q

What is nullipara?

A

Woman who has never completed a pregnancy beyond 20 weeks

21
Q

What is primipara?

A

Woman has delivered one fetus

22
Q

What is multipara?

A

Woman has completed at leasat 2 preganncies

23
Q

What are the three P’s?

A

What determines if a baby can get out

  1. Passenger
  2. Passage
  3. Power
24
Q

What are the characteristics of the passenger?

A
  1. presentation (does it lie transverse or breech)
  2. size of baby
  3. position (occiput anterior, looking down, occiput posterior, looking up)
25
Q

What is zero station?

A

Most inferior part of baby head is at the level of ischial spine

26
Q

What is cervical effacement?

A

When the cervix layers spread apart to allow for cervical dilation

27
Q

What is cephalopelvic disproportion?

A

When head of baby does not match shape of pelvis

Like fitting a square into a round hole

28
Q

What are the characteritics of powers?

A
  1. contractions
    - multiple influences for strength of contraction
  2. maternal effort
29
Q

What causes uterine contractions/cervical ripening?

A

WE don’t know but maybe

  1. prostaglandins
  2. oxytocin receptors
  3. gap junctions
  4. intracellular Ca
  5. collagenase, elastase
30
Q

What is labor defined by?

A

Regular uterine contractions that lead to cervical dilation

31
Q

What happens in cervical effacement?

A

When collagen chains are broken down
Hydrophobic glycosaminoglycans are replaced by hyaluronic cells
Cervical smooth muscle contraction causes cervical tissue to be pulled upward and incorporated into lower segment of corpus

32
Q

Why are gap junctions important?

A

Allow all the cells to contract concertedly

Hormones increase gap junctions and upregulate oxytocin receptors

33
Q

What are the most important hormones in labor?

A
  1. prostaglandins (E and F)
  2. oxytocin
  3. progesterone
  4. estrogen
  5. cortisol
34
Q

Why is estrogen crucial in labor?

A

It promotes myometrial cell hypertrophy, promotes gap junctions and upregulates OT recpetors and progesterone receptors

35
Q

Why is cortisol important?

A

Fetus cortisol activates alpha hydroxylase to conver progesterone to estrogen

36
Q

What are the 3 stages of labor?

A
  1. Stage 1 = closed to fully dilated
    • latent phase
    • active phase
  2. Stage 2: fully dilated to delivery
  3. Stage 3: placenta
37
Q

What is the transition point from latent to active phase in Stage 1?

A

New research is 6 cm

4cm is old research (Friedman)

38
Q

What are the characteristics of the first stage of labor?

A
  1. interval between onset of labor and dilation
    2 phases
    i. latent phase: onset of labor with slow cervical dilation to 4 cm and variable duration
    ii. active pahse: faster rate of cervical hange
39
Q

How long does it take for stage 2?

A

3 hours … maybe 4 hours

40
Q

What are the characteristics of placental separation?

A 
Signs = increased bleeding
Lenghtening of cord
Uterus rises and becomes globular
Usually within a few minutes after delivery 
More than 30 minutes is abnormal
41
Q

What is the definition of engagement?

A

Engagement occurs when widest diameter of fetal skull has passed the pelvic inlet

42
Q

What does dystocia mean?

A

Abnormal labor and delivery
Shoulder dystocia = shoulder cant get through
-gets brachial plexus injury

43
Q

What are common indications for C-sections?

A
  1. prior c-section
  2. abnormal labor
    • arrest or protraction of dilation or descent
  3. cephalopelvic disproportion
  4. congenital anomalies
  5. multiple gestations (twins)
  6. nonreassuring fetal heart tones/fetal intolerance to labor
  7. previa (placenta blocking cervix)
  8. fetal malpresentation (breech, transverse lie)
  9. elective

Reproduction Week 3 (8 decks)

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