Lecture 5 Physiology in Pregnancy

Question 1

Name the mechanical changes that occur during pregnancy

Answer 1

Relaxin hormone increases pliability and extensibility of connective tissue.
Pubic symphysis gap increases

Question 2

What is symphysis pubis dysfunction?

Answer 2

Happens when the ligaments that normally keep your pelvic bone aligned during pregnancy become too relaxed and stretchy too soon before birth

Question 3

Name the metabolic changes that occur during pregnancies

Answer 3

Basal metabolic rate increases
Insulin insensitivity
Increases storage of lipids

Question 4

Name other changes during pregnancy

Answer 4

Fatigue
Heartburn/reflux
Oedema
Pre-elampsia
Breast increase in size and vascularity

Question 5

Name thyroid changes during pregnancy

Answer 5

The liver produces more thyroid binding globulin total level of T4 and T3 increase
Hypertrophy of thyroid gland to ensure adequate levels of iodine trapped
Hyperemesis gravidarum
Thyrotoxicosis
Hypothyroidism

Question 6

What happens to the heart during pregnancy

Answer 6

Heart has to work harder due to weight gain, growing foetus and increased oxygen requirements

Question 7

What happens to the circulating blood during pregnancy

Answer 7

Circulating blood volume increases by 50-70%, red cell mass increases causing haemodilution resulting in anaemia

Question 8

What happens to the cardiac output during pregnancy

Answer 8

Increases by 30-50%

Question 9

What respiratory changes happen during pregnancy

Answer 9

Tidal volume increases
Respiratory rate increases (dyspnoea)
PCO2 levels lower
Functional residual capacity reduces
Asthma may improve

Question 10

What happens to the iron and folate requirement in pregnancy

Answer 10

Increase

Question 11

What happens to the overall white cell count and neutrophil count in pregnancy

Answer 11

Increases

Question 12

What happens to the coagulation systemic during pregnancy

Answer 12

Pregnancy is a hyper coagulable state
Clotting factors VII, IX and X increases and so does fibrinogen.
Protein S and C and anti-thrombin decrease
Fibrinolytic activity decreases

Question 13

What renal changes occur during pregnancy

Answer 13

Dilatation of the urinary collecting system
Hydronephrosis (more pronounced right)
GFR and creatine clearance increases
Kidneys excrete more protein but retain more sodium(water)
Glycosuria