Maternal adaptation Flashcards
State which hormone is responsible hypertrophy(1) and hyperplasia of the uterus (1)
Hypertrophy of muscle fibers- estrogen
Hyperplasia of uterine cells - progesterone
Describe Goodell’s sign, what causes it and when it is seen
Softening of the cervix due to increased vascularization from hypertrophy and engorgement of blood vessels below uterus
From week 4 and 8 approximately week 6
Describe Chadwick’s sign, what causes it and when it is seen
It is a bluish discoloration of the mucous membranes of the cervix, vagina and vulva caused by venous congestion as a result of increased blood flow
4-8 Weeks
Describe hegar’s sign, what causes it and when its seen
Compressibility and softening of the cervical isthmus
Caused by increased blood flow, estrogen and progesterone
4-12 weeks
Function of progesterone x2
Raise body temperature
Causes smooth muscle relaxation
What membrane produces HCG and its function
Produced by syncytiotrophoblast and stimulates corpus luteum to produces progesterone
What stimulates the thyroid binding globulin and where is it produced
Stimulated by high estrogen levels and produced by hepatic cells
Function of T4 thyroid hormone
Fetal neural development
Where is corticotropin releasing hormone produced and its function
By placenta
Potentiates the action of prostaglandins and oxytocin
Function of estrogen during labour x2
Softening and ripening the cervix
Hormones produced by fetus in utero that help in labour x2
Pituitary produces oxytocin
Adrenal glands produce cortisol which converts progesterone to estrogen which promotes cervical ripening
Frequency of vaginal exams during latent and active phase of labour x2
Once every 6 hours in latent and once every 4 hours in active
Complications of labour x5
Pain
Perineal tears
Excessive bleeding
Fetal distress
Retained placenta
Define uterine inversion
Placenta fails to separate from uterus hence it pulls it inside out as it exits
4 changes to the breast
Nipple becomes dark and large
Montgometry glands more prominent
Engorgement and dilation of superficial veins
Secretion by 8 weeks
Uterus position at term x2
Dextrorotation
Dextrodeviation
3 cervical changes
Softens
Proliferation of glands
Formation of mucus plug
Define Jacquemier’s sign and what causes it
Bluish discoloration of the vagina caused by increased blood supply in the venous plexus
4 categories of maternal adaptation
- Increased precursors for hormone production
- Improved transport capacity
- Exchange of nutrients and oxygen
- Removal of additional waste products by peripheral vasodilation
What causes the fall in BP x2
Decreased peripheral resistance
Formation of AV shunts in placenta
Causes of dyspnea in pregnancy x3
Reduced pCO2
Increased TV
Reduced TLC
Effects of bladder pressure from uterus x4
Increased micturition
Urinary stasis
Stress incontinence
Hydronephrosis and hydroureter
True or false. Free T3 &T4 levels change during pregnancy
False
3 anti insulin hormones
Prolactin, lactogen, cortisol
What causes ketoacidosis in pregnancy
Lipolysis since maternal source of energy shifts from glucose to lipids
Why is pregnancy a hypercoagulable state x4
Increased clotting factors
Decreased fibrinolytic agents
Venous stasis
Endothelial injury
GIT changes x5
Relaxation of GIT muscles
Increased transit time
Constipation
Hemorrhoids
Gums- soft and easily bleed
Musculoskeletal complications of pregnancy x2
Lumbar lordoisis
Carpal tunnel syndrome
Effect of relaxin and progesterone on pelvic ligaments x2
Relaxation and pain (pelvic girdle and coccygeal)
Effect of estrogen in pregnancy x3
Induce growth of fetal organs
Stimulate maternal tissue growth
Suppress FSH and LH
Why there is plasma volume expansion x4
To meet metabolic demands of fetus and placenta
To deliver nutrients and remove waste products
To protect from excessive blood loss during birth
To protect from effects of impaired venous return when standing up or in supine
Function of human placental lactogen x2
Mobilize FFA for mothers needs
Diverts glucose to placenta and fetus
When does HDL and LDL peak in pregnancy
Week 25 and 26
Effect of progesterone on clotting system x2
Blood stasis
Venodilation
Changes in clotting system x4
Decreased PT APTT
Decreased fibrinolysis
Increased fibrinogen
Increased clotting factors
What causes the fall in BP during mid second trimester
Formation of atrioventricular shunts in the placenta
How does the ECG change during pregnancy x3
ST changes
Inverted T waves on lead lll
Large or prominent Q waves on lead lll
Cause of physiologic edema
Pressure of gravid uterus on IVC
Why the increase in skin perfusion during pregnancy
As a means to lose heat of fetal metabolism via maternal circulation
Effect of progesterone on respiratory tract
Increases CO2 sensitivity and facilitates gas exchange
Changes in respiratory volumes x2
Increased tidal volume
Decreased functional residual capacity
Effects of uterus pressure on bladder x5
Stress incontinence
Increased micturition
Hydronephrosis
Hydroureter
Urine stasis
Git changes during pregnancy x5
Gastrointestinal reflux
Gall bladder relaxation
Bile tract stasis
Hemorrhoids
Soft gums
Musculoskeletal changes x4
Leg cramps
Pelvic tilt
Back arch
Waddling gait
Function of thyroxin
Fetal neural development
3 anti insulin hormones and their functions x3
Human placental lactogen, prolactin, cortisol
1. Increase insulin resistance in mother
2. Decrease peripheral uptake of glucose
3. Ensure continuous glucose supply to fetus
