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ObGyn > Maternal adaptation > Flashcards

Maternal adaptation Flashcards

1
Q

State which hormone is responsible hypertrophy(1) and hyperplasia of the uterus (1)

A

Hypertrophy of muscle fibers- estrogen
Hyperplasia of uterine cells - progesterone

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2
Q

Describe Goodell’s sign, what causes it and when it is seen

A

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

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3
Q

Describe Chadwick’s sign, what causes it and when it is seen

A

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

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4
Q

Describe hegar’s sign, what causes it and when its seen

A

Compressibility and softening of the cervical isthmus
Caused by increased blood flow, estrogen and progesterone
4-12 weeks

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5
Q

Function of progesterone x2

A

Raise body temperature
Causes smooth muscle relaxation

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6
Q

What membrane produces HCG and its function

A

Produced by syncytiotrophoblast and stimulates corpus luteum to produces progesterone

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7
Q

What stimulates the thyroid binding globulin and where is it produced

A

Stimulated by high estrogen levels and produced by hepatic cells

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8
Q

Function of T4 thyroid hormone

A

Fetal neural development

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9
Q

Where is corticotropin releasing hormone produced and its function

A

By placenta
Potentiates the action of prostaglandins and oxytocin

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10
Q

Function of estrogen during labour x2

A

Softening and ripening the cervix

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11
Q

Hormones produced by fetus in utero that help in labour x2

A

Pituitary produces oxytocin
Adrenal glands produce cortisol which converts progesterone to estrogen which promotes cervical ripening

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12
Q

Frequency of vaginal exams during latent and active phase of labour x2

A

Once every 6 hours in latent and once every 4 hours in active

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13
Q

Complications of labour x5

A

Pain
Perineal tears
Excessive bleeding
Fetal distress
Retained placenta

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14
Q

Define uterine inversion

A

Placenta fails to separate from uterus hence it pulls it inside out as it exits

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15
Q

4 changes to the breast

A

Nipple becomes dark and large
Montgometry glands more prominent
Engorgement and dilation of superficial veins
Secretion by 8 weeks

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16
Q

Uterus position at term x2

A

Dextrorotation
Dextrodeviation

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17
Q

3 cervical changes

A

Softens
Proliferation of glands
Formation of mucus plug

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18
Q

Define Jacquemier’s sign and what causes it

A

Bluish discoloration of the vagina caused by increased blood supply in the venous plexus

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19
Q

4 categories of maternal adaptation

A
  1. Increased precursors for hormone production
  2. Improved transport capacity
  3. Exchange of nutrients and oxygen
  4. Removal of additional waste products by peripheral vasodilation
20
Q

What causes the fall in BP x2

A

Decreased peripheral resistance
Formation of AV shunts in placenta

21
Q

Causes of dyspnea in pregnancy x3

A

Reduced pCO2
Increased TV
Reduced TLC

22
Q

Effects of bladder pressure from uterus x4

A

Increased micturition
Urinary stasis
Stress incontinence
Hydronephrosis and hydroureter

23
Q

True or false. Free T3 &T4 levels change during pregnancy

A

False

24
Q

3 anti insulin hormones

A

Prolactin, lactogen, cortisol

25
Q

What causes ketoacidosis in pregnancy

A

Lipolysis since maternal source of energy shifts from glucose to lipids

26
Q

Why is pregnancy a hypercoagulable state x4

A

Increased clotting factors
Decreased fibrinolytic agents
Venous stasis
Endothelial injury

27
Q

GIT changes x5

A

Relaxation of GIT muscles
Increased transit time
Constipation
Hemorrhoids
Gums- soft and easily bleed

28
Q

Musculoskeletal complications of pregnancy x2

A

Lumbar lordoisis
Carpal tunnel syndrome

29
Q

Effect of relaxin and progesterone on pelvic ligaments x2

A

Relaxation and pain (pelvic girdle and coccygeal)

30
Q

Effect of estrogen in pregnancy x3

A

Induce growth of fetal organs
Stimulate maternal tissue growth
Suppress FSH and LH

31
Q

Why there is plasma volume expansion x4

A

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

32
Q

Function of human placental lactogen x2

A

Mobilize FFA for mothers needs
Diverts glucose to placenta and fetus

33
Q

When does HDL and LDL peak in pregnancy

A

Week 25 and 26

34
Q

Effect of progesterone on clotting system x2

A

Blood stasis
Venodilation

35
Q

Changes in clotting system x4

A

Decreased PT APTT
Decreased fibrinolysis
Increased fibrinogen
Increased clotting factors

36
Q

What causes the fall in BP during mid second trimester

A

Formation of atrioventricular shunts in the placenta

37
Q

How does the ECG change during pregnancy x3

A

ST changes
Inverted T waves on lead lll
Large or prominent Q waves on lead lll

38
Q

Cause of physiologic edema

A

Pressure of gravid uterus on IVC

39
Q

Why the increase in skin perfusion during pregnancy

A

As a means to lose heat of fetal metabolism via maternal circulation

40
Q

Effect of progesterone on respiratory tract

A

Increases CO2 sensitivity and facilitates gas exchange

41
Q

Changes in respiratory volumes x2

A

Increased tidal volume
Decreased functional residual capacity

42
Q

Effects of uterus pressure on bladder x5

A

Stress incontinence
Increased micturition
Hydronephrosis
Hydroureter
Urine stasis

43
Q

Git changes during pregnancy x5

A

Gastrointestinal reflux
Gall bladder relaxation
Bile tract stasis
Hemorrhoids
Soft gums

44
Q

Musculoskeletal changes x4

A

Leg cramps
Pelvic tilt
Back arch
Waddling gait

44
Q

Function of thyroxin

A

Fetal neural development

45
Q

3 anti insulin hormones and their functions x3

A

Human placental lactogen, prolactin, cortisol
1. Increase insulin resistance in mother
2. Decrease peripheral uptake of glucose
3. Ensure continuous glucose supply to fetus

ObGyn (34 decks)

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