Maternal adaptation to pregnancy

Question 1

hCG

Answer 1

Prod by scTB

Signals presence blasto and maintains CL

Question 2

PRogestins

Answer 2

CL then placenta
smt muscle relax OTR inhib
increase mat vent, gluc deposition and increases temp

Question 3

Oestrogens

Answer 3

CL then placenta

breat, nipple, myo growth, CV change, h2o retention, insulin resistance, increase OTR in myo

Question 4

hPL

Answer 4

scTB

stim growth of mammary glands

Question 5

Placenta CRH

Answer 5

increases through pregnancy

Question 6

Relaxin

Answer 6

CL, decidua and placenta

Remodelling of CT in prep for labour

Question 7

Oxytocin

Answer 7

Post pit and placenta
Acts on uterus and breasts
Contracts smt muscle and PG production

Question 8

Prolactin

Answer 8

Ant pit
Milk prod when P and E decrease pp
increase through preg

Question 9

Why changes happen?

Answer 9

Volume support, nutrition, waste clearance, pregnancy maintenance

Question 10

Uterus

Answer 10

Increases mass (46g - 1012g) and volume (10ml - 5000ml)
smt muscle hyperplasia/hypertrophy, increased elastin and fibrin
uNK cells

Question 11

Cervix

Answer 11

Increase vasc, oedema and softening (O&P)
Increased glands
Hyperplasia and eversion

Question 12

Vagina

Answer 12

Venous congestion

Oest - increase glycogen deposits in epi - increased lactic acid - protects

Question 13

Breast

Answer 13

Duct and alveoli prolif

Prolactin for lactation

Question 14

Cardiovascular

Answer 14

Increased HR, SV and CO
TPR decreases 
Small decrease in BP 
Plasma volume increases 30-50%
Increase in ventricular muscle mass

Question 15

CV in labour

Answer 15

Each contraction 300-500mL of blood reenters maternal circulation and CO increases as labour progresses

Question 16

Respiratory

Answer 16

Increase o2, co2, tidal volume and ventilation
Decreases ppCO2 for gas exchange
Diaphragm moves up and ribs flare out - lungs squashed - sense of breathlessness

Question 17

Haematological

Answer 17

BV increases by 40% - plasma and interstitial fluid (dilutional anaemia)
Inc WBC
Increased iron req
Increase in proclotting factors and decrease in anticlotting - at risk of thromoboembolism

Question 18

Renal

Answer 18

Increased length and size of CD due to increase b.f.
Decreased tone - urine back up - pylonephritis
Inc GFR
Glycouria common - decreased reab
ATII resistance and RAAS activated - increase H2O reab

Question 19

GI

Answer 19

Prog - decreases GI motility - better nut reab but constipation
Progressive insulin resistance - more glucose for baby