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Reproductive System > Maternal Adaptations > Flashcards

Maternal Adaptations Flashcards

1
Q

What happens to the CVS during pregnancy?

A

Oxygen consumption increases

  • foetal oxygen requirements
  • increasing maternal metabolic rate
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2
Q

What happens to the plasma volume?

A

Increases

- increased afterload

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3
Q

What happens to the stroke volume?

A

Increases

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4
Q

What happens to the systemic vascular resistance?

A

Decreases due to vasodilation caused by progesterone

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5
Q

What happens to the heart rate?

A

Increases by 10-20 bpm

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6
Q

What happens to the cardiac output?

A

Increases

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7
Q

What times throughout pregnancy are women with pre-existing heart disease most at risk?

A

Labour

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8
Q

What are the ECG changes seen in pregnancy?

A

Atrial + ventricular ectopics
Left axis shift
ST depression + T wave inversion in inferior + lateral leads

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9
Q

What happens to urinary output?

A

Increases due to increased renal blood flow due to vasodilation by progesterone

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10
Q

What can occur in pregnancies to the renal system?

A

Ureter compression
UTIs
Urinary incontinence

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11
Q

Why does ureter compression occur?

A

Growth of the foetus

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12
Q

What is the effect of ureter compression?

A

Hydronephrosis - back flow of urine

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13
Q

Why do UTIs occur?

A

Stasis and increased pressure due to foetal position

Causes backflow to the kidneys

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14
Q

Why does urinary incontinence occur?

A

Pelvic floor muscles weakened

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15
Q

What can be found in the urine of pregnant women?

A

Glucose
Calcium
Protein
Bicarbonate

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16
Q

What happens to plasma osmolarity?

A

Decreased

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17
Q

What happens to progesterone levels?

A

Increased

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18
Q

What are the effects of progesterone?

A

Relaxes smooth muscle
Slows gastric emptying
Vasodialtion

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19
Q

What happens to oestrogen levels?

A

Increased

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20
Q

What are the effects of oestrogen?

A

Breast tissue growth
Water retention
Increased protein synthesis

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21
Q

What other hormone is produced?

A

Relaxin

22
Q

What is the effect of relaxin?

A

Softens the cervix and pelvic ligaments in preparation for birth

23
Q

What happens to prolactin levels?

A

Increased

24
Q

What are the effect of prolactin?

A

Stimulate breast development

Promotes lactation

25
Q

What can occur in pregnancy due to the GI system?

A

Acid reflux

Constipation

26
Q

Why does acid reflux occur?

A

Relaxation of the lower oesophageal sphincter due to progesterone

27
Q

Why does constipation occur?

A

Slowing of peristalsis due to progesterone

28
Q

How does immunity change in pregnancy?

A

Shifts from T helper 1 (cell mediated immunity) to T helper 2 (humoral immunity)

29
Q

What is the effect of hCG on maternal immunity?

A

Reduces levels of

  • IgA
  • IgG
  • IgM
30
Q

What happens to the respiratory system?

A

Increased oxygen demand - increases respiratory drive

31
Q

What happens to the tidal volume?

A

Increases

32
Q

What happens to respiratory rate?

A

Stable

33
Q

What is the ABG pattern in pregnancy?

A

pH 7.4-7.45
pO2 increased
pCO2 decreased

Mild respiratory alkalosis

34
Q

What are the early changes to the respiratory system?

A

Increase in subcostal angle
Increase transverse diameter
Increase circumference of chest

35
Q

What are the later changes to the respiratory system?

A

Elevation of the diaphragm

36
Q

What happens to glucose levels in pregnancy?

A

Increase in insulin resistance due to placental lactogen

Hyperplasia of pancreatic B cells - increase insulin levels

37
Q

What is gestational diabetes?

A

Diabetes first diagnosed in pregnancy

38
Q

How is gestational diabetes diagnosed?

A

Glucose tolerance test at 28 weeks

  • fasting glucose > 5.6
  • 75g sugar
  • 2 hours
  • glucose >7.8
39
Q

What is the effect of gestational diabetes on foetus?

A

Foetal macrosomia = larger baby

Post delivery foetal hypoglycaemia - hyperinsulinaemia still present

40
Q

What are the effects of gestational diabetes on the pregnancy?

A

Increased risk of stillbirth
Increased risk of requiring induction of labour
Polyhydraminos = excess amniotic fluid
Shoulder dystocia

41
Q

What is pre-eclampsia?

A

Raised blood pressure and proteinuria in pregnancy

42
Q

How is pre-eclampsia diagnosed?

A

> 140/90 on 2 separate occaisions >4 hours apart

Proteinuria

43
Q

What causes pre-eclampsia?

A

Impaired trophoblast differentiation + invasion causing insufficient placental bloodflow

44
Q

What are risk factors for pre-eclampsia?

A 
>40 
History of pre-eclampsia
Pre-pregnancy obesity 
Diabetes
Pre-existing hypertension 
Family history
45
Q

What do you give patients with pre-eclampsia risk factors?

A

75mg aspirin OD

46
Q

What are the symptoms of pre-eclampsia?

A 
Headache
Visual disturbance
RUQ pain 
Seizures
Hyperreflexia 
Oedema
47
Q

What are the effects of the foetus with pre-eclampsia?

A

IUGR = intrauterine growth constriction

Still birth

48
Q

How is pre-eclampsia managed?

A

Anti-hypertensives

If hyper reflexive - magnesium sulphate

Main treatment = delivery

49
Q

Why do you get anaemia in pregnancy?

A

Plasma volume increases 50%

Red cell mass only increases 20%

50
Q

How is anaemia in pregnancy managed?

A

Ferrous sulphate

Reproductive System (22 decks)

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