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ObGyne > Maternal Adaptations in pregnancy > Flashcards

Maternal Adaptations in pregnancy Flashcards

1
Q

Enlargement from stretching and hypertrophy in uterus is most marked at which area?

A

Fundus

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2
Q

Layers of the uterus

A

Outer hoodedlike layer
Middle layer of muscles
Inner sphincter-like fibers

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3
Q

The uterus rotates to which direction? This is caused by the recrosigmoid on the left side of the pelvis

A

Rotates to the RIGHT (dextrorotation)

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4
Q

accounts for “false labor”; irregular, unpredictable, sporadic contractions which rises in number in the last two weeks of gestation

A

Braxton-Hicks contractions

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5
Q

Uteroplacental blood flow is mediated by which small molecule?

A

Nitric oxide (a potent vasodilator)

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6
Q

VEGF and PIGF are attenuated in response to the excess of which hormone?

A

Soluble FMS-like tyrosine kinase 1 (sFlt-1)

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7
Q

Normal pregnancy has vascular refractoriness to which blood pressure mediator?

A

Angiotensin II

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8
Q

Increased vascularity and edema causes the cervix to turn to which color?

A

Bluish (Chadwick’s sign)

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9
Q

This process involves lowering collagen and proteoglycan concentrations and raises water content (compared with nonpregnant cervix)

A

Cervical ripening

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10
Q

Copious amounts of mucus rich in Ig and cytokines produced by endorcervical glands causes the formation of this structure. This is expelled at the onset of labor (bloody show)

A

Mucus plug

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11
Q

Char. pattern of cervical mucus seen when it is spread and dried on glass slide; caused by progesterone causes poor crystallization

A

Beading

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12
Q

Char. pattern of cervical mucus seen when amniotic fluid violates the cervical canal. It is caused by estrogen and salts leading to crystallization

A

Ferning

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13
Q

Organ that produces hCG which maintains the corpus luteum

A

Placenta

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14
Q

This ovarian structure produces the progesterone which maintains the endometrium. It functions maximally until 7 weeks of pregnancy.

A

Corpus luteum (CL)

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15
Q

Loss of polarity, pleiomorphism, intraluminal budding in cervical cells during the pregnancy

A

Arias-Stella reaction

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16
Q

Marked proliferation of cervical glands leads to the outward displacement of the os.

A

Eversion

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17
Q

This hormone is produced by the CL, the decidua, and the placenta. It aids in remodelling of reproductive tract connective tissue to accomodate labor

A

Relaxin

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18
Q

Benign ovarian lesions reflecting physiological follicle stimulation (hyperreaction luteinalis); linked to markedly elevated serum hCG levels (GTD, multifetal gestation)

A

Theca lutein cysts

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19
Q

Violet discoloration of the vagina and cervix resulting from increased vascularity

A

Chadwick sign

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20
Q

Thick, yellowish fluid expressed from the nipples by gentle massage

A

Colostrum

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21
Q

Reddish, slightly depressed skin; in multiparas, glistening, silvery lines from previous striae

A

Striae gravidarum

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22
Q

Rectus muscles separating in the midline when abdominal walls do not withstand the tension of the expanding pregnancy

A

Diastasis recti

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23
Q

Develops in 90% of women, usually more accentuated in those with darker complexion; may be due to the melanocyte-stimulating effects of estrogen and progesterone

A

Hyperpigmentation

24
Q

Brown-black pigmentation in the midline of the anterior abdominal wall

A

Linea nigra

25
Q

Irregular brownish patches of varying sizes appearing on the face and neck

A

Chloasma

26
Q

Vascular changes - likely due to which hormone

A

Estrogen (hyperestrogenemia)

27
Q

Common on the face, neck, upper chest, and arms; minute, red skin papules with radicles branching out from a central lesion

A

Vascular spiders/ angiomas

28
Q

Increased cutaneous blood flow serves to dissipate excess heat generated by augmented metabolism

A

Palmary erythema

29
Q

Phases of hair cyclic activity

A

Periods of hair growth (anagen)
Apoptosis-driven involution (catagen)
Resting period (telogen)

30
Q

Excessive hair loss in the puerperium

A

Telogen effluvium

31
Q

Metabolic rate increase in 3rd trimester

A

20%

32
Q

Additional metabolic rate increase with twin gestation

A

10%

33
Q

Average weight gain during pregnancy

A

12.5 kg (27.5 lbs)

34
Q

Total extra water during pregnancy

A

6.5 L
(water content from the fetus, placenta, and AF (~3.5L) + expanded maternal blood volume and from uterus and breast growth (3L)

35
Q

Carbohydrate metabolism characteristics during pregnancy

A

Mild fasting hypoglycemia, postprandial hyperglycemia, hyperinsulinemia

36
Q

Secreted by adipose tissue in non-pregnant humans; important for implantation, cell proliferation, and angiogenesis

A

Leptin

37
Q

Secreted by adipose tissue in non-pregnant humans; important for implantation, cell proliferation, and angiogenesis

A

Leptin

38
Q

Produced in maternal fat, not in the placenta
- inversely correlated with adiposity
- insulin sensitizer
- reduced in patients with GDM

A

Adiponectin

39
Q

Secreted by the stomach and placenta in response to hunger

A

Ghrelin

40
Q

Elevated levels of this hormone, along with leptin, impair uterine contractility

A

VISFATIN

41
Q

This refers to the decrease in hemoglobin concentration due to plasma expansion during pregnancy

A

Physiologic anemia of pregnancy

42
Q

All clotting factors increase EXCEPT:

A

Factors XI and XIII

43
Q

Most common ECG change during pregnancy

A

Left axis deviation

44
Q

Refers to a syndrome caused by compression of the great vessels by the uterus in the supine position

A

Supine hypotensive syndrome

45
Q

Refractoriness to angiotensin II is probably due to this hormone

A

Progesterone

46
Q

Pulmonary volumes that DECREASE during pregnancy

A

Functional Residual Capacity (FRC)
Total Lung Capacity (TLC)

47
Q

Pulmonary volumes that INCREASE during pregnancy

A

Inspiratory Capacity (IC)
Tidal Volume (may be unchanged or decreased)

48
Q

Pulmonary volumes that DO NOT CHANGE during pregnancy

A

Inspiratory Capacity (IC)
Tidal Volume (may be unchanged or decreased)

49
Q

Causes of elevated minute ventilation in pregnancy

A

•Enhanced respiratory drive due to PROGESTERONE
•Low expiratory reserve volume
•Compensated respiratory alkalosis

50
Q

GFR and renal blood flow changes during pregnancy

A

GFR increases by 25%, Renal blood flow increases by 80%

51
Q

Pathophysiology of increased risk of cholesterol gallstones in pregnancy

A

Progesterone inhibits CCK-mediated smooth muscles stimulation –> impairs GB contraction –> impaired emptying stasis –> cholesterol gallstones in pregnancy

52
Q

Constipation and elevated rectal vessels below the level of the enlarged uterus increases the risk for which GI tract abnormality?

A

Hemorrhoids

53
Q

Hormones that ensures lactation in early pregnancy

A

Prolactin

54
Q

This carrier protein increases due to ESTROGEN stimulation –> increases TOTAL T4 and T3 BUT do not affect free T4, T3

A

Thyroid-binding globulin

55
Q

The fetus relies heavily on maternal production of which thyroid hormone?

A

T4

56
Q

Pathophysiology of upper extremity weakness, numbness during pregnancy

A

Progressive lordosis + anterior neck flexion + shoulder girdle slumping
–> traction on the ulnar and median nerves

57
Q

Brownish-red opacities in the posterior surface of the cornea; often observed in pregnancy

A

Krukenberg spindles

ObGyne (2 decks)

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