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Obstetrics > Maternal adaptations to pregnancy > Flashcards

Maternal adaptations to pregnancy Flashcards

1
Q

During pregnancy, both pulmonary and systemic vascular resistance _______.

A
  • decrease
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2
Q

What is the trend in arterial blood pressure during pregnancy?

A
  • decreases to a nadir at mid-pregnancy and rises thereafter
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3
Q

Elevation in this hormone may also cause hydronephrosis and hydroureter during pregnancy.

A
  • progesterone
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4
Q

Why are women hypercoagulable during pregnancy?

A
  • coagulation factors are increased (except for 11, 13)
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5
Q

What is the change in cardiac output with pregnancy? What maneuver helps you notice this change the best?

A
  • 35-50% increase in CO during pregnancy

- best seen when a woman is on her left lateral supine position

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6
Q

During pregnancy all liver enzymes are unchanged except:

A
  • Alk Phos increases (d/t placental isoenzyme)
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7
Q

What is the recommended weight gain during pregnancy for someone with the following BMI:

a. <18.5
b. 18.5-24.9
c. 25-29.9
d. >30

A

a. <18.5 = 12.5-18 kg
b. 18.5-24.9 = 11.5-16 kg
c. 25-29.9 = 7-11.5 kg
d. >30 = 5-9 kg

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8
Q

Why can’t diabetes be diagnosed with a urine dip during pregnancy?

A
  • GFR increases so glucosuria is not necessarily abnormal
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9
Q

Physiological dyspnea during pregnancy is likely due to what hormonal change?

A
  • secondary to progesterone increase
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10
Q

What is the medical treatment for mastitis?

A
  • Dicloxacillin
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11
Q

This is defined as pigmentation of the linea alba.

A
  • linea nigra
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12
Q

Increased pigmentation during pregnancy is a result of an increase in what hormone?

A
  • increase in melanocyte stimulating hormone
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13
Q

If a pregnant patient presents with pruritus without a rash, what should you be concerned about?

A
  • Intrahepatic cholestasis of pregnancy
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14
Q

What is the difference in blood loss between an average vaginal delivery and a Cesarean section?

A
  • vaginal delivery = <500cc

- C-section = 1000 cc

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15
Q

Group 3 lesions include what 3 conditions?

A
  • pulmonary hypertension
  • Aortic coarctation with valve involvement
  • Marfan Syndrome with aortic dilation ( > 4 cm)
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16
Q

A 26-year-old female calls your office 4 days after delivery of her first baby. She complains of fever, chills and breast redness. She is breastfeeding. What diagnosis should you be concerned about?

A
  • Mastitis
17
Q

This is defined as a butterfly pigmentation of the face.

A
  • chloasma gravidarum
18
Q

What is the cause of low TSH concentrations during pregnancy?

A
  • Rising levels of serum hCG
19
Q

What cause the physiological anemia during pregnancy?

A
  • increase in plasma (40-45%) > increase in erythrocytes (33%)
20
Q

During pregnancy, inspiratory volumes (e.g. VC, IC) ________; while expiratory volumes (e.g. RV, RC, FRC) ________.

A
  • inspiratory volumes = increase

- expiratory volumes = decrease

21
Q

What change is seen with lung residual volume during pregnancy?

A
  • decreases
22
Q

By 6 weeks post-partum the patient should have lost how many pounds?

A

10 lbs

23
Q

What is Chadwick’s sign?

A

characteristic violet color of the vagina during pregnancy d/t hyperemia

24
Q

What are the total iron requirements of pregnancy?

A
  • 1,000 mg
25
Q

If a patient presents with mastitis and an abscess what is the treatment?

A
  • I&D

- systemic antibiotics

26
Q

What is the most common surgical emergency in pregnancy and during which trimester are you most likely to see it?

A
  • appendicitis

- rupture during 3rd trimester

27
Q

What anatomical change occurs to the appendix during pregnancy?

A
  • it is displaced upward and laterally
28
Q

What 3 hormones contribute to increases in uteroplacental blood flow?

A
  • estrogen
  • progesterone
  • nitric oxide
29
Q

What are the 2 common treatments for iron deficiency?

A
  • oral supplementation + vitamin C

- iron infusions

30
Q

What are the normal values for pH, PaO2, PaCO2, HCO3 during pregnancy?

A
  • pH = 7.45 (higher than normal)
  • PaO2 = 100 (higher than normal)
  • PaCO2 = 30 (lower than normal)
  • HCO3 = 20 (lower than normal)
31
Q

What is the leading cause of maternal mortatility?

A
  • cardiac disease
32
Q

A pregnant women presents with frequent vomiting. Her labs results are as follows:

  • high serum hCG level
  • low TSH level
  • normal T3/T4

What condition are you concerned for?

A
  • Hyperemesis gravidarum
33
Q

Uterine hypertrophy is stimulated primarily from what hormone?

A
  • Estrogen
34
Q

What murmur can be head in 90% of women?

A
  • systolic murmur
35
Q

On average, what is the total weight gain during the course of a single pregnancy for a healthy woman?

A

11 kg

Obstetrics (12 decks)

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