Maternal adaptations to pregnancy Flashcards
What is the weight and cavity size of a non-pregnant uterus?
The non-pregnant uterus is about 70 g with a 10-ml cavity.
How does the uterus change by 6 weeks of pregnancy?
At 6 weeks, the uterus is soft, globular, and asymmetric.
What is the size of the uterus at 12 weeks of pregnancy?
At 12 weeks, the uterus measures 8-10 cm and is rising out of the pelvis.
Where is the uterus located at 14 weeks of pregnancy?
At 14 weeks, the uterus is one-fourth of the way to the umbilicus.
What is the position of the uterus at 16 weeks of pregnancy?
At 16 weeks, the uterus is halfway to the umbilicus.
What is the position of the uterus at 20 weeks of pregnancy?
At 20 weeks, the fundus is approximately at the umbilicus.
What is the relationship between the number of weeks of gestation and the measurement of the uterus after 20 weeks?
After 20 weeks, the number of centimeters measured equals the number of weeks of gestation within 2 cm.
What is the weight and volume of the uterus by term?
By term, the uterus weighs about 1,100 g with a 5-L volume.
What changes occur in the cervix during pregnancy?
The cervix develops increased vascularity, softening of the isthmus, bluish color, softening of the cervix, and a thick mucus plug forms due to glandular proliferation.
What is an effect of pregnancy on the ovaries-corpus luteum?
Anovulation secondary to hormonal interruption of the feedback loop.
How long does the corpus luteum persist during pregnancy?
The corpus luteum persists under the influence of the hormone hCG until about 12 weeks.
What is the role of the corpus luteum during early pregnancy?
The corpus luteum is responsible for the secretion of progesterone to maintain the endometrium and pregnancy until the placenta takes over production.
What hormone do the ovaries produce during pregnancy?
The ovaries are also thought to be responsible for producing relaxin.
What is a noticeable change in the vagina during pregnancy?
Bluish color.
What happens to the vaginal mucosa during pregnancy?
There is thickening of the vaginal mucosa.
What change occurs in vaginal secretions during pregnancy?
There is an increase in vaginal secretions.
What physical change occurs in connective tissue in preparation for birth?
Some loosening of connective tissue occurs.
What is a change in breast size during pregnancy?
Increase in size secondary to mammary hyperplasia.
How does the areola change during pregnancy?
The areola becomes more deeply pigmented and increases in size.
What may be expressed from the breasts after several months of pregnancy?
Colostrum may be expressed after the first several months of pregnancy.
What appears on the surface of the nipple during pregnancy?
Appearance of sebaceous glands on the surface of the dark area of the nipple.
What happens to vascularity in the breasts during pregnancy?
Vascularity increases.
What is the role of the pelvis during pregnancy?
Responsible for load transfer of body weight and gravity, which increases in pregnancy.
What pelvic change occurs throughout pregnancy?
Progressive anterior tilt throughout the pregnancy.
What effect does pregnancy have on joint elasticity?
Elasticity in the joints can lead to distortion and asymmetry.
What happens to the pubic symphysis during pregnancy?
Weakening of the pubic symphysis.
What is a common oral condition during pregnancy?
Gingivitis is common and may result in bleeding of the gums.
What changes occur in salivation during pregnancy?
Increased salivation occurs.
What is epulis and when does it resolve?
Epulis is a focal swelling of gums that may develop and resolves after the birth.
Does pregnancy increase tooth decay?
Pregnancy does not increase tooth decay.
What happens to the lower esophageal sphincter during pregnancy?
Decreased lower esophageal sphincter pressure and tone occurs.
What is a common symptom related to the esophagus during pregnancy?
Heartburn is common.
What changes occur in gastric emptying time during pregnancy?
Decreased gastric emptying time occurs.
How does pregnancy affect gastric acidity?
Decreased gastric acidity and histamine output occurs.
What changes occur in the intestines during pregnancy?
Decreased tone and motility occur.
How does pregnancy affect vitamin absorption?
Altered enzymatic transport across villi results in increased absorption of vitamins.
What anatomical changes occur in the intestines due to pregnancy?
Displacement of intestines, cecum, and appendix by the enlarging uterus occurs.
What are the effects of pregnancy on the gallbladder?
Decreased tone and decreased motility.
How does pregnancy affect liver function?
Altered production of liver enzymes and altered production of plasma proteins and serum lipids.
What changes occur in the genitourinary/renal system during pregnancy?
Dilation of renal calyces, pelvis, and ureters, increased risk of urinary tract infection (UTI), decreased bladder tone, increased renal blood flow (35%-60%), decreased renal threshold for glucose, protein, water-soluble vitamins, calcium, and hydrogen ions, and increased glomerular filtration rate (40%-50%).
What happens to the renin-angiotensin-aldosterone system during pregnancy?
All components increase, resulting in retention of sodium and water, resistance to the pressor effect of angiotensin II, and maintenance of normal blood pressure.
How does pregnancy affect the musculoskeletal system?
Relaxin and progesterone affect cartilage and connective tissue, resulting in loosening of the sacroiliac joint and symphysis pubis, and encourages the development of the characteristic gait of pregnancy.
What is a common postural change during pregnancy?
Lordosis.
What respiratory changes occur during pregnancy?
The diaphragm rises about 4 cm, thoracic circumference increases by 5-6 cm, residual volume decreases, mild respiratory alkalosis occurs, nasal tissue congestion occurs, and tidal volume, minute ventilation, and minute oxygen uptake increase.
What is a potential respiratory experience during pregnancy?
Physiologic dyspnea due to increased tidal volume and lower Pco2.
What hematologic changes occur during pregnancy?
Blood volume increases from 30% to 50%, plasma volume expands resulting in physiologic anemia, hemoglobin averages 12.5 g/dl, and there may be a need for iron supplementation.
What state does pregnancy create in terms of coagulation?
Pregnancy can be considered a hypercoagulable state because fibrinogen and factors VII-X increase.
How does the cardiovascular system change during pregnancy?
Cardiac volume increases by approximately 10%, resting pulse increases by 10-15 beats per minute, slight cardiac shift occurs, 90% of pregnant individuals develop a physiologic systolic heart murmur, and cardiac output is increased.
What happens to diastolic blood pressure during the first two trimesters of pregnancy?
Diastolic blood pressure is lower due to the development of new vascular beds and relaxation of peripheral tone by progesterone, resulting in decreased flow resistance.
What are the vascular changes in the integumentary system during pregnancy?
Palmar erythema, spider angiomas, varicose veins and hemorrhoids, hyperpigmentation, chloasma, freckles, nevi, recent scars darkening, linea nigra, increased sweat/sebaceous activity, and striae gravidarum.
How does estrogen affect hair growth during pregnancy?
Estrogen increases the length of the anagen (growth) phase of hair follicles, and mild hirsutism may develop in early pregnancy.
What changes occur in the pituitary gland during pregnancy?
Prolactin levels are 10 times higher at term than in the nonpregnant state, and the pituitary gland enlarges by more than 100%.
What changes occur in the thyroid during pregnancy?
The thyroid increases in size (approximately 13%), remains euthyroid due to estrogen-induced increase in thyroxin-binding globulin (TBG), and TSH does not cross the placenta.
What changes occur in the adrenal glands during pregnancy?
The adrenal glands remain the same size but show an increase in the zona fasciculata that produces glucocorticoids, resulting in a two-fold increase in serum cortisol.
What changes occur in the pancreas during pregnancy?
There is hypertrophy and hyperplasia of the B cells, along with insulin resistance due to placental hormones, especially hPL.
What is the average weight gain during pregnancy?
The average weight gain is 28 lb, including contributions from the placenta, amniotic fluid, uterine growth, increased blood volume, breast tissue, fetus, and maternal fat deposits.
What are the recommended weight gain guidelines for pregnancy based on prepregnancy BMI?
Prepregnancy BMI < 18.5: gain 28-40 lb; BMI 18.5-24.9: gain 25-35 lb; BMI 25-29.9: gain 15-25 lb; BMI 30 or greater: gain 11-20 lb.
What is important to consider regarding gestational weight gain?
Gestational weight gain is complex; guidelines should recognize gaps and work to mitigate weight stigma and bias.
How is protein metabolism affected during pregnancy?
Protein metabolism is increased.
What changes occur in fat metabolism during pregnancy?
Fat deposit and storage are increased to prepare for breastfeeding.
How is carbohydrate metabolism altered during pregnancy?
Blood glucose levels are 10%-20% lower than prepregnant states.
