Maternal Adaptations to Pregnancy

Question 1

Change in peripheral resistance during pregnancy

Answer 1

Decreases due to increased circulating estrogens (increases PGI2), progesterone, and decreased vascular tone to the skin, kidneys, and mesenteric circulation

*Also will have wider pulse pressure due to great decrease in DP

Question 2

CO during pregnancy

Answer 2

Increased due to the increased preload on the heart, increased venous return, and decreased afterload (decreased PVR)

*Distensibility of the heart is increased by progesterone and estrogen

Question 3

Supine Hypotensive Syndrome

Answer 3

When a pregnant woman lays down, pressure is placed on the IVC leading to a decrease in venous return

=>Decreased arterial pressure

Question 4

Hematocrit during pregnancy

Answer 4

Decreases due to the large increase in blood volume

Question 5

Plasma proteins during pregnancy

Answer 5

Decreased albumin => Decreased viscosity of blood
-Liver is less sensitive to these changes during pregnancy

Increased clotting factors and binding globulins

Question 6

Renal physiology during pregnancy

Answer 6

Increased renal blood flow, GFR, protein excretion, and glucose excretion

Decreased serum creatinine and Na+

Question 7

Na+ retention during pregnancy

Answer 7

Occurs due to activation of the Renin-Angiotensin-Aldosterone system by progesterone and estrogen; uterus will also secrete renin

*This system is activated in spite of the increased blood volume

Question 8

Osmolarity in pregnancy

Answer 8

Decreased; ADH secretion point is also shifted leftward as ADH is unusually secreted even tho the osmolarity is decreased

Question 9

Respiratory Changes during pregnancy

Answer 9

Increased pressure from the diaphragm => Decreased RV and FRC

*TV is increased => Increased alveolar ventilation even tho there is no increase in the RR

VC is the same

Question 10

pCO2 during pregnancy

Answer 10

Is decreased because the BMR cannot keep up w/ the rate of alveolar ventilation

=> Central chemoreceptors operate @ a lower point; kidneys excrete HCO3-

Question 11

Pituitary during Pregnancy

Answer 11

Grows; PRL and ACTH levels increase

FSH, LH, and TSH levels decrease

*GH levels are approximately the same, however, most of it is from hGH

Question 12

GI system during pregnancy

Answer 12

Decreased gastric motility, emptying, and tone of the LES

=>Can lead to heartburn

-Gallbladder also has decreased emptying

Question 13

Intrauterine Growth Restriction

Answer 13

Results from a decrease in placenta perfusion `

Question 14

Products of the second meiotic division of the primary follicle

Answer 14

Haploid ovum and a second polar body