Maternal Changes In Pregnancy Flashcards
What are the reasons for changes in pregnancy?
→ High levels of fetal steroids
→ Mechanical displacement
→ Fetal requirements
What kind of an event is pregnancy?
→ Physiological
What can pregnancy do physiologically to existing conditions?
→ Exacerbate an existing condition
→ uncover a hidden or mild condition
What are 6 changes that occur during pregnancy?
→ Increase in uterus size
→ Increase metabolic requirements of the fetus
→ Structural and metabolic requirements of the fetus
→ Removal of fetal waste products
→ Prevision of amniotic fluids
→ preparation for delivery and puerperium
In what systems do pregnancy changes occur?
→ Respiratory system → Cardiovascular system → GI → Urinary → Endocrine
What are the three placental peptides?
→ hCG, hPL, GH
What takes over progesterone production?
→ Corpus luteum
What is the corpus luteum kept alive by?
→ hCG
What are the placental and fetal steroids?
→ Progesterones
→ Estradiol
→ Estrogen
What 4 hormones induce insulin resistance?
→ Growth hormone
→ Corticotropin releasing hormone
→ Estrogen
→ Human placental lactogen
Why do you want the myometrium to be quiescent?
→ Contractions would cause miscarriage
What is the total weight gain during pregnancy?
→ 12.5 - 13kg
What is the breakdown of the weight gain during pregnancy?
→ Fetus + placenta - 5kg → Fat and protein - 4.5kg → Body water 1.5kg → Breasts - 1kg → Uterus 0.5-1kg
Where is fat mainly laid down?
→ Anterior abdominal wall
What does the basal metabolic rate rise by in mid and late gestation?
→ 350kcal/day - mid
→ 250kcal/day - late
How does glucose get to the fetus?
→ Facilitated diffusion across the placenta
Where does the fetus store glucose?
→ in the liver
Describe what happens to maternal glucose reserves in the first trimester
→ Pancreatic ß cells increase in number
→ plasma insulin increases
→ Fasting serum glucose decreases (laid down as stores and used by muscle)
Describe what happens to fetal glucose reserves in the second trimester
→ hPL causes insulin resistance
→ less glucose into stores
→ increases availability in serum glucose so more crosses the placenta
Describe how gestational diabetes occurs?
→ Hormones antagonise the effects of insulin
→ Insulin increases
→ Beta cells become hypertrophied
→ Glucose is going into cells to be stored
→ insulin resistance gets higher due to hPL
→ The body makes more insulin to overcome the resistance
→ if you are already obese and insulin resistant you get gestational diabetes
Describe how water gain occurs in pregnancy
→ Estrogen and progesterone activate the RAAS system
→ Sodium is retained
→ Plasma volume increases by 40-50%
→ A litre of amniotic fluid is made
Why do you breathe quicker and deeper during pregnancy?
→ Estrogen and progesterone increase respiratory sensitivity to CO2
What does the minute volume increase by?
→ 40%
What is gas transfer like between mother and fetus
→ high O2 in mothers blood it favors transfer to the fetus
→ high CO2 in fetus it goes to the mother
