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Physiology 2 > Maternal Changes In Pregnancy > Flashcards

Maternal Changes In Pregnancy Flashcards

1
Q

What are the changes in pregnancy that are designed to cope with the main event?

A 
Increase in uterus size 
Increased uterine metabolic requirements
Structural and metabolic requirements of the foetus
Removal of foetal waste products
Provision of amniotic fluid
Preparation for delivery and puerperium
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2
Q

What systems do the placental steroids effect?

A

RAAS, resp system, GIT blood vessels and uterine myometrium contractility

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3
Q

What is the total amount of weight gain in pregnancy?

A

12-13 Kg

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4
Q

How much does the foetus and placenta weigh?

A

5Kg

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5
Q

How much do fats and protein increase in weight by?

A

4.5Kg

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6
Q

How much does the body water increase by?

A

1.5Kg

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7
Q

How much do the breasts increase in weight by?

A

1 kg

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8
Q

How much does the uterus increase in weight by?

A

0.5-1kg

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9
Q

Why do you need to increase energy in pregnancy?

A

To cope with increased respiration and cardiac output, labour, post labour and storage in the foetus

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10
Q

Where are the increased fat and protein stores found?

A

Interior abdominal wall

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11
Q

How much does the basal metabolic rate increase by in pregnancy?

A

250-350 kcal/day

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12
Q

How does the fetus get energy?

A

Activate transport through the placenta

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13
Q

What happens to glucose metabolism in the first trimester?

A

Pancreatic beta cells increase in number
Plasma insulin increases
Fasting serum glucose decreases

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14
Q

What happens to glucose metabolism in the second trimester?

A

hPL causes insulin resistance so there’s less stored glucose and more serum glucose

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15
Q

How does the body retain water in pregnancy?

A

E2 and progesterone act on the RAAS to retain sodium

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16
Q

How much water is retained in a pregnant human?

A

8,5L

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17
Q

Where does all the excess fluid get stored?

A

Ankles, lungs, connective tissue and ligaments

18
Q

Ankles, lungs, connective tissue and ligaments

A

Increases respiratory sensitivity to CO2, changes in thoracic anatomy and deeper breathing

19
Q

How does gas exchange change in pregnancy?

A

Arterial pO2 increases 10% and pCO2 decreases 15-20% to facilitate gas transfer between the foetus and mother

20
Q

By how much does the plasma volume increase in pregnancy?

A

40-50%

21
Q

By how much does the red cell mass increase in pregnancy?

A

18-20%

22
Q

What is haeomodilution?

A

Apparent anaemia that happen when the concentration of Hb falls

23
Q

What happens in the gut to allow for increased red cell mass?

A

Increased iron absorption efficiency

24
Q

Why is there an increase in white cells and clotting factors in pregnancy?

A

Increased fibrinogen for placental separation but an increased risk of thrombosis

25
Q

What happens to the heart in pregnancy?

A

Increased heart rate and stroke volume (ie increased cardiac output)

26
Q

What results from the heart being pushed around because of the expanding uterus?

A

Changing ECG and heart sounds

27
Q

Where does blood flow increase to in pregnancy?

A

Uterus, placenta, muscle, kidneys and skin

28
Q

What causes the reduced peripheral resistance in pregnancy?

A

Increased cardiac output and vasodilation by steroids

29
Q

Why does blood flow to the skin happen in pregnancy?

A

To assist in heat loss

30
Q

How does progesterone affect the GIT?

A

Reduces gut motility, relaxes the lower oesophageal sphincter and affects appetite and thirst

31
Q

When is it advised to take folic acid supplements?

A

3 months before conception up to week 12

32
Q

What can folic acid deficiency be linked to?

A

Spina bifida

33
Q

Why are pregnant people at an increased risk of a UTI?

A

Progesterone is a smooth muscle relaxant, so dilates the kidneys and ureters

34
Q

How much does blood flow to the kidneys increase in pregnancy?

A

40-50%

35
Q

Why doesn’t the second trimester cause increased urinary frequency?

A

Uterus is lifted out of the pelvis

36
Q

By term, what proportion of blood flow is in the placenta/ uterus at any given time?

A

1/6

37
Q

Why is the lower uterine segment less muscular and more fibrous than the rest of the uterus?

A

Act like a tunnel in labour

38
Q

What is the cervix’s primary function in pregnancy?

A

Stay closed and retain the pregnancy

39
Q

Why does the cervical tissue soften from 8 weeks?

A

Gradual preparation for expansion

40
Q

Why is there a big increase in mucus production from the cervix in pregnancy?

A

Protective

Physiology 2 (38 decks)

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