Maternal Changes in Pregnancy Flashcards
what is a normal weight gain during pregnancy? how is this distributed?
12.5-13kg
5kg foetal and placental
- 5 kg fat and protein stores
- 5kg body water
- 5-1kg breast tissue
what is the purpose of laying down fat and protein stores?
used as a energy store for the foetus, and for preparing for labour
how are the increased protein and fat stores established? where?
increased production and decreased use of energy stores
laid down on the anterior abdominal wall
what happens to the BMR during pregnancy?
increases - by 350 kcal/day in midGA, 250kcal/day in late GA
due to increased T3 and T4 levels – levels of thyroxine binding globulin also increase - so blood levels of freeT3 and T4 remain normal
how does glucose storage change during pregnancy?
in the first trimester there is an increase in beta cells - meaning increase insulin and increased glucose into maternal stores
at the 2nd trimester - there is production of hPL - this causes insulin resistance and less glucose is put into storage - higher plasma glucose levels transfer to the foetus for storage
why is it important to monitor maternal blood glucose?
if it is too high there could be a hPL imbalance -leading to gestational diabetes
what are the 4 main causes of increased body water?
resetting of the osmostat
decreased thirst threshold
Na+ retention - due to oestrogen and progesterones effect on RAAS
Decreased plasma oncotic pressure - due to increase albumin- causes water to be drawn in
what is the effect of an increase in body water
increased venous pressure- means cappillary leakage and oedema
why is it important to keep the weight gain in pregnancy to the specified levels?
reduces the chances of compliations
what GI changes can occur during pregnancy?
increased appetite and thirst
decreased gut motility - leads to constipation
relaxation of the LOS - leads to acid reflus
what cervical changes occur during pregnancy?
increased vascularity
there is tissue softening - appears more blue
connective tissue restructuring to prepare for expansion
poliferation of glands
what urinary changes occur during pregnancy?
increased renal blood flow –> increased eGFR –> increased clearance of some drugs, creatinine, urea
there is dilation and relaxation of the bladder - results in urinary stasis and UTI
maternal steroids and the uterus pressing against the bladder mean there is increased urgency
what CVS changes occur during pregancy?
increased CO - due to increased heart rate and stroke volume
steroid hormones cause vasodilation - lead to decreased TPR - increased blood flow
neoangiogenisis - means increased surface cappilaries - spider navei for heat loss
increase in uterus size means the heart is displaced to the left - changes to ECG and heart sounds
what changes occur to the blood during pregnancy?
increased blood plasma volume and increased RBC count - they are not in proportion - so there is haemodilution
apparent anaemia due to this - different normal physiological range in pregnancy
blood becomes hyper coagulable due to increase in F VII, VIII and X
what respiratory changes occur during pregnancy?
increased sensitivity to CO2
ribs splay and become displaced upwards
- breathe deeper
- increased minute volume
- increased PO2 and decreased PCO2
overall allows good placental gas transfer
