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πš™πš‘πš’πšœπš’πš˜πš•πš˜πšπš’ 𝟸 : πš›πšŽπš™πš›πš˜πšπšžπšŒπšπš’πš˜πš— > Maternal Changes In Pregnancy > Flashcards

Maternal Changes In Pregnancy Flashcards

1
Q

What are the reasons for changes in pregnancy?

A

β†’ High levels of fetal steroids
β†’ Mechanical displacement
β†’ Fetal requirements

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2
Q

What kind of an event is pregnancy?

A

β†’ Physiological

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3
Q

What can pregnancy do physiologically to existing conditions?

A

β†’ Exacerbate an existing condition

β†’ uncover a hidden or mild condition

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4
Q

What are 6 changes that occur during pregnancy?

A

β†’ Increase in uterus size
β†’ Increase metabolic requirements of the fetus
β†’ Structural and metabolic requirements of the fetus
β†’ Removal of fetal waste products
β†’ Prevision of amniotic fluids
β†’ preparation for delivery and puerperium

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5
Q

In what systems do pregnancy changes occur?

A 
β†’ Respiratory system
β†’ Cardiovascular system
β†’ GI 
β†’ Urinary 
β†’ Endocrine
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6
Q

What are the three placental peptides?

A

β†’ hCG, hPL, GH

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7
Q

What takes over progesterone production?

A

β†’ Corpus luteum

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8
Q

What is the corpus luteum kept alive by?

A

β†’ hCG

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9
Q

What are the placental and fetal steroids?

A

β†’ Progesterones
β†’ Estradiol
β†’ Estrogen

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10
Q

What 4 hormones induce insulin resistance?

A

β†’ Growth hormone
β†’ Corticotropin releasing hormone
β†’ Estrogen
β†’ Human placental lactogen

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11
Q

Why do you want the myometrium to be quiescent?

A

β†’ Contractions would cause miscarriage

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12
Q

What is the total weight gain during pregnancy?

A

β†’ 12.5 - 13kg

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13
Q

What is the breakdown of the weight gain during pregnancy?

A 
β†’ Fetus + placenta - 5kg 
β†’ Fat and protein - 4.5kg 
β†’ Body water 1.5kg 
β†’ Breasts - 1kg
β†’ Uterus 0.5-1kg
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14
Q

Where is fat mainly laid down?

A

β†’ Anterior abdominal wall

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15
Q

What does the basal metabolic rate rise by in mid and late gestation?

A

β†’ 350kcal/day - mid

β†’ 250kcal/day - late

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16
Q

How does glucose get to the fetus?

A

β†’ Facilitated diffusion across the placenta

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17
Q

Where does the fetus store glucose?

A

β†’ in the liver

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18
Q

Describe what happens to maternal glucose reserves in the first trimester

A

β†’ Pancreatic ß cells increase in number
β†’ plasma insulin increases
β†’ Fasting serum glucose decreases (laid down as stores and used by muscle)

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19
Q

Describe what happens to fetal glucose reserves in the second trimester

A

β†’ hPL causes insulin resistance
β†’ less glucose into stores
β†’ increases availability in serum glucose so more crosses the placenta

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20
Q

Describe how gestational diabetes occurs?

A

β†’ Hormones antagonise the effects of insulin
β†’ Insulin increases
β†’ Beta cells become hypertrophied
β†’ Glucose is going into cells to be stored
β†’ insulin resistance gets higher due to hPL
β†’ The body makes more insulin to overcome the resistance
β†’ if you are already obese and insulin resistant you get gestational diabetes

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21
Q

Describe how water gain occurs in pregnancy

A

β†’ Estrogen and progesterone activate the RAAS system
β†’ Sodium is retained
β†’ Plasma volume increases by 40-50%
β†’ A litre of amniotic fluid is made

22
Q

Why do you breathe quicker and deeper during pregnancy?

A

β†’ Estrogen and progesterone increase respiratory sensitivity to CO2

23
Q

What does the minute volume increase by?

A

β†’ 40%

24
Q

What is gas transfer like between mother and fetus

A

β†’ high O2 in mothers blood it favors transfer to the fetus

β†’ high CO2 in fetus it goes to the mother

25
Q

What does the plasma volume increase by?

A

β†’ 40-50%

26
Q

How does Hb concentration change in pregnant women?

A

β†’ it decreases

β†’ Red cell count goes up by 20% but the plasma goes up by 40% so the Hb is more diluted

27
Q

How is more iron absorbed?

A

β†’ Transferrin

28
Q

Why do you become hypercoagulable?

A

β†’ clotting factors increase

29
Q

What does smoking do to fetal blood?

A

β†’ Increases maternal carboxy-Hb which reduces binding of O2

β†’ fetal hypoxia

30
Q

How is blood transferred from the mother to the fetus?

A

β†’ Fetal blood has increased Hb
β†’ Increased O2 binding
β†’ Oxygen is given up by maternal Hb

31
Q

How much does cardiac output increase by?

A

β†’ 40-50%

32
Q

What is preeclampsia?

A

β†’ High blood pressure

33
Q

What is blood pressure like during pregnancy and why?

A

β†’ Blood pressure = peripheral resistance x CO
β†’ if CO goes up by 40-50% the blood pressure must go down
β†’ peripheral resistance must decrease
β†’ HIGH VOLUME AND LOW PRESSURE

34
Q

Where does blood flow increase?

A

β†’ Uterus
β†’ Placenta
β†’ Muscle
β†’ Kidney and skin

35
Q

Why does neoangiogenesis occur?

A

β†’ Extra capillaries in skin to assist with heat loss

36
Q

How does acid reflux occur?

A

β†’ in the third trimester the LOS tends to relax

37
Q

What does progesterone do to the GI tract?

A

β†’ Increases appetite
β†’ Smooth muscle relaxation throughout the whole gut
β†’ a common side effect is constipation

38
Q

What does deficiency of folic acid lead to?

A

β†’ Spina bifida - neural tube defect

39
Q

How much folic acid should be taken?

A

β†’ 5mg/day upto week 12

40
Q

Why do pregnant women get UTIs?

A

β†’ If you ultrasound a pregnant woman’s kidneys they are dilated
β†’ You may not void everything and get static urine and get UTIs

41
Q

How much does the filtrate increase by and why?

A

β†’ 40-50% because all the cardiac output goes through the kidney as well

42
Q

Why is there increased frequency in urination during pregnancy?

A

β†’ Baby’s head is pressing on the bladder in very late pregnancy

43
Q

What does the uterus hypertrophy in response to?

A

β†’ Estrogen

44
Q

Where is the incision for a C section done?

A

β†’ Just above the symphysis

45
Q

When does the cervix tissue soften?

A

β†’ From 8 weeks

46
Q

What is the function of the cervix?

A

β†’ To retain the pregnancy

47
Q

What happens to the glands in the cervix?

A

β†’ Great increase in mucus production

β†’ Anti-infective

48
Q

What happens when the placenta is delivered?

A

β†’ Rapid fall in steroids

49
Q

What happens to the uterus after delivery?

A

β†’ Rapidly loses oedema but contracts slowly

β†’ Never returns to pre-pregnancy size

50
Q

What enables prolactin?

A

β†’ Removal of steroids

πš™πš‘πš’πšœπš’πš˜πš•πš˜πšπš’ 𝟸 : πš›πšŽπš™πš›πš˜πšπšžπšŒπšπš’πš˜πš— (12 decks)

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