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Women's Health > Maternal fetal physiology > Flashcards

Maternal fetal physiology Flashcards

1
Q

During pregnancy, progesterone increases. What are some of the effects of this?

A

decreases smooth muscle tone

increases CO2 chemoreceptor sensitivity

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2
Q

When does the placenta start to take over the production of Progesterone?

A

7-8 weeks

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3
Q

Estrogen increases during pregnancy. What are some of the effects of this?

A

Oxytocin receptors increase -for uterine contraction
Breast ductal growth
Palmar erythema/ spider angiomas
Hepatic biosynthesis of proteins

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4
Q

What physical changes occur in the heart of the mother?

A

LA, and LV increase in size

Left access deviation

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5
Q

What happens to cardiac output?

A

increases by 30-50%

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6
Q

What happens to vascular resistance?

A

decreases due to progesterone

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7
Q

A woman comes in and her bp is 130/90, her last visit was 110/75. What are you concerned about?

A

Preeclampsia

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8
Q

Why is it recommended to have women sleep on their side in the 3rd trimester?

A

Inferior vena cava syndrome, the weight of the fetus presses down on the vena cava

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9
Q

Diastolic murmurs and hypertension are abnormal or normal?

A

abnormal

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10
Q

Increased S2 sounds, splits with inspiration
distended neck veins
low-grade systolic ejection murmur
S3 Gallop, 3rd heart sound

These are all abnormal or normal?

A

normal

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11
Q

What may change on a pregnant chest x-ray?

A

widened subcostal angle

more prominent pulmonary vasculature

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12
Q

How does the tidal volume and minute ventilation change?

A

increases 30-40%

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13
Q

Does total lung capacity increase or decrease with increased demand from baby and mom?

A

decreases- loss of space compensation occurs in min volume and tidal volume increases

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14
Q

Explain why atrial CO2 levels drop in maternal arteries?

A

The decreased CO2 levels increase the affinity for it when picking up CO2 from the placental Arteries aiding in the transference of O2 to baby

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15
Q

What happens to RBC and Plasma levels? What factor is needed due to these changes

A

Increase

adequate iron 60 mg recommended daily

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16
Q

A woman is said to be physiologically anemic during pregnancy why is that?

A

Dilution of the total blood volume due to increases in plasma. The increase in RBCs is not enough to proportionally increase the Hb and Hct.

17
Q

How does Hgb compare in pregnant vs non-pregnant?

A

12.5g/dL in pregnant

14 g/dL in non pregnant

18
Q

What level of Hgb would classify a woman as anemic?

A

<11 g/dL

19
Q

It is normal to have elevated WBCs, how high can they be and when are they highest?

A

Highest during labor and puerperium(6 wks postpartum)

20
Q

What changes occur in clotting?

A

Increased fibrinogen and factors

21
Q

Due to the hematological changes, what is the increased risk?

A

thromboembolism

22
Q

Is herniation higher or lower risk and why during pregnancy?

A

Higher risk due to the displacement of GI system

23
Q

Smooth muscle relaxation due to progesterone has what effects on the GI?

A

GERD increases -esophageal sphincter relaxation
Decreased Motility - hemorrhoids, constipation
Increased gallstones
pruritis- reduced transport of bile acids

24
Q

Proteinuria, glucosuria decreased blood pressure, ankle edema, back pain which of these is most concerning?

A

Proteinuria

25
Q

What happens during fasting states in pregnancy?

A

increased free fatty acids in the blood, glucose stores are reserved for the baby

26
Q

What changes to the skin are normal during pg?

A 
hyperpigmentation
- chloasma
- linea nigra
-nipples
Palmar erythema 
spider angiomata
acne
pruritis
27
Q

Describe changes to the breast in pg?

A

25-50 increase in size
nipples and areola darken and enlarge
changes occur rapidly in the first 8 wks

28
Q

What is the primary nutrient inutero and how does it get to the baby?

A

glucose facilitated diffusion

29
Q

What does the placenta produce after implantation?

A

hCG

30
Q

What are the functions of hCG?

A
  1. promotes progesterone production
  2. promotes angiogenesis of uterine vasculature
  3. promotes blockage of immune cells by mother
  4. suppresses contractions
  5. growth and differentiation of umbilical cord
  6. signal endometrium for implantation
31
Q

What does human placental lactogen do?

A

increase glc and amino acids to fetus

encourages insulin resistance in mom

32
Q

How do human placental lactogen levels change throughout pregnancy?

A

they increase

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