Maternal Fetal Physiology - Hill Flashcards
What are the consequences of a woman being hypervolemic and anemic during pregnancy?
1) less viscous blood
2) reduce resistance flow
3) these help with placental perfusion and lowers cardia work
Are all pregnant women screened for diabetes?
YES
What is gestational DM?
increased insulin resistance from human placental lactogen (hPL), progesterone, prolactin and cortisol
When is insulin resistance highest in pregnancy?
3rd trimester
Does glucose or insulin cross the placenta?
1) Glucose crosses placenta
2) insulin DOES NOT cross placenta
Does TSH cross the placenta?
NO
What thyroid hormones increase during pregnancy?
1) TBG
2) total T4
3) total T3
What thyroid levels stay the same during pregnancy overall?
1) Free T3 and T4 increase in the first trimester and then they normalize
2) TSH decreases first trimester then normalizes
What is the action of progesterone?
smooth muscle relaxer
What changes are seen with kidneys during pregnancy?
1) increase in size, blood flow and GFR
2) decrease in BUN/Cr, UA, osmolality
3) urinary stasis (300ml always)
What cardiac factors change during pregnancy?
1) increase in CO, HR, preload
2) decrease in afterload (from lower SVR)
What respiratory changes are seen in pregnancy women?
1) increases:
a) Minute volume
b) tidal volume
c) inspiratory capacity (mildly)
d) PaO2
e) pH
2) Decreases
a) functional residual capacity
b) PaCO2
c) total lung capacity
d) residual volume
e) Expiratory reserve volume
What CV changes are seen in pregnancy?
1) increase
a) CO
b) HR
c) preload
2) Decrease
a) Afterload
b) SVR
What hemeatologic changes are seen in pregnancy?
1) increase
a) PV
b) RBC mass
c) TBV
2) Decreased
a) H/H
b) blood viscosity
What are “normal” changes during pregnancy?
1) respiratory alkalosis
2) EKG changes
3) cardiomegaly
4) SVTs
5) nasal stuffiness and epistaxis
6) hydronephrosis (R > L)
