Maternal Physio - GIT Flashcards
1
Q
Organs displaced upward by the enlarging uterus
A
The stomach, appendix, and intestines
2
Q
Appendix position and implication
A
- Displaced upward and laterally
- Pain from appendicitis may occur much higher in the abdomen because the gravid uterus pushes the appendix up
3
Q
Gastric emptying time
- During pregnancy
- During labor
A
- During pregnancy
- Unchanged
- During labor
- Prolonged during labor and administration of analgesic agents
4
Q
Gum changes
A
- May be hyperemic and softened
- Epulis of pregnancy
- focal, highly vascular swelling of gums but regresses spontaneously after delivery
5
Q
Effects of progesterone in GIT
A
- ↓ lower esophageal sphincter tone → heartburn
- ↓ bowel peristalsis → constipation → hemorrhoids
Memory aid:
-
Progesterone has a somehow relaxing effect
- Relaxed ES tone
- Relaxed bowel → ↓ bowel peristalsis
6
Q
Mechanism for hemorrhoid development
A
Constipation and elevated pressure in veins below the level of the uterus
7
Q
Liver enzyme(s) with increased activity
A
- Alkaline phosphatase activity in serum almost doubles during pregnancy
- Total albumin
- Serum globin
8
Q
Liver enzyme(s) with decreased activity
A
- ALT
- AST
- GGT
- Bilirubin
- Serum albumin
9
Q
Albumin levels in pregnancy
A
Serum albumin ↓, but total albumin ↑ because of a greater volume of distribution
10
Q
Liver size in pregnancy
A
Remains the same
11
Q
Why are pregnant women prone to cholestasis?
A
- Progesterone inhibits CCK-mediated smooth muscle stimulation → impairs gallbladder contraction → increased residual volume and cholestasis
- Estrogen inhibits intraductal transport of bile acids → contributes to cholestasis
- Memory aid:*
- Progesterone – relaxing effect – inhibits CCK – impaired GB contraction
12
Q
Cholestasis with increased lipids and cholesterol leads to
A
Higher incidence of gallstones, cholecystitis, and biliary obstruction
