Maternal Physio - Urinary

Question 1

Serum creatinine and creatinine clearance in pregnancy

Answer 1

• Serum creatinine
  
  • Decreased
• Creatinine clearance
  
  • Increased by about 30%
• Summary:*
• The clearance is increased so the actual crea is decreased

Question 2

Is glucosuria abnormal in UA?

Answer 2

May not be abnormal

Question 3

Is proteinuria abnormal during pregnancy?

Answer 3

Yes

Question 4

Probable cause of hematuria

Answer 4

Often a result of contamination during collection

Question 5

Changes in the ureters and mechanism

Answer 5

Dilate due to compression from uterus at the pelvic brim and the effect of progesterone

Question 6

Dilation of right versus left ureter and rationale

Answer 6

R > L due to the dextroversion of the uterus

Question 7

Effect of dilated ureters

Answer 7

Dilated ureters cause ↑ glomerular size and ↑ fluid flow → enlarged kidneys

Question 8

Why pregnant women are at risk to asymptomatic bacteriuria and pyelonephritis

Answer 8

Decreased ureteral peristalsis and increased ureteral compression cause urinary stasis

Question 9

Right hydronephrosis in pregnancy

Normal or abnormal?

Answer 9

Normal

Question 10

Bladder anatomical changes

• Trigone
• Size and tortuosity of vessels

Answer 10

• Trigone
  
  • Bladder trigone is elevated
• Size and tortuosity of vessels
  
  • Increase in size and tortuosity

Question 11

Is continence maintained in pregnancy?

Answer 11

Yes

• bladder pressure increases at term but
• Intraurethral pressure increases as well

Question 12

Why is the bladder susceptible to trauma and infection

Answer 12

Increased preseure from pressenting part

↓

Impaired drainage of blood and lymph from bladder base

↓

Edema

Susceptibility to trauma and infection