Maternal Physiology Flashcards
Uterus
Week 12
Abdominal organ
Dextrorotation
Isthmus enlargement and thinning
Softening and compressibility of the isthmus occurring on the 6th to 8th w AOG
Hegar’s sign
Softening of cervix pronounced on 6th to 8th wk AOG
Goodell’s sign
Poor pap smear quality during pregnancy
Arias Stella reaction
Bluish or purplish discoloration of vagina at 6 w AOG
Chadwick’s sign
Cervical mucous changes
Vaginal secretion changes
Crystallization or beading
Acidic
T or F
Montgomery glands of the breast increase in size starting the 3rd month of pregnancy
2nd
Melanocyte Stimulating Hormone effects
Linea nigra
Darkening of the areola
Chloasma or melasma
Hyperestrogenemia
Spider nevi
Palmar erythema
Corticosteroids
Striae gravidarum at breast and abdomen
Water metabolism
Inc water retention
Fall in plasma osmolality
Protein metabolism
+500g fetus and placenta
+500g uterus breast blood
CHO metabolism
Periph insulin resistance
Mild fasting hypoglycemia
Postprandial hyperglycemia
Resets lipostat in hypothalamus causing hyperlipidemia
Progesterone
Na and K
Ca and Mg
Fe
Inc: Enhanced tubular reabsorption of Na and K
Dec: Total calcium levels decline but ionized ca is unchanged
100 mg requirement
Weight gain
First trimester
2nd
3rd
2
11
11
Hypercoaguable state
All coag factors inc except
11 and 13
Dec in CBC
Hematocrit
Platelets
Ocular changes
Dec IOP inc vitreous outflow
Dec corneal sensitivity
Inc corneal thickness edema
Skeletal changes
Progressive lordosis
Inc mobility of pelvic joints
Pulmonary changes
TV and Resting minute ventilation inc
FRC and RV dec due to elevation of diaphragm
ABG
Relative alkalosis
Blowing off more CO2 than nonpregnant
Cardiac changes
HR + 10 bpm Inc plasma volume by 40-60 Inc CO by 30-40 Dec DBP TPR Inc venous pressure in LE
Periods of inc CO
28 w
Labor
Postpartum
1st week pp
GUT changes
Urinary stasis Asx bacteriuria
Freqency and nocturia
Hydroureter
Renal changes
Inc GFR by 50% RPF Clcr
Dec serum BUN Crea UA
GIT changes
Appendix displaced downward and laterally
Inc gastric emptying time and
Dec LES tone causing heart burn
Progesterone inhibits CCK causing cholelithiasis and pancreatitis
Estrogen inhibits bile acid transmission to GB causing pruritus
Epulis
Endocrine changes
Pituitary gland enlarges by 135%
Inc prolactin and oxytocin
Adrenal and thyroid hyperplasia
Immunologic changes
Inc WBC IgA IgG
Dec T helper cells and neutrophils
