Maternal Physiology

Question 1

Weight of Uterus for nonpregnant

Answer 1

70 gms

Question 2

Weight of uterus for pregnant

Answer 2

1100 gms

Question 3

Volume of uterus for nonpregnant

Answer 3

=10 mL

Question 4

Volume of uterus for pregnant

Answer 4

5L

Question 5

Length of uterus for nonpregnant

Answer 5

2.5-3.5 cm

Question 6

Length of uterus for pregnant

Answer 6

9-10 cm

Question 7

At 4 weeks AOG, begins to undergo profound softening and cyanosis

Produce copius amount of anti-bacterial tenacious mucus

Coonsistency of mucus: CRYSTALIZATION or beading due to progesterone

Basal cells in the SCJ are likely to be prominent in size, shape, and staining qualities

Answer 7

CERVIX

Question 8

Softening of cervix modtly significant on the 6th-8th week

Answer 8

GOODELL’s sign

Question 9

Physiologic eversion of the cervix

Answer 9

Squamous epithelium of ectocervix becomes hypersctive, endocerevical glands become hyperplastic, and endocervical epithelium proliferates and grows out over the ectocervix

Question 10

Poor pap smear quality during pregnancy

Answer 10

Arias Stella reaction

Question 11

Stretching and marked hypertrophy of muscle cells

Considerable increase in elsstic tissue

Accumulation of fibrous tissue, particulary in the external muscle layer

1. Conversion of secretory endometrium to decidua begind several days after implantation
2. Consistency
   - progressive softening of the uterus
   - HAEGAR’s sign (softening and compressibility of the isthmus occuring on the 6th-8th week AOG
3. By 12 weeks
   - becomes an abdominal organ and with ascent of uterus from pelvis, it usually undergoes destrotation
   - beginning at 12 weeks of pregnancy, the isthmus enlarges and thins secondary to hormonal of influences of pregnancy and uterine distention
   - during labor, the isthmus expands and is termed the LOWER UTERRINE SEGMENT

Answer 11

UTERUS

Question 12

Ovulation ceases

Single corpus luteum can be found in pregnant women

This functions maximally during the 1st 6 to 7 weeks of pregnancy - 4 to 5 weeks post ovulation

Decidual reaction

Increased size of ovarian veins

Luteomas of pregnancy

Theca-lutein cysts; elevated serum levels of hCG

Answer 12

OVARY

Question 13

Progressive hyperplasia and hypertrophy of the vaginal epithelium in marked thickening of the mucosa

Increased vaginal discharge coming from the cervix

pH becomes acidic

Answer 13

VAGINA

Question 14

Bluish/Purplish discoloration of the vagina at 6 weeks AOG

Answer 14

CHADWICK’s sign

Question 15

Breast changes starting 2nd month

Answer 15

Increase in size

Delicate veins become viable

Nipples are larger, darker and more erectile

Areola become broader and darker

Montgomery glands increase in size

Question 16

Water metabolism

Answer 16

Increased water retention

Fall in plasma osmolality of approximately 10 mOsm/kg induced by a resetting of osmotic thresholds for thirst and vasopressin secretions

+6.5L= fetus, placenta and amniotic fluid (3.5L) + maternal 3.0L

Question 17

Protein metabolism

Answer 17

+1kg=500g (fetus and placenta) + 500g maternal (uterus, breast and hemoglobin/plasma proteins)

Question 18

CHO metabolism

Answer 18

Normal pregnancy: mild fasting hypoglycemia, postprandial hyperglycemia and hyperinsulinemia

Pregnancy-induced statemof peripheral insulin resistance

Plasma concentrations of free fatty acids, triglycerides and cholesterol are higher

Accelerated starvation

Question 19

Metabolic changes

Answer 19

Lipids, lipoproteins and apolipoproteins in plasma increase

Storage of fat occurs primarily during midpregnancy

Deposited mostly in central

Progesterone acts to reset a lipostat in the hypothalamus

Maternal hyperlipidemia: TRIGLYCEROL and CHOLESTEROL LEVELS in very-low density lipoprotein (VLDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL) are increase