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Maternal Physiology Flashcards

1
Q

Uterus of pregnant woman

A

Thin walled muscular organ
5L to 20 L
500-1000x greater than non pregnant
1100g weight

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2
Q

Uterus

There is increase in myocytes size and accumulation of fibrous tissue at

A

External muscle layer

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3
Q

Uterine hypertrophy early in pregnancy is stimulated by the action of

A

Estrogen and progesterone

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4
Q

Myocyte arrangement

Archers over the fundus and extends into the various ligaments

A

Outer hood like layer

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5
Q

Myocyte arrangement

Dense network of muscle fibers perforated in all directions by blood vessels

A

Middle layer

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6
Q

Middle layer form a figure of

A

8

Allow the. Muscle fibers to constrict and penetrate blood vessel

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7
Q

Myocyte arrangement

With sphincter like fibers around the Fallopian tube orifices and internal cervical os

A

Internal layer

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8
Q

Height of fundus

First few weeks

A

Maintain original piriform or pear shape

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9
Q

Height of fundus

12 weeks

A

Corpus and fundus - globular or spherical

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10
Q

Height of fundus

End of 12 week

A

Can be palpated in the abdominal cavity

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11
Q

Uterine contractility

Irregular contractions that are normally painless

A

Braxton hicks contractions

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12
Q

Braxton hicks intensities

A

5-25 mmHg

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13
Q

Uterine contractility

Number of contractions increase in the last week or two

A

10-20 minutes with rhythmicity

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14
Q

Utero placental blood flow

A

500-750 ml/min

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15
Q

Utero placental blood flow

Placental perfusion is dependent on

A

Total uterine blood flow

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16
Q

Utero placental blood flow

Uterine blood flow is proportional to

A

Contraction intensity

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17
Q

Utero placental blood flow regulation

Maternal placental BF progressively increases during

A

Gestation by vasodilation

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18
Q

Utero placental blood flow regulation

Doubled by 20 weeks to accommodate the size of the uterus. This is also consequence of estrogen stimulation

A

Uterine artery

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19
Q

Utero placental blood flow regulation

Regulates blood flow

A

Estradiol
Progestin
Relaxin

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20
Q

Utero placental blood flow regulation

Make blood vessel contract

A

Norepinephrine

Angiotensin 2

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21
Q

Cervix maintenance of pregnancy

1 month after conception, the cervix begins to undergo pronounced softening and cyanosis. Because of

A

Edema of the entire cervix

Hyperplasia of cervical glands

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22
Q

Cervix maintenance of pregnancy

Necessary to permit functions as diverse as maintenance of a pregnancy to term,and repair following parturition

A

Rearrangement of collagen rich

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23
Q

Cervix maintenance of pregnancy

Metabolism have a role in all these changes

A

Estrogen

Progesterone

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24
Q

Cervix maintenance of pregnancy

These normal pregnancy induced changes represent an extension or eversion of the

A

Proliferating columnar endocervical glands

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25
Q

rich in immunoglobulins and cytokines and may act as an immunological barrier to protect the uterine contents against infection

A

Mucus plug

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26
Q

Cervical mucus consistency changes as a result of progesterone

A

Beading

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27
Q

Beading

When cervical mucus is spread and dried on a glass slide it is characterized by

A

Poor crystallization

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28
Q

Arborization of crystals observed as a result of amniotic fluid leakage

A

Ferning

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29
Q

Pregnancy is associated with both endocervical gland hyperplasia and hyper secretory appearance

A

Arias Stella reaction

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30
Q

This protein hormone is secreted by corpus luteum as well as the decidua and the placenta

A

Relaxin

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31
Q

Secretion of relaxin has many maternal physiological adaptations

A

Remodeling of reproductive tract
Initiation of augmented renal hemodynamics
Decreased serum osmolality
Increase uterine artery compliance

32
Q

Benign ovarian lesions result from exaggerated physiological follicle stimulation

A

Theca lutein cysts

33
Q

Ovaries

A

Ovulation cease during pregnancy

Maturation of new follicle is suspend

34
Q

Fallopian tube

During pregnancy

A

Undergoes little hypertrophy

35
Q

Fallopian tube

Decidual cells may develop in the stroma of the

A

Endosalpinx

36
Q

Fallopian tube

May result to Fallopian tube torsion

A

Increase size of gravid uterus

Para tubal ovarian cysts

37
Q

Vagina and perineum

Common size of bartholins gland cysts

38
Q

Vagina and perineum

Increased vascularity prominently affects the vagina and result in the violet color characteristics

A

Chadwick sign

39
Q

Vagina and perineum

Papillae of the vaginal epithelium undergo hypertrophy to create a fine

A

Hobnailed appearance

40
Q

Breast

Increase in size and delicate veins become visible just beneath the skin.

A

> 2 months

41
Q

Breast

First few months can be expressed from the nipples by fluently palpation

A

Colostrum

A thick yellow fluid

42
Q

Breast

Glands of Montgomery

A

Small elevations scattered through the areola

Hypertrophic sebaceous gland

43
Q

Breast

Increase size of gland Montgomery may develop

A

Gigantomastia which need surgery

44
Q

Reddish, slightly depressed streaks commonly develop in the abdominal skin and sometimes in the skin over the breast and thighs

A

Striae gravidarum

45
Q

Rectus muscle separate at the midline d/t abdominal wall tension

A

Diastasis recti

46
Q

Linea alba takes on dark brown or black pigmentation

A

Lines Nigra

47
Q

Irregular, brownish patches of varying size on the face and neck,
So called mask of pregnancy

A

Chloasma

Melasma gravidarum

48
Q

Angiomas , develops 2/3 of white women and 10% of black women

A

Vascular spiders

49
Q

Vascular spiders common in the

A

Face
Neck
Upper chest
Arms

50
Q

2/3 of white women and 1/3 of black women

Most likely d/t hyoerestrogenemia

A

Palmar erythema

51
Q

Metabolic changes

3rd trimester, maternal basal metabolic rate is increasedby

52
Q

Total pregnancy energy demands

A

1st T: 77,000kcal or 85kcal /day
2nd T: 285kcal/day
3rd T: 475 kcal /day

53
Q

Metabolic changes

Metabolic alterations that increase accumulation of cellular water, fat and protein

A

Maternal reserves

54
Q

Water content of the fetus, placenta and amniotic fluid

55
Q

Accumulates from increase in maternal BV and in the size of uterus and breast

56
Q

So extra water in normal pregnancy

57
Q

Maternal body water, rather than fat, contributes more significantly to

A

Infant birth weight

58
Q

Protein metabolism

Product of conception rich rather than carbo and fat

59
Q

Protein metabolism

Fetus placenta weigh about 4kg and contain

A

500g of protein

60
Q

Protein metabolism

500g is added to the uterus as

A

Contractile protein

61
Q

Protein metabolism

Breast in the glands and yo maternal blood as

A

Hemoglobin and plasma proteins

62
Q

Carbohydrate metabolism

A

Mild fasting hypoglycemia
Postprandial hyperglycemia
Hyperinsulinemia

63
Q

Carbohydrate metabolism

Pregnancy induced state of peripheral insulin resistance d/t sustained

A

Postprandial supply of glucose to the fetus

64
Q

Carbohydrate metabolism

Insulin sensitivity in late pregnancy

A

45-70% lower than in nonpregnat state

65
Q

Calcium

A

Decline
Follows lowered plasma albumin
Serum ionized calcium is unchanged
3rdT 80% 30 g of calcium

66
Q

Magnesium

A

Serum level decline
Phosphate level lie within the non pregnant range
Elevated rebel phosphate

67
Q

Sodium and potassium

A 
1000mEq Na
300mEq K
Glomerular filtration increased
Excretion is unchanged
Total is decreased slightly d/t expanded plasma volume
68
Q

Iodine

A

Req increase
T4 thyroxine increase
Fetal thyroid increase during 2nd half of pregnancy
Iodide GFR increase by 30-50%

69
Q

Blood volume begin to increase

70
Q

Plasma volume expands by approximately 15% compared with that of pregnancy

A

12 menstrual week

71
Q

Maternal BC expands more rapidly by

72
Q

Slower rate of BV

73
Q

Blood volume

Plateau

A

Last several weeks

74
Q

Blood volume

Expansion results from increase in both

A

Plasma

Erythrocytes

75
Q

Blood volume

Elevated maternal plasma erythropoietin level that peaks at

A

3rd T and corresponds maximal erythrocyte production.

76
Q

Meron pa yung Last part. Aralin mo pa

A

Hindi nkasama dito sa BS

77
Q

Uterus of non pregnant women

A

79g

Almost solid

OB (6 decks)

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