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Life Cycles > Maternal Physiology > Flashcards

Maternal Physiology Flashcards

1
Q

How does TBW change in pregnancy?

A

Increase- 6.5 L to 8.5 L

Chronic volume overload

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2
Q

Increase in what blood components lead to increased TBW?

A

Plasma volume

RBC mass

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3
Q

What happens to serum sodium levels during pregnancy?

A

Decrease

Water retention > Na retention

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4
Q

What is the lower limit for normal serum Na?

A

135 mmol

131 in pregnancy- drops 3-4 mmol

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5
Q

ANP/BNP become elevated during pregnancy, can BNP still be used to screen for CHF?

A

Yes

Increases is much greater in CHF than the normal physiologic response to pregnancy

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6
Q

What accounts for the dilutional anemia seen in pregnancy?

A

Plasma volume increases more than RBC mass

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7
Q

What is responsible for decreased systemic vascular resistance in pregnancy?

A

Progesterone

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8
Q

In what position is a pregnant woman’s CO greatest?

A

Left lateral position

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9
Q

Low birth weight is associated with women who do large amounts of standing work, what is this attributed to?

A

Decreased CO

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10
Q

Blood flow increases to what organs during pregnancy?

A

Kidneys
Uterus, breast
Skin

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11
Q

What changes are seen on CXR in a pregnant woman?

A

Flattened left heart border
Prominent pulmonary vasculature
Heart position more horizontal
Elevation of diaphragm

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12
Q

What changes does pregnancy have on pulmonary gas exchange?

A 
RR no change
TV increase
Hyperventilation- progesterone
PaCO2 decreases
PaO2 increases
pH increases
Bicarb decreases
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13
Q

What does increased TV during pregnancy result in?

A

Increased O2 uptake

Increased minute ventilation = RR*TV

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14
Q

What happens to forced viral capacity during pregnancy?

A

Remains unchanged

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15
Q

What happens to ERV during pregnancy?

A

Decreased

Due to elevated diaphragm

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16
Q

A pregnant woman has a PCO2 of 40, what is this a sign of?

A

Impending respiratory failure

Should be low due to hyperventilation

17
Q

What term is used to describe the physiologic urinary tract changes during pregnancy?

A

Relative hydronephrosis of pregnancy- vasculature, interstitial volume, urinary dead space (dilation of renal pelvis, calyces, ureters)

18
Q

When does relative hydronephrosis resolve?

A

Week 6 postpartum

19
Q

What hormone is responsible for relative hydronephrosis of pregnancy?

A

Progesterone- SM relaxation

20
Q

Aside from progesterone what else cause relative hydronephrosis of pregnancy?

A

Mechanical compression due to enlarging uterus

21
Q

How can relative hydronephrosis of pregnancy make interpretation of urinary images difficult?

A

More difficult to evaluate urinary tract obstruction

Ultra sound

22
Q

Define calculus.

A

Stone

23
Q

Relative hydronephrosis increases the risk of what infection?

A

Pyelonephritis- urinary stasis

24
Q

What is a normal GFR?

A

100 mL/min

25
Q

What measurement approximates GFR?

A

Creatinine- slight overestimate

26
Q

What is the lower limit of normal for CRCL?

A

97 M

88 W

27
Q

What changes do you expect to see in a pregnant woman’s BUN and Cr?

A

Both decreased

Result of increased GFR + increased plasma volume

28
Q

A woman has chronic renal insufficiency, what effect can a pregnancy have on her disease?

A

1/3 in women may have worsening

29
Q

What is physiologic anemia of pregnancy?

A

Hemodilution

Plasma volume>RBC mass

30
Q

What causes increased risk for intravascular coagulation during pregnancy?

A

Virchow’s triad

stasis, endothelial damage, changes in clotting factors

31
Q

What effect does pregnancy have on PT/PTT/thrombin time?

A

Drop slightly (still normal range)

32
Q

Where do most DVTS occur? Where does most pyelonephritis occur? (During pregnancy)

A

DVT- 90% L

Pyelonephritis- 90% R

33
Q

What is the standard of care for diagnosis DVT?

A

Doppler US

34
Q

What is the treatment for DVT during pregnancy?

A

LMW heparin

35
Q

Nausea and vomiting of pregnancy complicates 70% of pregnancies. There are many medicines and alternative therapies, what vitamin seems to benefit women?

A

Vitamin B6

36
Q

What is hyperemesis gravidarum?

A 
Refractory nausea/vomiting
Associated with:
Weight loss
Dehydration
Ketonemia
Electrolye imbalances
37
Q

What is hyperemesis gravidarum associated with?

A

Increased levels of hCG

Hyperthyroidism

38
Q

Hyperpigmentation is seen in 90% of pregancies, what hormone is responsible for these changes?

A

hCG

linea nigra, areolae, nipples, genital skin, axillae, melasma

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