MATERNAL PHYSIOLOGY Flashcards
Hegar’s sign
softening of the ISTHMUS
Braxton-Hicks Contraction
painless uterine contraction without cervical dilatation
Arias-Stella Reaction
endocervical gland hyperplasia and hypersecretory appearance
Corpus Luteum
production of progesterone 6th-7th week
Relaxin
secreted by corpus luteum, decidua, and placenta in similar pattern as hCG
for remodeling of reproductive tract to accomodate parturition
Theca Lutein Cyst
benign ovarian lesion that results from exaggerated physiological follicle stimulation (hyper reaction)
Hyperreactio luteinalis
exaggerated physiological follicle stimulation (hyper reaction)
weight gain if BMI before pregnancy is normal
12.5 kg or 27.5 lbs
pitting edema
INCREASED venous pressure BELOW the level of the uterus d.t. PARTIAL occlusion of the vena cava by the gravid uterus
DECREASED interstitial colloid osmotic pressure
Leptin Deficiency
associated with ANOVULATION and INFERTILITY
Abnormally elevated Leptin
associated with PREECLAMPSIA and GESTATIONAL DM
Hypervolemia begins to increase
1st trimester
Hypervolemia expands most rapidly
2nd trimester
Iron requirement during normal pregnancy
1000 mg
T - helper and T cytotoxic cells (suppressed activity in pregnancy)
DECREASE secretion of IL-2, interferon-y and TNF-B
Coagulation and Fibrinolysis during Pregnancy
INCREASE - fibrinogen, factor VII, factor X, plasminogen
DECREASE - activated PTT, tPA, antithrombin III, protein C and total protein S
Increased in cervical mucus plug which act as barrier against infection for the fetus
IgA and IgG
Increased during the 1st trimester in cervical and vaginal mucus
IL-1B
Factors associated with thrombocytopenia in pregnancy
hemodilution
increased platelet consumption
production of thromboxane A2 –> platelet aggregation
Increased CO in pregnancy is due to
DECREASED systemic vascular resistance
INCREASED HR
Cardiac sounds during pregnancy
exaggerated splitting of the first heart sound
loud easily heard 3rd sound
systolic murmur
Arterial pressure decreases during
24-26 weeks
Principal prostaglandin of endothelium; ↑ during late pregnancy and regulates blood pressure and platelet function
Prostacyclin (PGI2)
Endothelin 1
Potent vasoconstrictor produced in endothelial and vascular smooth muscle cells and regulates local vasomotor tone
Nitric Oxide
Potent vasodilator is released by endothelial cells and may have important implications for modifying vascular resistance during pregnancy
Renal Function Tests
DECREASE serum creatinine
INCREASE CrCl
Dried cervical mucus d.t. progesterone
Beading/ Crystallization
Seen on a glass slide as a result of amniotic fluid leakage which is an ARBORIZATION OF ICE CRYSTALS
Ferning
Greater vascularity and hyperemia in the perineum, vulva, vagina and cervix –> violet color characteristic
Chadwick sign
Represents exaggerated luteinization reaction of normal ovary
Luteoma of Pregnancy
Secreted by corpus luteum, decidua and placenta
For REMODELING of reproductive tract CT to accommodate parturition
RELAXIN
Exaggerated physiological follicle stimulation (hyperreaction luteinalis)
Theca Lutein Cyst
Normal pregnancy characterized by (related to carbohydrate metabolism)
mild fasting HYPOglycemia
postprandial HYPERglycemia
HYPERinsulinemia
Factors responsible for INSULIN RESISTANCE
Progesterone Placentally derived growth hormone Prolactin Cortisol Tumor Necrosis Factor Leptin
Secreted by adipose tissue
Important for implantation, cell proliferation and angiogenesis
Important for development of pancreas, kidney, heart and brain
Leptin
Cooperates w/ leptin (neuroendocrine factor) in energy
for homeostasis modulation; role in fetal growth and cell proliferation
Ghrelin
Iron and Iodine requirement
INCREASED
Total serum calcium and serum magnesium
DECREASED
DECREASED during pregnancy (Hematologic and Immunologic changes)
Hgb and Hct
Whole blood viscosity
TH1 response
TH1 secretion of IL-2, IF-1, TNF
INCREASED concentrations of ALL clotting factors in pregnancy EXCEPT
Factors XI and XIII
Secreted in response to chamber-wall stretching
ANP (atrial natriuretic) and BNP (brain natriuretic peptide)
regulate blood volume by natriuresis, diuresis and vascular smooth-muscle relaxation
BNP - INCREASED IN SEVERE PREECLAMPSIA
Principal prostaglandin of endothelium
INCREASED in LATE pregnancy
Prostacyclin (PGI2)
regulates blood pressure and platelet function
maintain VASODILATION
DECREASED in PREECLAMSPIA
Produced in endothelial and vascular smooth muscle
Production stimulated by angiotensin II, arginine, vasopressin and thrombin
Endothelin
(+) secretion of ANP, aldosterone and catecholamines
ELEVATED LEVELS – associated with preeclampsia
potent VASOCONSTRICTOR
Potent VASODILATOR
Released by endothelial cells
Nitric Oxide
Mediator of PLACENTAL VASCULAR TONE and DEVELOPMENT
abnormal synthesis linked to preeclampsia development
Changes in lung volumes during pregnancy
REDUCED
Functional Residual Capacity (FRC)
Expiratory Reserve Volume (ERV)
Residual Volume (RV)
INCREASED Inspiratory Capacity (IC) Tidal Volume (VT)
UNAFFECTED
Lung compliance
Maximum breathing capacity
Forced Vital Capacity
Tests of renal function
DECREASED
Serum Creatinine
INCREASED
Creatinine Clearance
