MCQ's: Pregnancy Physiology

Question 1

What are tocolytics?

Answer 1

Medication used to suppress labour by causing uterine relaxation.

Question 2

What is physiological changes is progesterone responsible for?

Answer 2

Progesterone is responsible for most of the hormonally mediated changes occuring during pregnancy including:

smooth muscle relaxation, 
vasodilatation, 
bronchodilatation, 
renal tract dilatation, 
decreased GI motility and constipation
Increased BASAL TEMPERATURE - thermogenic

Question 3

What stage of pregnancy does aortocaval compression become signficant?

Answer 3

20 weeks gestation

Question 4

Cardiac output is increased by a change in what factor?

Answer 4

Stroke volume.

Question 5

By how much does blood volume increase in pregnancy by term?

Answer 5

45-50%

Question 6

Which hormones stimulate respiration?

Answer 6

Oestrogen and progesterone.

Question 7

What are oxytocics used for in pregnancy?

Answer 7

Oxytocics (such as syntocinon) are given to induce labour, to those in labour making slow progress, and after delivery of the fetus at C-section to ensure uterine contraction and reduce intrauterine bleeding.

Question 8

Drugs able to cross the placenta?

Answer 8

Warfarin (teratogenic), Lidocaine, Morphine

Question 9

Which of the following drugs cause tocolysis?
Select true or false for each of the following statements.

A.	Salbutamol				
B.	Isoflurane				
C.	Sevoflurane				
D.	Nitrous oxide				
E.	Magnesium

Answer 9

A. True.
B. True.
C. True.
D. False. Nitrous has no effect on uterine tone making it useful during general anaesthesia for C-section.
E. True.

Tocolysis is the relaxation of uterine smooth muscle as a result of administration of a drug.

The following drugs cause tocolysis: salbutamol, terbutaline, ritodrine, volatile agents, magnesium and GTN.

Question 10

In what percentage of pregnancies does:

1. Heart burn occur
2. Pre-ecclampsia

Answer 10

Heart burn: 75-85%

Pre-ecclampsia: 5-6%

Question 11

What are the absolute contra-indications to an epidural?

Answer 11

Absolute contraindications to epidural are:

• Patient refusal,
• allergy to local anaesthetic,
• infection (cellulitis) over the site of placement,
• coagulopathy,
• raised intracranial pressure,
• profound hypovolaemia.

Question 12

What are the relative contraindications to an epidural?

Answer 12

Relative contraindications include:

• bacteramia,
• neurological disorders (eg MS, syringomyelia),
• fixed cardiac output state (eg aortic stenosis, HOCM),
• previous spinal surgery,
• anatomical abnormalities (eg spina bifida)

Question 13

What are the clinical features of pre-ecclampsia and ecclampsia?

Answer 13

Pre-eclampsia is a disorder characterised by hypertension and proteinuria (oedema is no longer a diagnostic requirement).

It may progress to eclampsia (fitting) or HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) or both