misc- physiology of pregnancy Flashcards
Chadwick’s Sign
bluish discoloration of the cervix, vagina
linea nigra
seen in dark women-
cholasma/Melasma
blotchy pignmemtation of face
women on OCP
Cardiovascular Physiology
arterial and venous BP both fall until the 24th wk of pregnancy then it returns to baseline BP
- INCREASED venous return can cause varicose veins and hemorrhoids
- INCREASED plasma volume (5–> 7.5L blood)–> HR, SV, CO all increase–> systolic ejection murmur
- DECREASE systemic vascular resistance to
are diastolic murmurs normal in pregnancy?
never
-only normal is systolic ejection murmur no greater than 3+
Hematologic changes in pregnancy - volume expansion will dilute the blood. Hb WILL BE between
10-12 –> not anemic
high white count, high ESR
normal in pregnancy
GI - Physio
decreased tone–> decreased emptying time constipation
Resp - Physio
INCREASE in minute ventilation –> DECREASE pC02–> Resp Alkalosis–> –> SHORTNESS OF BREATH during pregnancy
—->urine pH will INCREASE (alkaline or neutral) –> —>increased risk of UTI
Urinary tract - Physio
increased blood flow–>kidneys increase length and width (hypertrophy until 3 month postpartum)…more so on the R. side–> can lead to stasis of flow-> pyelonephritis
…reason is that the kidneys have to discard two blood toxins
Endocrine- Physio
Estrogen increases TBG and total Thyroxine (T4) and total T3.
Free T3 and free T4 do not change
–normal lab values–
-Pituitary Gland increases 100%–> makes it susceptiple to postpartum hemorrhage–>Sheehan’s Syndrome –>
NO PROLACTIN: decrease or absent breast engorgement
NO FSH/LH engorgement–> secondary amenorrea
Adrenal Gland–> increased cortisol which increases sugar–> gestational diabetes
Which vessel will give you a sense of how the baby is doing?
Umbilical artery (2) - bc it takes blood from the fetus to the placenta
Fetal circulation - three shunts
- ductus venosus (becomes ligamentum venarum)
- foramen ovale (RA–>LA bypass lungs)
- ductus arteriosus
Expected Resp labs
increase minute ventilation, tidal volume and inspiratory capacity with DECREASED residual volume
What causes a pregnant woman to develop pulmonary edema?
During pregnancy, plasma osmolarity is decreased increasing the susceptibility to pulmonary edema.
–can occur with tocolytics, heart disease, preeclampsia
Pregnant woman w. R. flank pain, colicky present for two weeks. No dysuria etc.
R. ureter dilated > L. ureter due to cushioning of the sigmoid colon to the L. ureter while the R. ureter is compressed due to uteral dextrorotation.
