NCB II- physiologic changes in PG Flashcards
average weight gain in PG? variances?
24-30 lbs for a person of optimal wt
if overweight may gain less
if underweight may gain more
average distribution of wt gain? fetus placenta & amniotic fluid uterine muscle breasts fat blood EC fluid
fetus 7-7.5 lbs placenta and amniotic fluid 4 lbs uterine muscle 2 lbs breasts 3 lbs fat 3 lbs blood 3.3 lbs EC fluid 6.6 lbs
during what weeks does the fetus rapidly gain wt? when does the placenta, blood vol and EC fluid increase progressively vs plateau? when does amniotic fluid peak? when is there the biggest growth in breast tissue?
fetus: 30-40 wks
placenta etc: progressive from 10-32/34 wks, plateaus till 40 wks
amniotic fluid: 35-36 wks
breast tissue: in early PG
uterine size increase is stimulated by what hormone? what happens during the first 20 wks, the 2nd 20 wks?
Estrogen
1st 20 wks: increase in size of uterine muscle
2nd 20 wks: thinning of uterine muscle and increases w/fetal size
what two cervical changes take place during PG?
effacement and dilation
what 3 changes take place in the vaginal vault?
softening
increase in cervical mucous
decrease in pH
what 3 changes take place in breast tissue?
increased pigment in areola
colostrum pre or postnatally
increase in size dt hypertrophy of alveoli
what 4 skin changes can take place and what are the causes of the changes?
chloasma- mb dt folic acid deficiency, can make mom photosensitive
linea nigra darkens- mb dt vit B deficiency
stretch marks- esp w/excessive obesity, some genetic tendency, 50% get and 50% of those will keep them
increased hair growth- starts in 3rd mo dt prolonged growth of hair phase, 2-4 mo PP will get hair loss
2 MS changes?
relaxin softens ligaments to facilitate expansion of pelvic girdle
lumbar lordosis dt increased abd wt
% inc in cardiac outflow? in blood volume? what is increased blood volume dt?
30-40% inc in cardiac output
blood vol increases up to 35% dt increased Na2+ retention, adequate dietary salt and increased synthesis of albumin
4 causes of physiologic edema of PG? what test to do at every visit to check for?
increased capillary P= fluid to tissues
increased capillary permeability
relative Na2+ retention
fetal P in pelvis= decreased venous return from legs= pushes fluid into tissue
monitor at every visit by pretibial edema check
benign ejection systolic heart murmurs are common in PG dt what 3 causes?
increased stroke volume
more rapid ejection of blood from heart
mild anemia
pulse increases by how many beats in PG?
10-15 bpm
what % inc in O2 is needed? split b/w fetus, placenta and maternal metabolism of this increase? % inc in tidal vol? does respiration rate increase?
20% inc, 1/3 for placenta and fetus, 2/3 for maternal metabolism
40% inc in tidal volume
no increase in respiration rate, if see this then might need to think about some other cause than decreased intra-abdominal space
what 5 changes happen in relation to the KDs?
increased urine production
P in bladder increases frequency of urination in 1st and 3rd trimesters
increased Na2+ reabsorption from aldosterone
50% inc in glomerular filtration causes increase in glucose in urine
uterus can compress ureters which can lead to inc risk of UTIs which can lead to premature delivery
