Normal physiologic changes in pregnancy: Circulatory, Haematological, Respiratory & Renal changes Flashcards
Several physiological changes occur to support the growth and development of the fetus and to prepare the mother for labour and delivery.
These transient changes are due to _____________,__________ , and the ____________ of the mother and fetus.
hormonal effects, fetal size
physiological needs
Circulatory changes in pregnancy
Heart rate _______eases
Stroke volume _______ eases
Cardiac output _______eases
Mean arterial pressure _______eases
Peripheral resistance _______eases (35%)
Heart rate increases (10-20%)
Stroke volume increases (10%)
Cardiac output increases (30-50%)
Mean arterial pressure decreases (10%)
Peripheral resistance decreases (35%)
Circulatory changes in pregnancy
______eased BP usually reaches its (highest or lowest?) point by ________ weeks gestation
Decr
lowest
20-24
Features in pregnancy that may Mimic Heart Disease
Signs:______ blood pressure
Auscultation:________ >80%, systolic ejection murmur >90%
Chest x-ray: Change in heart _______ and ________, increased vascular markings
Low
S3 gallop
position & size
Features in pregnancy that may Mimic Heart Disease
ECG: _______________ wave changes, left axis deviation, ________________
Non-specific ST-T
Left Ventricular Hypertrophy
Hematological changes in pregnancy
______eased plasma volume
______ease red cell mass by 20-30%
______eased white blood cell count
Platelet count slightly ______
______eased coagulation factors (Hypercoagulable)
Incr; Incr; Incr; reduces
Incr
Hematological changes in pregnancy
-_____eased risk for thromboembolic disease
-Increase in fibrinogen, all coagulation factors except ___,____,______
- _______ in protein S and sensitivity to activated protein C (APC)
Incr; Incr
II, V, XII
Fall
Hematological changes in pregnancy
Increased plasma volume: starts at the _____ week with a maximum rise at ——-_——- weeks
Increase red cell mass by 20-30% : leads to a __________ or ______________
6th
30-34
decrease in the haematocrit or dilutional anaemia
Hematological changes in pregnancy: Features that may mimic pathological conditions
Decrease in ______
Decrease in ______________
Increased _____ may, in error, be termed as a feature of _____
PCV
haemoglobin concentration
WBC
sepsis
Respiratory changes in pregnancy
Changes are primarily mediated by ________
Increased oxygen consumption ie _______% greater than the non-pregnant state
progesterone
20
Respiratory changes in pregnancy
Oxygen consumption
_____% is consumed by the gravid uterus and its content
-____% by the heart and kidneys
-______% by the respiratory muscle
-_______ by the mammary tissues
50
30
18
rest
Respiratory changes in pregnancy
——— eased CO2 loss from _________ leads to mild respiratory _______[ Lead to
____ease in tidal volume by 30-40%
30-40% ____ease in minute ventilation
Mechanical changes in the diaphragm resulting in elevation
Incr; hyperventilation
alkalosis
incr; incr
Respiratory Features that may mimic pathological conditions
The patient may feel ______ even in the presence of a normal respiratory rate (from ________________)
ABG: shows __________________
CXR: prominent pulmonary vasculature due to ______________________
dyspneic; relative hyperventilation
compensated respiratory alkalosis
increased circulating blood volume
Renal changes in pregnancy
_______eased renal blood flow by 50-75%
• _____eased in the glomerular filtration rate (GFR) by 50%
• _____eased Albumin
______eased GFR results in ______eased urea, creatinine and uric acid by about 40–50%
Incr
Incr
Decr
Incr; Decr
Renal changes in pregnancy
The effect of renin-angiotensin-aldosterone system leads to:
- Increased ____________
- _____________
- _________________
tubular absorption of Na+
Excretion of K+
Water retention
