OB (2/10) Flashcards
Total blood volume during pregnancy increases from 76 mL/kg to ____________ mL/kg
94
why is there a prominent increase in blood volume in the parturient?
- helps transports nutrients to the fetus better ( d/t: low SVR & thinner blood)
- protects the mother from the amount of blood loss with delivery
average blood loss with vaginal delivery
400-600 mL
average blood loss with C - section
800-1000 mL
estrogen and progesterone are increased __________ fold in pregnancy
100
T/F: pregnancy is a hypercoagulable state
true
pregnancy is associated with what coagulation changes
- enhanced plt turnover (i.e. greater plt consumption)
- clotting
- fibrinolysis
what coagulation factors are INCREASED in concentration at term pregnancy
- factor I (fibrinogen)
- Factor VII (procovertin)
- Factor VIII (antihemophilic factor)
- Factor IX (christmas factor)
- Factor X (stuart power factor)
- Factor XII (hageman factor)
what coagulation factors are decreased at term pregnancy
Factor XI (thromboplastin) & XIII (fibrin-stabilizing factor)
which coagulation factors are UNCHANGED at term pregnancy
Factor II (prothrombin) and Factor V (proaccelerin)
change in PT and PTT at term pregnancy
shortened by 20%
TEG changes at term pregnancy
hypercoagulable
Fibrinopeptide A, Fibrin degradation products, plasminogen are all ____________ at term pregnancy
increased
changes to bleeding time and plt count at term pregnancy
no change
change to antithrombin III at term pregnancy
decreased
what is more important in pregnancy: plt count or plt fx?
plt function
what is gestational thrombocytopenia
low plt count, but no bleeding or bruising.
if pt has this, they will have it every subsequent pregnancy
T/F: it is a contraindication to give pt with gestational thrombocytopenia and epidural
false; typically still do epidurals in theses pts.
during a C-section, the first 300-400 mL that ends up in the suction canister is __________________
amniotic fluid
changes to hematology/coagulation with delivery and first day post-partum
- rapid decrease in plt count, fibrinogen, factor VIII, and plasminogen
- increase in antifibrinolytic activity
- clotting times remain shortened
- hypercoagulable state continues