Physio- Physiologic Adaptions to Pregnancy- Karius

Question 1

What happens about 9 days after ovulation if pregnancy has occurred?

Answer 1

placental hCG is secreted to prevent corpus luteum apoptosis

Question 2

what time period must fertilization of the ovum occur with in?

Answer 2

24-48 after the ovulation

Question 3

what is in direct contact w/ maternal circulation and contains the stuff necessary for production of peptides and hormones of pregnancy like hCG, hPL and CRH?

Answer 3

synciotrophoblast

Question 4

what week of pregnancy do hCG levels peak at?

Answer 4

10th week

Question 5

what is the function of Human Chorionic Gonadotropin?

Answer 5

maintains corpus luteum
promotes progesterone secretion
fetal testicular testosterone secretion
maternal thyroid stimulation

Question 6

what hormone contributes to altered glucose metabolism in women?

Answer 6

Human placental lactogen

Question 7

when is hPL dectectable in seru and what can the upper range of secretion of this hormone reach?

Answer 7

detectable levels in serum occur 4-5 wks in gestation.

1g/ day

Question 8

name one more function/ effect of hPL?

Answer 8

mobilizes free fatty acids
directly stimulates release of insulin
contributes to insulin resistance assoc. w/ pregnancy
maybe angiogenic to fetal vasculature

Question 9

what causes the release of chorionic ACTH and fetal lung maturation?

Answer 9

Corticotropin releasing hormone (CRH)

Question 10

what hormone takes over from the corpus leteum at about week 8 and its secretion will continue throughout pregnancy?

Answer 10

progesterone

Question 11

what hormone increases throughout pregnancy and is an indicator of fetal well-being?

Answer 11

estrogen

Question 12

what causes relaxation of pelvic ligaments?

Answer 12

relaxin

Question 13

what cells produce relaxin?

Answer 13

decidual cells

Question 14

what causes the increase in maternal-placental blood flow?

Answer 14

vasodilation. estrogen. vascular refractoriness to angiotensis II

Question 15

what effect does the placenta have on the maternal TPR?

Answer 15

decreases the TPR about 20% due to vasodilation & addition

Question 16

what effect does pregnancy have on cardiac output?

Answer 16

increases cardiac output.

Question 17

how much is the blood volume increased by?

Answer 17

50% increase. CO increased to > 6L/min

Question 18

what changes in hemotocrit results? What portion of the blood is increasing most?

Answer 18

decrease in hemotocrit

plasma vol expands most

Question 19

what is the mechanism of the plasma osmolarity decreasing?

Answer 19

the osmoreceptors in brain reset. brain tells body to bring in more water.

Question 20

how does estrogen develop a hypercoagulable state?

Answer 20

increase fibrinogen, factors V,VII,VIII and X
D-dimer increases
resistence to activated protein C

Question 21

what change in respiratory drive is seen? driven by what?

Answer 21

increase in respiratory drive. O2 consumption increases 30-60%.
early driven by progesterone effect in brain. then driven by chemoreceptors

Question 22

what do pulmonary fxns only show minor changes in FRC,RV, and ERV?

Answer 22

elevation of the diaphragm

Question 23

what does the arterial ph of the mother show?

Answer 23

compensated respiratory alkalosis

Question 24

what renals adaptations are seen?

mediators of this change?

Answer 24

size increases- hyrdronephrosis

progesterone and relaxin mediate this change. progesterone > relaxin

Question 25

changes seen in GFR and Filtration fraction?

Answer 25

GFR increases (due to renal plasma flow increasing) 
FF is not altered.