Physio- Physiologic Adaptions to Pregnancy- Karius Flashcards
What happens about 9 days after ovulation if pregnancy has occurred?
placental hCG is secreted to prevent corpus luteum apoptosis
what time period must fertilization of the ovum occur with in?
24-48 after the ovulation
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?
synciotrophoblast
what week of pregnancy do hCG levels peak at?
10th week
what is the function of Human Chorionic Gonadotropin?
maintains corpus luteum
promotes progesterone secretion
fetal testicular testosterone secretion
maternal thyroid stimulation
what hormone contributes to altered glucose metabolism in women?
Human placental lactogen
when is hPL dectectable in seru and what can the upper range of secretion of this hormone reach?
detectable levels in serum occur 4-5 wks in gestation.
1g/ day
name one more function/ effect of hPL?
mobilizes free fatty acids
directly stimulates release of insulin
contributes to insulin resistance assoc. w/ pregnancy
maybe angiogenic to fetal vasculature
what causes the release of chorionic ACTH and fetal lung maturation?
Corticotropin releasing hormone (CRH)
what hormone takes over from the corpus leteum at about week 8 and its secretion will continue throughout pregnancy?
progesterone
what hormone increases throughout pregnancy and is an indicator of fetal well-being?
estrogen
what causes relaxation of pelvic ligaments?
relaxin
what cells produce relaxin?
decidual cells
what causes the increase in maternal-placental blood flow?
vasodilation. estrogen. vascular refractoriness to angiotensis II
what effect does the placenta have on the maternal TPR?
decreases the TPR about 20% due to vasodilation & addition
what effect does pregnancy have on cardiac output?
increases cardiac output.
how much is the blood volume increased by?
50% increase. CO increased to > 6L/min
what changes in hemotocrit results? What portion of the blood is increasing most?
decrease in hemotocrit
plasma vol expands most
what is the mechanism of the plasma osmolarity decreasing?
the osmoreceptors in brain reset. brain tells body to bring in more water.
how does estrogen develop a hypercoagulable state?
increase fibrinogen, factors V,VII,VIII and X
D-dimer increases
resistence to activated protein C
what change in respiratory drive is seen? driven by what?
increase in respiratory drive. O2 consumption increases 30-60%.
early driven by progesterone effect in brain. then driven by chemoreceptors
what do pulmonary fxns only show minor changes in FRC,RV, and ERV?
elevation of the diaphragm
what does the arterial ph of the mother show?
compensated respiratory alkalosis
what renals adaptations are seen?
mediators of this change?
size increases- hyrdronephrosis
progesterone and relaxin mediate this change. progesterone > relaxin
changes seen in GFR and Filtration fraction?
GFR increases (due to renal plasma flow increasing) FF is not altered.
