Physiologic Changes of Pregnancy

Question 1

The pregnant body is hyperdynamic. What does this mean?

Answer 1

Increased workload, increased metabolic rate causes increase in oxygen consumption.

Question 2

The pregnant body is hypermetabolic. What does this mean?

Answer 2

Increased oxygen consumption is required to increase the metabolic rate for fetal needs. This increases risk of maternal decompensation.

Question 3

What are examples of maternal decompensation related to oxygen?

Answer 3

Dyspnea, venous engorgement, edema. This gives less oxygen to the fetus

Question 4

What are normal cardiac changes during pregnancy?

Answer 4

Increases stroke volume 30-50%; Increased HR 20%; decreased vascular resistence

Question 5

What are normal hematologic events associated with pregnancy?

Answer 5

Increased total blood volume by 35% (2000ml); Increased plasma volume by 50%; increased RBC mass 17%

Question 6

How much blood can be lost before s/sx hypovolemia are shown?

Answer 6

35% (2,500 ml)

Question 7

Why is the patient at increased risk for DIC?

Answer 7

Pt is in a hypercoagulable state with decreased fibrinolytic activity. Further increased risk of hx of DVT, PE or has any blood disease conditions such as APLAS (Antiphospholipid syndrome) or Factor 5 mutation

Question 8

Plasma fibrinogen should be between what parameters during pregnancy?

Answer 8

300-600mg/dl