Physiological Changes Flashcards
Vertebral column
°^ and Positive Epidural pressure in lateral position
° ^ EP during labor returns to normal 7-12 hrs post-partum
° unchanged CSF pressure, ^ with contraction
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Sleep
° Pregnancy-associated sleep disorder
° ^ REM sleep 2° progesterone and cortisol
° Snoring and ^ Airway resistance
° Transient restless leg syndrome.
CNS
° ^ CBF 44ml/min/100g 1st tri and 51.8ml/min/100g
° ^ BBB permeability
° ^ capillary density
° ^ pain threshold
°
Sympathetic NS
° ^ dependency on SNS for haemodynamic stability.
Musculoskeletal system
° Back pain 2° lumbar lordosis and relaxin
° 2° to lumbar lordosis : meralgia parasthetica( stretch of lateral femoral cutaneous nerve), poor center of gravity
° brachial plexus neuropathy 2° anterior neck flexion
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Endocrine: Thyroid
° Enlarges 50-70%
° 50% ^ total T3 T4 but not free portion
° Reduce TSH
° No fetal T4 in 1st tri, depends on mothers
Endocrine :Glucose metabolism
°mean [] normal
° lower [] 3rd tri
° Fasting hypoinsulinemia
° Insulin resistance 2° placental laxtogen
° ^ Glucose level after carb load
Endocrine: Adrno-Cortical
° ×2 ^ in corticosteroid binding globulin with
° 100% ^ in cortisol [] 1st tri and 200% 3rd tri
°unbound cortisol 2x ^
° ^ clearance of betamethasone
Kidneys
° ° ^ RBF and size ° Vasodilation results in reduced svr with ^ GFR & RPF, reduced blood urea nitrogen [] ° ^chance of hydronephrosis ° ^ creat clearance 150-200ml/min ° Proteinuria ° ° °
Liver and gallbladder
° Normal enzymes
° Normal size and morphology
° ^ ALP activity
° increased risk of gallstones secondary to biostasis and increased cholesterol and bio
° progesterone inhibits g it and gall bladder motility
GIT
° stomach outwards to left and 45°to right Low tone of LUS °GERD ° Normal gastric empying °Constipation °Lower GI acid, higher volumes ° °
Cardiac changes in pregnancy: signs of abnormalities
Loud 4th
Diastolic murmur
>3/6 systolic murmur
Fixed split so
