Physiological Changes In Pregnancy Flashcards
Factors affecting maternal adaptation to pregnancy
- Availability of hormones and their precursors
- Improved transport capacity
- Maternal fetal exchange
- Removal of additional waste products
Causes of fluid retention during pregnancy
- Na retention
- Osmostat reset
- Decrease in thirst threshold (thirstier faster)
- Decrease in plasma oncotic pressure
Consequences of fluid retention
- Decrease in Haemoglobin conc.
- Decrease in hematocrit
- Dec in serum albumin
- Inc stroke volume
- Inc renal blood flow
Causes of physiological anaemia during pregnancy
- Inc in plasma volume.
- Increase in rbc mass
- decrease in harm conc.
- Transfer of iron to fetus
Normal haem conc during pregnancy @ 36 wks
Normal haem conc during pregnancy @ 36 wks 10-11 (10.9g/dL)
Hamatocrit levels during pregnancy
Hamatocrit levels during pregnancy 32-34%
Why are pregnant women given iron supplements?
To avoid decrease of iron in bone marrow which would cause a decrease in rbc volume and ferritin levels post pregnancy
What happens to folic acid during pregnancy?
Increase in folic acid clearance causes decrease in plasma folate If she has adequate folic acid intake in diet, supplement not necessary
Hypercoaguble state in pregnancy caused by
Increase in factors 7,8,9,10,12
Increase in fibrinogen by 50%
Von willerbrand factor increase
Why is the use of a d-diner test not used for suspected thromboembolism in pregnant women?
Maternal D-dimes increases progressively so d dimer test would not be indictave of thromboembolism (useless test)
How does body of pregnant woman counter increase in coagulation?
Increase in plasminogen
Decrease in alpha 2 antiplasmin
Causes increase in fibronlytic activity which counters coagulation
Venous thromboembolism occurrence in pregnancy
5 times greater
Lab findings that decrease physiologically in pregnancy
Haem conc
Haematocrit
Plasma folate
Protein S
Creatinine
Lab tests that increase during pregnancy
ESR
Fibrinogen
Factors 7,8,9,10,12
Active c protein resistance
D dimer
Alkaline phosphatase
Haem concentration normal vs pregnancy (term)
Normal 13.3g/dL
Pregnancy 11g/dL
Haematocrit normal vs preg at term
Normal 38-45 Pregnant 32-34
Plasma folate
Normal 5.4 - 20 ng/mL
Preg 1.4-20 CHECK
Creatinine normal vs pregnancy
Normal 73
Pregnancy 64
Fibrinogen Normal vs pregnancy
Normal 300 Pregnancy 450
Alkaline phosphatase normal vs Preg
Normal 30-130
Pregnancy 133-418
Respiratory changes in pregnancy
Diaphragm elevation
Change in chest wall
Increase in lung volume
Increase in minute ventilation
Increase in tidal volume
Physiological dyspnea
Decrease in functional residual capacity and residual volume
Causes of physiological dyspnea in pregnant women
Decrease in functional residual capacity
Decrease in residual volume.
Blood gas changes in pregnancy
Decrease in pCO2
Increase in p02
Slight change in pH
Increase in bicarb excretion
Increase in o2 availability
Causes of physiological dyspnea in pregnant women
Decrease in functional residual capacity
Decrease in residual volume.
Example sentence: Physiological dyspnea in pregnant women is caused by a decrease in functional residual capacity and residual volume.
Blood gas changes in pregnancy
Decrease in pCO2
Increase in pO2
Slight change in pH
Increase in bicarb excretion
Increase in O2 availability
No additional information
Cardio changes in pregnancy
Increase in HR
Increase in stroke volume
Increase in cardiac output
Decrease in mean arterial pressure
Decrease in pulse pressure
Decrease in peripheral resistance
No additional information
GIT changes in pregnancy
Gingivitis due to decreased immune resistance
Increased gastric activity (acid reflux)
Constipation
No additional information
Renal changes
Increase in:
Kidney size
Renal blood flow
Glomerular filtration rate
Renal plasma flow
Clearance of most substances (glycosidic normal in pregnancy)
Dilation of renal pelvis and ureters
Decrease in Plasma creatinine
No additional information
Source of estrogen and progesterone in pregnancy
Corpus luteum then placenta
No additional information
Hormonal changes in pregnancy
HCG produced
Increase in prolactin concentration due to progesterone and estrogen
Increase in corticosteroids concentration
Increase in angiotensin 2, renin, and aldosterone
Insulin resistance develops
Decrease in TSH early pregnancy and T4 late pregnancy
No additional information
Skin changes in pregnancy
Striae gravidarum
Increase in sebaceous activity
Hirsutism
Hyperpigmentation
No additional information
Uterus changes in pregnancy
Decidua develops
Increase in vascularity
Formation of lower segment later in pregnancy
Hypertrophy of muscular coat
No additional information
Cervix changes in pregnancy
Softer
Cervical os closed
Cervical ectropion (turns outwards) common
Increase secretion mucus plug
No additional information
Symptoms of pregnancy
Amenorrhea
Morning sickness
Breast symptoms
Increase in abdomen size
Fetal movement
No additional information
Test to confirm pregnancy
B-HCG in urine or serum
No additional information
Pregnancy sac visibility via US
4-5 wks
No additional information
Yolk sac visible in US
5 wks
No additional information
Fetal heart activity at
6-7 wks
No additional information
Morphology of fetus clear at
9 wks
No additional information
