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Obstetrics > Physiological Changes In Pregnancy > Flashcards

Physiological Changes In Pregnancy Flashcards

1
Q

Factors affecting maternal adaptation to pregnancy

A
  1. Availability of hormones and their precursors
  2. Improved transport capacity
  3. Maternal fetal exchange
  4. Removal of additional waste products
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2
Q

Causes of fluid retention during pregnancy

A
  1. Na retention
  2. Osmostat reset
  3. Decrease in thirst threshold (thirstier faster)
  4. Decrease in plasma oncotic pressure
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3
Q

Consequences of fluid retention

A
  1. Decrease in Haemoglobin conc.
  2. Decrease in hematocrit
  3. Dec in serum albumin
  4. Inc stroke volume
  5. Inc renal blood flow
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4
Q

Causes of physiological anaemia during pregnancy

A
  1. Inc in plasma volume.
  2. Increase in rbc mass
  3. decrease in harm conc.
  4. Transfer of iron to fetus
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5
Q

Normal haem conc during pregnancy @ 36 wks

A

Normal haem conc during pregnancy @ 36 wks 10-11 (10.9g/dL)

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6
Q

Hamatocrit levels during pregnancy

A

Hamatocrit levels during pregnancy 32-34%

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7
Q

Why are pregnant women given iron supplements?

A

To avoid decrease of iron in bone marrow which would cause a decrease in rbc volume and ferritin levels post pregnancy

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8
Q

What happens to folic acid during pregnancy?

A

Increase in folic acid clearance causes decrease in plasma folate If she has adequate folic acid intake in diet, supplement not necessary

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9
Q

Hypercoaguble state in pregnancy caused by

A

Increase in factors 7,8,9,10,12
Increase in fibrinogen by 50%
Von willerbrand factor increase

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10
Q

Why is the use of a d-diner test not used for suspected thromboembolism in pregnant women?

A

Maternal D-dimes increases progressively so d dimer test would not be indictave of thromboembolism (useless test)

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11
Q

How does body of pregnant woman counter increase in coagulation?

A

Increase in plasminogen
Decrease in alpha 2 antiplasmin
Causes increase in fibronlytic activity which counters coagulation

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12
Q

Venous thromboembolism occurrence in pregnancy

A

5 times greater

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13
Q

Lab findings that decrease physiologically in pregnancy

A

Haem conc
Haematocrit
Plasma folate
Protein S
Creatinine

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14
Q

Lab tests that increase during pregnancy

A

ESR
Fibrinogen
Factors 7,8,9,10,12
Active c protein resistance
D dimer
Alkaline phosphatase

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15
Q

Haem concentration normal vs pregnancy (term)

A

Normal 13.3g/dL
Pregnancy 11g/dL

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16
Q

Haematocrit normal vs preg at term

A

Normal 38-45 Pregnant 32-34

17
Q

Plasma folate

A

Normal 5.4 - 20 ng/mL
Preg 1.4-20 CHECK

18
Q

Creatinine normal vs pregnancy

A

Normal 73
Pregnancy 64

19
Q

Fibrinogen Normal vs pregnancy

A

Normal 300 Pregnancy 450

20
Q

Alkaline phosphatase normal vs Preg

A

Normal 30-130
Pregnancy 133-418

21
Q

Respiratory changes in pregnancy

A

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

22
Q

Causes of physiological dyspnea in pregnant women

A

Decrease in functional residual capacity
Decrease in residual volume.

23
Q

Blood gas changes in pregnancy

A

Decrease in pCO2
Increase in p02
Slight change in pH
Increase in bicarb excretion
Increase in o2 availability

24
Q

Causes of physiological dyspnea in pregnant women

A

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.

25
Q

Blood gas changes in pregnancy

A

Decrease in pCO2
Increase in pO2
Slight change in pH
Increase in bicarb excretion
Increase in O2 availability

No additional information

26
Q

Cardio changes in pregnancy

A

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

27
Q

GIT changes in pregnancy

A

Gingivitis due to decreased immune resistance
Increased gastric activity (acid reflux)
Constipation

No additional information

28
Q

Renal changes

A

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

29
Q

Source of estrogen and progesterone in pregnancy

A

Corpus luteum then placenta

No additional information

30
Q

Hormonal changes in pregnancy

A

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

31
Q

Skin changes in pregnancy

A

Striae gravidarum
Increase in sebaceous activity
Hirsutism
Hyperpigmentation

No additional information

32
Q

Uterus changes in pregnancy

A

Decidua develops
Increase in vascularity
Formation of lower segment later in pregnancy
Hypertrophy of muscular coat

No additional information

33
Q

Cervix changes in pregnancy

A

Softer
Cervical os closed
Cervical ectropion (turns outwards) common
Increase secretion mucus plug

No additional information

34
Q

Symptoms of pregnancy

A

Amenorrhea
Morning sickness
Breast symptoms
Increase in abdomen size
Fetal movement

No additional information

35
Q

Test to confirm pregnancy

A

B-HCG in urine or serum

No additional information

36
Q

Pregnancy sac visibility via US

A

4-5 wks

No additional information

37
Q

Yolk sac visible in US

A

5 wks

No additional information

38
Q

Fetal heart activity at

A

6-7 wks

No additional information

39
Q

Morphology of fetus clear at

A

9 wks

No additional information

Obstetrics (15 decks)

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