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Obstetrics Junior > Physiological changes in pregnancy > Flashcards

Physiological changes in pregnancy Flashcards

1
Q

What happens to the uterus by the 12th week of pregnancy?

A

The uterus rises out of the pelvic cavity and becomes upright.

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2
Q

By which week is the uterus midway between the umbilicus and symphysis pubis?

A

By the 16th week.

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3
Q

When is the uterus just below the umbilicus?

A

By the 20th week.

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4
Q

Where is the uterus located by the 30th week?

A

It is midway between the umbilicus and xiphisternum.

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5
Q

What happens after 38 weeks of pregnancy regarding the uterus?

A
  • Lightening occurs
  • The fetus sinks down
  • Fundus can be palpated below the xiphisternum.
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6
Q

How does lightening affect maternal breathing?

A

Maternal breathing usually improves after lightening.

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7
Q

How does the cervix change during pregnancy?

A

The cervix remains tightly closed during pregnancy.

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8
Q

What happens to the mucous in the cervix during pregnancy?

A

The mucous becomes thicker and more viscous.

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9
Q

How does the vaginal wall change during pregnancy?

A

The vaginal wall becomes thicker and more vascular.

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10
Q

How does blood supply to the venous plexus in the vagina change?

A

The blood supply increases.

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11
Q

How do the labia minora change during pregnancy?

A

The labia minora become more pigmented.

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12
Q

What changes occur in the vulva during pregnancy?

A

Superficial varicosities may appear, and the vulva skin becomes edematous.

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13
Q

What causes pain at the vulva and thigh during pregnancy?

A

Pudendal nerve compression.

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14
Q

What causes pain in the right and left iliac fossa during pregnancy?

A

Stretching of the round ligament.

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15
Q

How do pregnancy hormones affect the vascular system?

A

Pregnancy hormones cause vasodilation of the smooth muscle in the vascular system.

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16
Q

How does blood pressure change during pregnancy?

A

BP initially reduces until about 22–24 weeks and then rises to pre-pregnancy levels at term.

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17
Q

What happens to systemic vascular resistance during pregnancy?

A

Systemic vascular resistance falls, leading to an increase in cardiac output.

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18
Q

How does the ventricular muscle mass change during pregnancy?

A

It increases to accommodate the higher cardiac output.

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19
Q

When does cardiac output reach its maximum during pregnancy?

A

Around 28 weeks until term.

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20
Q

What happens to the inferior vena cava during pregnancy?

A

The gravid uterus exerts pressure on the IVC, which can lead to supine hypotension syndrome

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21
Q

How does heart rate change during pregnancy?

A

Heart rate increases, peaking around 32 weeks.

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22
Q

What happens in the supine position during labor?

A

Cardiac output increases by up to 25% due to uterine contractions, and stroke volume increases by up to 35%.

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23
Q

What is the effect of the recumbent position during labor?

A

It results in better hemodynamic parameters, with minimal increase in cardiac output, stroke volume, and heart rate.

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24
Q

What position helps avoid supine hypotensive syndrome?

A

Left lateral recumbent position.

25
Q

Why does oxygen demand increase during pregnancy?

A

Due to increased oxygen consumption and metabolic demand.

26
Q

How does the capillary system change in pregnancy?

A

Capillaries dilate, causing engorgement throughout the respiratory system, including the nasopharynx, larynx, trachea, and bronchi.

27
Q

What happens to minute ventilation during pregnancy?

A

Minute ventilation increases by 40%.

28
Q

Does the respiratory rate change during pregnancy?

A

No, respiratory rate does not change.

29
Q

What happens to tidal volume during pregnancy?

A

Tidal volume increases.

30
Q

How is the forced expiratory volume (FEV1) affected by pregnancy?

A

There is no change in FEV1.

31
Q

What happens to the subcostal angle during pregnancy?

A

The subcostal angle increases.

32
Q

How does chest circumference change during pregnancy?

A

Chest circumference increases.

33
Q

What happens to PO2 and PCO2 during pregnancy?

A

PO2 increases, while PCO2 decreases.

34
Q

How does total lung capacity change in pregnancy?

A

Total lung capacity decreases by 15%.

35
Q

What happens to plasma volume and red cell mass during pregnancy?

A

Plasma volume increases more than red cell mass, leading to hemodilution.

36
Q

How does hemoglobin concentration change during pregnancy?

A

Hemoglobin concentration falls.

37
Q

What happens to platelet count during pregnancy?

A

Platelet count falls progressively but stays within normal limits.

38
Q

How does the white cell count change during pregnancy?

A

White cell count increases, mainly due to polymorphonuclear cells.

39
Q

What is the state of the coagulation system during pregnancy?

A

Pregnancy is a hypercoagulable state.

40
Q

What contributes to thrombosis risk during pregnancy?

A

Venous stasis and pressure from the gravid uterus.

41
Q

What causes relaxation of smooth muscle in the gastrointestinal tract during pregnancy?

A

The high levels of progesterone.

42
Q

What is the effect of progesterone on the lower esophageal sphincter?

A

It reduces the tone, increasing the risk of gastroesophageal reflux.

43
Q

How does the transit time in the gastrointestinal tract change during pregnancy?

A

Transit time increases, and peristalsis is reduced.

44
Q

What happens to the small bowel during pregnancy?

A

Small bowel motility is reduced, which enhances iron absorption.

45
Q

What happens to the large bowel during pregnancy?

A

The transit time increases, leading to more water absorption and constipation.

46
Q

How does the gallbladder change during pregnancy?

A

Gallbladder emptying is delayed, which can predispose to gallstone formation.

47
Q

How does the liver function change during pregnancy?

A
  • Albumin and globulin levels decrease
  • Liver enzyme and serum bilirubin levels remain unchanged
  • Alkaline phosphatase levels increase.
48
Q

What happens to the ureters during pregnancy?

A

Ureters dilate due to progesterone and pressure from the gravid uterus.

49
Q

How does kidney function change during pregnancy?

A
  1. Renal plasma flow (RPF) and glomerular filtration rate (GFR) increase,
  2. Urea, creatinine, and uric acid levels decrease.
50
Q

What is the risk of urinary tract infections during pregnancy?

A

Pregnancy increases the risk of urinary tract infections, with up to 4–7% of women developing asymptomatic bacteriuria.

51
Q

How does the thyroid change during pregnancy?

A

The thyroid increases hormone production due to elevated hCG levels, affecting thyroid metabolism.

52
Q

How does the parathyroid change during pregnancy?

A

Parathyroid glands enlarge, and calcium absorption increases to support fetal development.

53
Q

How does the insulin resistance change during pregnancy?

A

Insulin resistance increases due to placental hormones, leading to potential gestational diabetes.

54
Q

How do the spine and pelvis change during pregnancy?

A

The spine’s curvature changes, often causing lower back pain, and pelvic instability may occur due to ligament relaxation.

55
Q

What causes pelvic discomfort during pregnancy?

A

Relaxation of ligaments and joints due to pregnancy hormones, especially relaxin.

56
Q

How does pigmentation change during pregnancy?

A

Increased hyperpigmentation
- chloasma (darkened facial areas)
- linea nigra (dark line on the abdomen).

57
Q

What happens to hair growth during pregnancy?

A

Increased hair growth, and mild hirsutism (excess hair growth) may occur.

58
Q

What are common skin changes during pregnancy?

A

Stretch marks (striae gravidarum) may appear, especially on the abdomen, breasts, and thighs.

Obstetrics Junior (7 decks)

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