physiological changes in pregnancy Flashcards
how does the uterus change in pregnancy?
1.Becomes bigger: increases in weight
2.Dextro-rotation:
when the uterus is tilted and twisted to the right.
occurs in 80% pregnant women
3.Lower uterine segment
forms from month 4. grows to 10cm. thats why c section scars can disappear. lower segmeent dissapears post pregnancy.
why is placing heavily pregnant women in left lateral position 30degrees important?
prevents aorta caval compression
how are maternal bones impacted by pregnancy?
many different changes occur across bones in the body, resulting in symptoms experienced by women eg neck pain, heaches, leg pain, arm pain and numbness.
All changes occur due to Relaxation of pelvic joints and ligaments caused by Progesterone and relaxin
Anterior tilt of pelvis -> sciatica + back pain
Hyperextension of knees -> foot pain
woman comes in with A butterfly pigmentation appears on the checks and nose. she is worried she may be pregnant. what is this?
Chloasma gravidarum (pregnancy mask)
It usually disappears few months after labour.
what are Striae distensae?
a type of stretch marks that occurs on skin that has been subjected to stretching and has damaged connective tissue.
purplish bands on the medial aspect of the thigh
what causes linear nigra?
pigmentation of the Linea Alba,
Due to Increased Melanocyte Stimulating Hormone - MSH
what normal changes to urine might you see on urine dip?
Glycosuria of a mild degree occurs in 35-50% of all pregnancies
what are Luteinising hormone and follicle-stimulating hormone levels in pregnancy?
undetectable
what is aorto caval compression?
Aortic caval compression from the gravid uterus impedes venous return and reduces maternal cardiac output;
abdominal aorta and inferior vena cava compressed
Why is test for maternal diabetes first conducted at 28 weeks?
Insulin resistance increases as pregnancy progresses;
develops around mid pregnancy. at this time point testing would catch 98%+ who will become resistant.
manifestation of gestational diabetes in susceptible individuals
why does insulin resistance develop in pregnancy?
driven by increase in cortisol and human placental lactogen
why is eating before labour an issue?
pregnant women have Gastric emptying is delayed.
if you add epidural or other anaesthetics to this, risk of aspiration increases
why is there an increased risk of VTE in pregnancy?
Increased coagulation factors during pregnancy
issues with anaesthetics in pregnancy?
The increased vascularity and tissue oedema in the upper airway makes intubation during general anaesthesia more difficult
what changes on urinalysis are normal for pregnant women?
Glycosuria ++
Leucocytes +
what cardiac changes are normal in a pregnant woman?
Soft systolic murmur
