Physiology changes in pregnancy II Flashcards
Increase or decrease / procoagulant or anticoagulant - Fibrinogen
Fibrinogen is a procoagulant that increases
Increase or decrease / procoagulant or anticoagulant - Factor VII
Factor VII is a procoagulant that increases
Increase or decrease / procoagulant or anticoagulant - Factor VIII
Factor VIII is a procoagulant that increases
Increase or decrease / procoagulant or anticoagulant - Factor X
Factor X is a procoagulant that increases
Increase or decrease / procoagulant or anticoagulant - von Willebrand
von Willebrand is a procoagulant that increases
Increase or decrease / procoagulant or anticoagulant - PA-1
PA-1 is a procoagulant that increases
Increase or decrease / procoagulant or anticoagulant - PA-2
PA-2 is a procoagulant that increases
Increase or decrease / procoagulant or anticoagulant - Factor XI
Factor XI is a procoagulant that decreases
Increase or decrease / procoagulant or anticoagulant - Factor XIII
Factor XIII is a procoagulant that decreases
Increase or decrease / procoagulant or anticoagulant - Protein S
Protein S is an anticoagulant that decreases (the actual numerical value increases by trimester, but the overall value is still decreased)
Increase or decrease / procoagulant or anticoagulant - Factor II
Factor II is a procoagulant that stays the same
Increase or decrease / procoagulant or anticoagulant - Factor V
Factor V is a procoagulant that stays the same
Increase or decrease / procoagulant or anticoagulant - Factor IX
Factor IX is a procoagulant that stays the same
Increase or decrease / procoagulant or anticoagulant - Protein C
Protein C is an anticoagulant that stays the same
Increase or decrease / procoagulant or anticoagulant - Antithrombin 3
Antithrombin 3 is an anticoagulant that stays the same
True or false - thyroid changes that occur during pregnancy are the same as with OCPs
True
Increase or decrease - T4
Increase
Increase or decrease - Iodide
Decrease
Increase or decrease - Free T4
Stays the same
Increase or decrease - TSH
Stays the same (initially decreases then increases)
Increase or decrease - FTI (free T4 index)
Stays the same
What drug to use for hyperthyroidism in the 1st trimester
PTU
Adverse effect of PTU
Liver toxicity/agranulocytosis (maternal)
What drug to use for hyperthyroidism in the 2nd trimester?
Methimazole
Adverse effect of methimazole if used before the 2nd trimester
Aplasia cutis
What drug to use for hyperthyroidism in the third trimester?
Methimazole
What is the limiting dimension for delivery?
Ischial spines
What is the average bispinous diameter (ischial spines)?
10.5cm
What is the diagonal conjugate?
Distance from the sacral promontory to the symphysis pubis
Why do we measure the diagonal conjugate instead of the true/obstetric conjugate?
The true/obstetric conjugate cannot be reached
While the diagonal can be clinically assessed
Calculation for the obstetric conjugate
Diagonal conjugate - 1.5
A contracted obstetric conjugate =
<10.5cm
What is the measurement of the biparietal diameter at term?
9.3cm
What is the measurement of the femur length at term?
7.4cm
How can you use CRL to estimate weeks of gestation?
CRL (cm) + 6.5cm [ex 3.5cm + 6.5cm = 10 weeks]
Definition of Engagement
BPD passed the plane of the inlet, presenting part at ischial spines
Pelvic class that is round
Gynecoid
Pelvic class that is considered a “good delivery shape” and prognostically good
Gynecoid
Pelvic class that is an anterior-posterior egg shape
Anthropoid
Pelvic class that is associated with an increased OP delivery
Anthropoid (it is the only one w OP in the name and increased OP deliveries)
What population has increased anthropoid pelvises (OP deliveries) ?
African American (common blunted ischial spines and medium pubic arch)
Pelvic class that has an anterior-posterior diamond shape
Android
Pelvis shape that is the most limited in the transverse plane for flexed fetal head
Android
Pelvic class that is considered a “bad delivery shape”
Android; it has the least transverse diameter of outlet, also only prominent ischial spines and only narrow suprapubic arch
Pelvic class that has the shape of a flat oval
Platypelloid
Pelvic class that is persistent transverse (very wide)
Platypelloid
What population is a platypelloid pelvic increased in?
Korean women