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Systems: Reproduction AB > Physiology in Pregnancy > Flashcards

Physiology in Pregnancy Flashcards

1
Q

What general changes occur during pregnancy?

A
  • Mechanical
  • Metabolism
  • Fatigue – particularly early pregnancy
  • Heartburn/reflux
  • Oedema
  • Breasts
  • Thyroid
  • General state of immunosuppression
  • Weight gain
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2
Q

What changes occur to the breasts during pregnancy?

A
  • Increased size and vascularity – warm tense and tender
  • Increased pigmentation of the areola and nipple
  • Secondary areola appears
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3
Q

What appears on the areolas?

A

Montgomery tubercles

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4
Q

When can colostrum be expressed?

A

From the end of the 3rd month

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5
Q

When do significant changes occur in the CVS?

A

Early in the first trimester

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6
Q

What changes does the CVS undergo?

A
  • Increased circulating volume
  • Systemic vascular resistance falls
  • Increased blood flow
  • Increased cardiac output
  • Increased stroke volume
  • Increased heart rate
  • Increased O2 consumption
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7
Q

What happens to cardiac output in the supine position?

A

25% reduction

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8
Q

When does maximal systemic vascular resistance decrease occur?

A

20-32 weeks

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9
Q

By how much does cardiac output increase?

A

40%

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10
Q

Why do women experiencing pain during labour?

A

Increasing catecholamines

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11
Q

What intrapartum CS changes occur?

A

Auto transfusion of contractions

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12
Q

What happens to cardiac output during labour and post-delivery?

A
  • Increases by 10% in labour
  • Increases 80% in 1st hour post-delivery
  • Continues to fall over the 1st 24 hours
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13
Q

What happens to blood volume post delivery?

A

Decreases by 10% 3 days post-delivery

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14
Q

What happens to blood pressure post delivery?

A

Falls then increases again days 3-7

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15
Q

What happens to SVR post delivery?

A

Increases over the first 2 weeks to 30% above delivery levels

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16
Q

What happens to heart rate post delivery?

A

Returns to pre-pregnancy levels over 2 weeks

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17
Q

When do CVS return to normal?

A

3 months post-partum usually

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18
Q

When does BP reach pre-pregnancy levels?

A

Usually by 6 weeks post-partum

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19
Q

What doesn’t change in the respiratory system with pregnancy?

A

PEFR and FEV1

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20
Q

What happens to blood gases with pregnancy?

A
  • Decrease in PCO2

- Increase in PO2

21
Q

What respiratory changes take place during pregnancy?

A
  • Increase in oxygen demand
  • Increase in minute ventilation
  • Increased respiratory rate
  • Increased tidal volume
  • Decreased functional residual capacity
22
Q

By how much does minute volume increase?

A

40-50%

23
Q

By how much does oxygen demand increase?

A

20%

24
Q

What may be present in the urine of pregnant women?

A

Glucose and microscopic haematuria

25
Q

How many women develop oedema?

A

80%

26
Q

What changes occur to the renal system?

A

-Dilatation of the urinary collecting system
-Increased renal plasma flow
-Increases protein excretion
Increased GFR
-Increase creatinine clearance

27
Q

How much does renal plasma flow increase by, by the end of the 2nd trimester?

A

60-80%

28
Q

How much does creatinine clearance increase by?

A

Up to 50%

29
Q

What haematological state are pregnant women in?

A

Hypercoaguable

30
Q

What haematological changes are there?

A
  • Plasma volume increases
  • Decreased platelet count
  • Increase in iron requirement
  • Increase in folate requirement
  • Increase in WCC
  • Decrease Hg
  • Decrease haematocrit
  • Decrease RCC
31
Q

What does not change haematologically due to pregnancy?

A

No change to MCV or MCHC

32
Q

By how much does the iron requirement increase?

A

2-3 fold

33
Q

By how much does the folate requirement increase?

A

10-20 fold

34
Q

What happens to Hg during pregnancy?

A

Decrease

35
Q

What happens to WCC during pregnancy?

A

Increase

36
Q

What happens to platelets during pregnancy?

A

Apparent decrease (change due to dilution not actual decrease)

37
Q

What happens to CRP during pregnancy?

A

No change

38
Q

What happens to ESR during pregnancy?

A

Increase

39
Q

What happens to urea during pregnancy?

A

Decrease

40
Q

What happens to creatinine during pregnancy?

A

Decrease

41
Q

What happens to urate during pregnancy?

A

Decrease but increases with gestation

42
Q

What happens to 24hr protein during pregnancy?

A

Increase

43
Q

What happens to total protein during pregnancy?

A

Decrease

44
Q

What happens to albumin during pregnancy?

A

Decrease

45
Q

What happens to AST/ALT/GGT during pregnancy?

A

Decrease/no change

46
Q

What happens to Alk phosphate during pregnancy?

A

Dramatic increase (due to additional production by the placenta)

47
Q

What happens to bile acids during pregnancy?

A

No change

48
Q

What happens to D dimer during pregnancy?

A

Increase

Systems: Reproduction AB (35 decks)

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