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Reproduction > Physiology in Pregnancy > Flashcards

Physiology in Pregnancy Flashcards

1
Q

What happens to thyroxin demand during pregnancy

A

It increases

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2
Q

What is the commonest cause of hypothyroidism

A

Grave’s Disease (autoimmune)

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3
Q

What does a hypothyroid mother require in pregnancy

A

Potential adjustment of levothyroxine dose

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4
Q

What produces oestrogen during pregnancy

A

Placenta

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5
Q

What produced progesterone during pregnancy

A

Initially corpus lute

Then the placenta

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6
Q

What anti-insulin hormones are produced during pregnancy

A

Human placental lactose
Prolactin
Cortisol levels

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7
Q

Why are anti-insulin hormones produced during pregnancy

A

To reduce the mothers peripheral uptake of glucose

Ensure there is a continuer supply of glucose to the foetus

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8
Q

Risk factors for gestational DM

A

Age
High BMI
FH Type II DM
Smoking

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9
Q

Rx for gestational DM

A

Diet change
Physical activity

Insulin
Metformin

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10
Q

What is the main risk in gestational DM

A

Macrosomia

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11
Q

What does gestational DM increase the risk of in later life

A

Type II DM

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12
Q

Dx criteria for gestational DM

A

Fasting plasma glc 5.6 mmol/L or above

Two-hour plasma glc 7.8mmol/L or more

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13
Q

Pathology of gestational DM

A

Usually as pregnancy progresses there is increase in insulin resistance

However normally counteracted by insulin production

In women with gestational DM compensatory in insulin production does not occur

Which results in blood sugar levels

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14
Q

Describe breast changes in pregnancy

A

Increase in:
Size
Vascularity
Pigmentation of areola and nipple

colostrum like fluid can be expressed from end of 3rd month

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15
Q

How does womens weight change with pregnancy

A

Increases

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16
Q

Why is there a general state of immunosuppression in pregnancy

A

Because the baby is a forge in body

Need to stop any attacks on the baby

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17
Q

Where does oedema in pregnancy particularly occur

A

Lower limbs

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18
Q

What happens to systemic vascular resistance

A

Falls

Due to progesterone

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19
Q

What is the CVs response to decreased systemic vascular resistance

A

Increase in CO by 30-50%

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20
Q

Why should you NOT do CPR on a pregnant woman lying flat

A

Due to pressure from the foetus and the uterus on the IVC

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21
Q

How should you perform CPR in a pregnant woman

A

Left lateral position

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22
Q

When does CVS changes return to normal after delivery

A

3mnths

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23
Q

What happens to O2 demand

A

It sig. increases

24
Q

What happened to RR

A

Increase

25
Q

What happens to tidal volume

A

Increases

26
Q

What happens to functional residual capacity

A

It decreases

As the lungs get smaller and have less space

27
Q

What is the effect of pregnancy on the stomach

A

Upward displacement a the uterus grows

28
Q

What is the result of upwardly displaced stomach

A

Increase in intragastric pressure

29
Q

What does increased intragastric pressure mean pregnant women are more susceptible to

A

GORD

30
Q

Why can pregnancy cause constipation

A

Due to the production of progesterones

Which decrease gut motility

31
Q

What happens to urinary collecting system

A

Dramatic dilatation

32
Q

What happens to renal blood plasma flow

A

Increases dramatically

33
Q

What happens to GFR and creatinine clearance

A

It increases

Due to increased renal blood plasma flow

34
Q

Why is glycosuria common in pregnancy

A

As pregnancy is a state of relative insulin resistance

As the placenta produces anti-insulin factors

35
Q

What happens to creatinine levels in pregnancy

A

They decrease due to increased clearance at the kidneys from increased renal plasma flow

36
Q

What happens to the ureters and bladder in pregnancy

A

Dilatin

Due to progesterone

37
Q

What does dilation of the ureters and bladder potential lead to

A

Urinary stasis

38
Q

What does urinary stasis increase the risk of in pregnancy

A

Increased risk of UTI

And Pyelonephritis

39
Q

Is microscopic haematuria normal in pregnancy

A

Yes but investigate if it persists after pregnancy

40
Q

What happens to protein excretion

A

It increases

41
Q

What happens to plasma volume

A

it increases

42
Q

What type of anaemia can occur

A

Dilution anaemia

43
Q

Why does dilution anaemia commonly occur

A

As plasma volume increases

But RBC count does not increase

44
Q

What happens to folate requirements

A

There is 10-20 fold increase in requirements

45
Q

Why should women take folic acid supplements

A

Because there is a dramatic increase in their folate requirements

46
Q

What happens to platelet count

A

It decreases

But functions as normal

47
Q

What hypercoaguable state changes occur in pregnancy

A

Increase in fibrinogen
Increase in clotting factors
Decrease in fibrinolysis

48
Q

Why do hypercoaguable changes occur in pregnancy

A

To aim to prevent haemorrhage at delivery

49
Q

What does progesterone do to blood vessels

A

Causes ventilation

And consequently stasis of blood

50
Q

What does stasis of blood in pregnancy increase risk of

A

Thromboembolic disease:
DVT
PE

51
Q

Why can warfarin NOT be given during pregnancy

A

It is teratogenic

52
Q

What is given as anti-coagulant in pregnancy

A

LMWH

53
Q

what happens to urea during pregnancy

A

Decreases due to higher renal blood flow and therefore higher excretion/clearance

54
Q

Why do asthmatics not suffer major complications during pregnancy

A

Because progesterone induced bronchodilator

55
Q

What happens to HR

A

It increases

56
Q

What mechanical changes occur during pregnancy

A

Change in the curvature of the spine

57
Q

What else will contribute to weight gain in pregnancy

A

Oedema

Reproduction (14 decks)

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