Physiology in Pregnancy Flashcards

1
Q

What changes happen to a women’s breasts during pregnancy?

A
  • Increased size and vascularity (warm, tense and tender)
  • Increased pigmentation of the areola and nipple
  • Secondary areola appears
  • Montgomery tubercules appear on the areola
  • Colostrum like fluid can be expressed from the end of the 3rd month
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2
Q

What happens to the cardiovascular system during pregnancy?

A
  • Increased circulating blood volume
  • Systemic vascular resistance falls
  • Increased blood flow
  • Increased cardiac output (due to increased stroke volume)
  • Increased heart rate
  • 25% reduction of cardiac output in the supine position
  • Increased oxygen consumption
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3
Q

What cardiovascular changes occur during labour?

A
  • Autotransfusion of contractions
  • Pain: increased catecholamines
  • CO increases by 10% in labour and by 80% in first post delivery hour
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4
Q

What cardiovascular changes occur after birth?

A
  • Returns to normal after 3 months
  • Blood volume decreases by 10% 3 days post delivery
  • BP initially falls then increases again 3-7 days later
  • SVR increases over first 2 weeks to 30% above delivery levels
  • HR returns to normal over 2 weeks
  • CO begins to fall after the first hour and then over the next 24 weeks
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5
Q

What happens to the respiratory system during pregnancy?

A
  • 20% increase in oxygen demand
  • 40-50% increase in minute ventilation
  • Increased RR and increased tidal rate
  • Decreased functional residual capacity
  • PEFR and FEV1 are unchanged
  • Decreased PCO2
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6
Q

What happens to the renal system during pregnancy?

A
  • Massive dilatation of the urinary collecting system
  • Increased renal plasma flow (60-80% by end of 2nd trimester)
  • Increased GFR and creatinine clearance
  • Protein excretion increases
  • Microscopic haematuria may be present and 80% develop oedema
  • Glycosuria is common
  • Urate levels increase with gestation
  • Urea and creatinine levels decrease
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7
Q

What haematological changes happen during pregnancy?

A
  • Plasma volume increases
  • Hg, Hcrit and RCC decrease
  • No change in MCV or MCHC
  • Decreased platelet count
  • 2-3 fold increase in requirement for iron
  • 10-20 increase in folate requirements
  • WCC increases
  • Hypercoagulable
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