Physiology in Pregnancy Flashcards
Genera changes in pregnancy (9)
Mechanical - backpain Metabolism Fatigue Oedema Heartburn/reflux Breasts Thyroid General state of immunosuppression Weight gain
Why does oedema occur in pregnancy?
Tendency for sodium and water retention
Why does heartburn or reflux occur in pregnancy?
Softening of oesophageal sphincter
What changes are seen in thyroid hormones during pregnancy?
TBG, T3 and T4 increase
Levels of free T3 and T4 remain the same
TSH decreases
What can occur as a result of iodine deficiency seen in pregnancy?
Iodine deficiency can be exacerbated by the diet
Thyroid will increase in size to increase uptake
What are the consequences for baby should the pregnant mother have Grave’s disease?
Antibodies can cross the placenta
Baby will be hypothyroid
How must AI hyperthyroidism be treated in a pregnant woman?
NOT ANTITHYROIDS
Use propanolol
Describe six breast changes seen in pregnancy
Increased size Increased vascularity Increased pigmentation of areola and nipple Secondary areola forms Montogomery tubercle forms on areola Colostrum fluid can be expressed
From which month in a pregnancy may colostrum start to be expressed?
3rd month
What is colostrum and what other applications might it have if harvested?
‘First milk’
Contains antibodies
Treat cleft palate, premature babies and babies of a low weight for gestation
In which trimester do cardiovascular changes occur in pregnancy?
First trimester
List some of the cardiovascular changes seen in pregnancy
Circulating blood volume increases - 50-70% non-pregnant
Systemic vascular resistance falls
Increased blood flow and blood pressure
Increased cardiac output - stroke volume increases
Heart rate increases
Increased oxygen consumption
What intrapartum cardiovascular changes occur?
Autotransfusion of contracttions - pain increases amount of catechoamines
Increases cardiac output
How large is the increase in cardiac output during and after labour?
10% during labour
80% 1 hour post-delivery
How long after pregnancy before CV function returns to ‘normal’?
3 months
What is the increase in oxygen demand during pregnancy?
20%
List some respiratory changes in pregnancy
Minute ventilation increased by 40-50%
Increased tidal volume
Increased respiratory rate
Decreased functional residual capacity
PEFR and FEV1 unchanged
Decreased PCO2
What changes are seen in renal plasma flow during pregnancy?
Increases
60-80% by end of second trimester
Does protein excretion increase or decrease in pregnancy?
Increases
What signs and symptoms are common in pregnancy in relation to renal changes?
Oedema
Microscopic haematuria
Glycosuria
Urate incraeases as gestation increases
What are the changes in urate, urea and creatinine during pregnancy?
Urate increases as gestation increases
Urea and creatinine decrease
Describe changes in iron and folate requirements during pregnancy
2-3 fold increase in iron requirements
10-20 fold increase in folate requirements
How does haemoglobin, haematocrit and red cell count change with pregnancy?
All decrease
How does platelet count change with pregnancy?
Decreases
