Physiology Of Normal Preganancy Flashcards
Tired, swollen, gasping for breath, weight gain, iron tbs,ets, anaemia, sleeping hard, panic attacks , varicose veins, glucose in urine, postpartum pain
Sx of preg
Blood volume increase or decrease
What happens to Hb and haemotocrit
Increases and so does red cells count gibing a physiological anaemia
Increase cardiac output due to raise in HR AND SV
Plasma volume increase - diltuinal leading to heamologicla anemia
Plateaus at 32 weeks
He autocrat and hb concentrations fall due to haemodilution hence physiological anaemia
Drop in blood pressure in first two trimesters
Cardiovascular symptoms
Palpitation
Dizziness and pedal oedema
Explain how
Palpitations due to increase Hr and SV
Vasodilation cause skin to flush, peripheral resistance decreasing blood pressure sand dizziness, kidneys also decrease urine output and can lead to COP and pedal oedema
What is supine hypotension
Causes what
Lying on back compresses the IVC impairing venous return increasing the chances of hemoroids and venous return
Endothelial dysfunction can occur due to changes in vascular permeability, tone and haemostasis this leads to complications such as and what conditions
Pulmonary oedema , hypertension and thrombosis and conditions such as pre-eclampsia, growth restriction, miscarriage and abruption
Resp changes in preg what happens
Ventilation increases due to progesterone ( bronchodilator and acts on resp centres)
Tidal volume increase , RR stays the same
Residual volume decreases,
Breathing is more diaphragmatic so have subjective dyspnoea (SOB) - differentiate with PE which would present with acute SOB with chest pain
PE is increased due to pro coagulant state
Compensatory respirator alkalosis at pH7.44 ( bicarbonate ions drop to maintain pH)
Renal changes in preg
Increas in kinda size
Ureters become dilated - risk of UTI
later preg - right side hydronephrosis due to uterine compression across right ureter
Increased perfusion 140-170 so raised GFR but reduction in urea, creatinine and bicarbonate
Plasma osmolality due to progesterone and renin
Remember for drug metabolism volume of distribution and excretion both increased
Gastrointestinal changes in preg
Decreased tone of gastroeospheal sphincter and delayed gastric emptying , reduced gastric peristalsis caused by progesterone causing N+V
Reduced intestinal motility cause of this leading to constipation
Are metabolic rates increased
10-15% 21
Increased absorption of nutrients
Slowed GI system due to progesterone
Weight gain increase
Resistance to effect if insulin need more to achieve same effect pre preg
Haematological changes in preg
Dilutionalnanemai
Increase in white cell count
Lower platelet - gestational thrombocytopenia
Hyper coagulant state - thrombotic events increased due to increase in clotting factors ecdeot 11 and antithrombin 3
Raised fibrinogen and ESR normal in pregnancy
Lactation in preg
4 hormone sand what they do
Oestrogen ducts
Progesterone lobules
Prolactin in milk production litre per day- suckling reflex
Oxytocin is ejection
Skin changes
Hyperpigmentation
Lines nigra , umbilicus and areola
Spider naevi, palmer erythema
Stretch marks
Ligmental laxity - symphysis pubis dysfunction and lower back pain
Lower posture change - exaggerated posture change so you get an exaggerated lumbar lordosis
Post natal problems - mental heath
3 stages as such - timeline
Post natal blues - high recurrence rate few days to weeks
Post natal depression more severely 2w to 6months duration treat with support and help or meds
Post natal psychosis hallucination, mania and self harm medication and ect to treat
Pain in the groin and lower abdomen during pregnancy may be normal, due to what ligament attaching from where to where
uterine fundus and labia majora
The ectocervix is normally lined with stratified squamous non-keratinized epithelium. what is the endocerix lined with
Simple columnar epithelium
