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Obstetrics > Physiology of pregancy > Flashcards

Physiology of pregancy Flashcards

1
Q

what is the average weight gain in pregnancy in each trimester?

A

1st: 2 kg
2nd: 4 kg
3rd: 6 kg

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2
Q

What changes does the uterus undergo during pregnancy

A
  1. development of the decidua
  2. muscle hypertrophy
  3. increased vascularity
  4. formation of the lower uterine segment
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3
Q

How does the uterine size change during pregnancy?

A

10-12 weeks: fundus at symphysis pubis
22-24 weeks: fundus at umbilicus
36 weeks: fundus at xiphisternum
Fundus may then sink down in the last 4 weeks (lightening)

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4
Q

What are the effects of oestrogen and progesterone on the breasts?

A

Oestrogen: causes active growth and branching of the ducts as well as the skin of the nipples
Progesterone: further hyperaemia and prolifertion of the glandular epithelum of the alveoli

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5
Q

when do the glands in the breast begin secreting?

A

12 weeks

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6
Q

which pelvic joints increase in mobility, become softened and relaxed?

A

The sacroiliac and ligaments and fibrocartilage of the pubic symphysis

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7
Q

How much does the blood volume increase by? what is the increase of plasma and red cells?

A

Blood volume increases by 40%. Plasma volume increases by 500-1500 ml and red cell volume increases by 400ml.

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8
Q

How much does cardiac output increase by?

A

rises by 40% from 3.5l/min to 6 l/min

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9
Q

How much does tidal volume increase by?

A

40%

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10
Q

What are other respiratory changes that are progesterone induced?

A

pCO2 falls from 38 to 32
pO2 rises from 95 to 105
Plasma bicarbonate falls
Respiratory type alkalosis results and facilitates the transfer of gasses between mother and fetus

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11
Q

What are the changes to the GIT during pregancy?

A
  1. increased appetite, thirst and occasional cravings
  2. relaxation of the cardio-oesophageal junction, increases reflux oesophagitis, hiatus hernias and heartburn
  3. Gastric motility and emptying is decreased
  4. Small intestine has decreased peristalis
  5. large intestine has decreases moltility
  6. biliary stasis and hyper oestogenic effects (no liver dysfunction)
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12
Q

What are the basic changes to the kidney during pregnancy?

A
  1. hypertrophy of function ( GFR increases by 25-50%)
  2. leakage of some substances
  3. altered haemodynamics (blood flow increases by 25-50%)
  4. exaggerated response to posture
  5. Increases by 1-2 cm in its long axis
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13
Q

What are the peptide hormones produced by the trophoblast and the placenta?

A
  1. Human Chorionic gonadotropin (peaks at 8-10 weeks)
  2. Human placental lactogen (peaks at term) causes: lipolysis, hyperinsulinism, resistance to insulin, hyperglycemia, mammary growth and colustrum secretion
  3. Placental proteins
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14
Q

what are the biological actions of oestrogens?

A
  • Enhancement of RNA and protein synthesis of all cells
  • Growth of uterus
  • development of the alveoli of the breasts
  • softening of the cervix
  • sodium and water retention
  • Growth and dilatation of the blood vessels of the genital tract
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15
Q

What are bilogical actions pf progestogens?

A
  • reduction in myometrial contractility
  • relaxation of smooth muscle -> vasodilation
  • thermogenic
  • fat deposition
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16
Q

what are the changes in thyroid hormones during pregnancy?

A
  • thyroid gland increases in size and becomes more vascular
  • increase in thyroid binding globulin and prealbumin
  • increase in T3 and T4
17
Q

How much does the uterine blood flow and skin perfusion increase during preganncy

A

Uterus: + 500 ml/min
Skin: + 500 ml/min

18
Q

What is the cause of the overall decrease in vascular resistance?

A
  • low vascular resistance in the placental bed

- Progesterone effect on vasodilation

19
Q

What are the changes to white cells and platelets during pregnancy?

A

White cells: little change in number but profound decrease in cell mediated immunity
Platelets: increased coaguability (increase in clotting factors) and mild decrease in platelets (consumption)

20
Q

What is the upper limit of creatinine during pregancy?

A

80

21
Q

What are the metabolic changes in pregnancy that make glucose available for the fetus?

A
  • Increase in post-prandial maternal glucose
  • lower fasting levels
  • maternal insulin resistance
  • increased maternal lipolysis

Obstetrics (27 decks)

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