Physiology of Pregnancy: 10 DONE Flashcards
Reproductive changes
Period?
Uterine changes? 4
Vaginal & Cervical changes? 3
KNOW THIS!!!!
Amenorrhea
Uterine changes
* Quickening (fetal movement)
* Ballottement (rebound)
* Predictable growth pattern
* Braxton Hicks (randomly contracts)
Vaginal & Cervical changes
* Goodell sign - soften of cervix
* Chadwick sign - bluish color of cervix
* Leukorrhea (discharge), increased vascularity
Cardiovascular changes
What happens to blood volume?
What happens to cardiac output and BP?
Can result in?
Expanded blood volume by 30-50% increases cardiac output
(but not BP)!!!!
Adding more fluid but not more components
Can result in physiologic anemia!!!!!!!; which means hemoglobin levels are lower than usual.
Renal changes
Alot more?
What leads to UTI?
A lot more blood flow to the kidney (increases by 50%)
increased urinary frequency and incomplete emptying increases risk of UTI
Integumentary changes KNOW THIS!!!!
Increased?
What kind of hyperpigmentations? 3
Vascular changes? 3
Hair and nails? 1
Increased sweat
Hyperpigmentation of skin
-Linea nigra - pigmented line from symphysis pubis to fundus (temporary)
-Striae gravidarum - stretch marks (PERMANENT)
-Melasma (mask of pregnancy) on face
Vascular changes
-Angiomas, varicose veins
-Palmar erythema
-Pruritus (important to differentiate from cholestasis, which is itchiness on palms of hand and soles of feet.
Hair and Nails
-Increased growth
Immune changes
what is the misconception?
When are they immunocompromised?
KNOW THIS!!!!
Misconception that pregnant people are completely immunocompromised.
There is a minor suppression in beginning and end needed for the fetus to grow, so for body to not attack fetus needs quieting of immune system so baby can grow.
Gastro changes
N&V predicted by? what to do?
Heartburn and reflux what to do?
constipation?
KNOW THIS!!!!
N&V- predicted by high hCG and high estrogen level!!!!!!! BLAND FOODS
Heartburn and reflux common
(SIT UP RIGHT, DRINK WATER, avoid spicy food.. etc
Increased emptying time/decreased motility
* Constipation, hemorrhoids common
Endocrine changes
Pancreas produces increased levels of what?
What’s the anti-insulin hormone?
What secretes it?
What happens if it works too good?
Pancreas produces increased levels of insulin as pregnancy progresses.
But placenta secretes an anti-insulin hormone (Human Placental Lactogen or hPL) that keeps blood glucose levels stable as pregnancy progresses.
if HPL works too good then leads to gestational diabetes
Endocrine
Names of hormones and what they do?
HCG?
Progesterone?
Estrogen?
Prolactin?
Relaxin?
Oxytocin?
KNOW THIS!!!!
HCG: stimulates the corpus luteum to produce progesterone and shows up on preg tests
Progesterone: Prepares the uterus for pregnancy. Thickens the lining.
Estrogen: helps the uterus grow, maintains uterine lining, regulates other key hormones and triggers the development of baby’s organs.
Prolactin: Produces milk
Relaxin: Inhibits uterus contraction to prevent premature birth
Oxytocin: Causes contractions
Presumptive signs of pregnancy?
(Subjective)
8
BBQ FAN UU
KNOW THIS!!!!
Breast changes
Braxton Hicks (patient) feeling contractions
Quickening
(Fetal movement)
Fatigue
Amenorrhea
N&V
Urinary frequency
Uterine enlargement
Probable signs of pregnancy?
(Objective)
6
BBG CH+
KNOW THIS!!!!
Braxton Hicks (provider)
Ballottement
(Rebound of fetus)
Goodell’s sign (cervix)
(Softening of cervix)
Chadwick’s sign
(Bluish color of vagina/cervix)
Hegar’s sign
(Softening of lower uterine segment)
+ Pregnancy Test
Positive signs of pregnancy?
3
VDF
Definately KNOW THIS!!!!
Visualization of fetus
Detection of fetal heart tones
Fetal movement by examiner
Estimate due date: Neagele’s rule
know this duh
first date of last period - 3 months + 7 days
GP?
GTPAL?
If they are pregnant? G
doesnt count in Ps
know this also
Gravidity: Total number of pregnancies
Parity: Number of pregnancies greater than or equal to 20 WEEKS, irrespective of outcome
- Primipara: Pregnant for the first time
- Multipara: 2+ pregnancies
Term: Born at or after 37 weeks
Preterm: Born 20-36.6 weeks
Abortions: Spontaneous or elective
Living: Number of children born alive
Fundal height
alos know this
Estimation of gestational age
AT 20 WEEKS FUNDAL HEIGHT SHOULD BE AT THE UMBILICUS
If someone is 18 weeks pregnant you should measure 18 cm +/- 2 so between 16/20 is fine
