Physiology of pregnancy

Question 1

How long is pregnancy approx

Answer 1

270 days from conception to birth

Question 2

Changes in physiology in pregnancy

Answer 2

Increase in basal metabolic rate by 15%
Cardiac output increases by 30-40% as the heart works harder 
Blood volume increases 
O2 utilisation increases 
Ventilation increases

Question 3

Average weight put on during pregnancy

Answer 3

24 lbs, foetus contributes to 7 lbs

Question 4

Main hormones in pregnancy

Answer 4

Oestrogen, progesterone and hCG

Question 5

What week does hCG peak

Answer 5

Weeks 7-12

Question 6

Function of hCG

Answer 6

Supports the function of the corpus luteum until the placenta takes over

Question 7

Function of oestrogen

Answer 7

Helps to maintain the uterus and its lining

Question 8

Function of progesterone

Answer 8

Thickens uterine lining (endometrium)

Inhibits FSH and LH

Question 9

Function of FSH

Answer 9

Stimulates follicular growth in ovaries

Stimulates oestrogen secretion

Question 10

Function of LH

Answer 10

Surge causes ovulation

Results in the formation of a corpus luteum

Question 11

Function of relaxin

Answer 11

Helps prepare the mother’s body for childbirth

Question 12

What occurs during the first trimester

Answer 12

Morning sickness - peaks during the first trimester, positive correlation with birth weight
Sensitivie/ sore breasts
Frequent urination 
Constipation 
Fluctuating emotions

Question 13

What occurs during the second trimester

Answer 13

Nausea and continuous vomiting 
Frequent urination 
Insomnia 
Indigestion and muscle cramping 
Leukorrhea - vaginal discharge - increased secretion from the vagina/ cervix

Question 14

What occurs during the third trimester

Answer 14

10% of patients experience mild to moderate depression
Breathlessnes - pressure on diaphragm
Oedema of the ankles, toes - pressure on vena cava
Pre - eclampsia
Eclampsia

Question 15

What changes occur in the digestive and urinary systems

Answer 15

Nausea, vomiting and constipation
Gastric reflux and heartburn
Downward pressure of the uterus on urinary bladder

Question 16

What changes occur in the cardiovascular system

Answer 16

Increased blood volume

May hammer venous return

Question 17

What changes occur in the respiratory system

Answer 17

Increased demand for oxygen
Increased maternal metabolic rate
Respiratory mucosa may swell in response to the increased blood flow during pregnancy

Question 18

What changes occur to the skin

Answer 18

Skin stretching
Increased (melanocyte stimulating hormone produced by the pituitary gland)
Melasma, the ‘mask of pregnancy’

Question 19

What is secretory differentiation in lactation

Answer 19

The tissues getting ready

Question 20

What is secretory activation in lactation

Answer 20

The tissue delivering

Question 21

What is the suckling reflex

Answer 21

Neuro- endocrine reflex
Positive feedback
When an infant is suckling, a neural message is sent to the hypothalamus
Prolactin is released from the anterior pituitary for milk production
Oxytocin is released from the posterior pituitary for milk secretion
Suckling at breast increases prolactin levels so at each feeding, levels risk hence more milk production

Question 22

Effects of drugs if prescribed during the first trimester

Answer 22

Can cause congenital malformations (teratogenesis)

Question 23

What is the period of greatest risk in pregnancy

Answer 23

3rd to 11th week

Question 24

What LA can you not give during pregnancy

Answer 24

Felypressin/ Octapressin as it has oxytocin which induces labour

Question 25

Can gingivitis be induced during pregnancy?

Answer 25

Yes

Question 26

What is a pregnancy granuloma

Answer 26

Large mass of fibrous cells

Question 27

What causes a pregnancy granuloma

Answer 27

Increased progesterone in combination with local irritant and bacteria

Question 28

Characteristics of a pregnancy granuloma

Answer 28

Erythematous, smooth, lobulated

Generally located on the gingiva

Question 29

Is there a link between perio disease and birth weight?

Answer 29

Periodontitis has been associated with preterm birth and low birth weight