Physiology of Pregnancy Flashcards

1
Q

Amount that cardiac output increases. Due to?

A

30-50%. Increase in stroke volume then heart rate

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2
Q

What happens to systemic vascular resistance? Due to?

A

Decreases. Due to elevated Progesterone — relaxes smooth muscle

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3
Q

How much does blood pressure decrease?

A

SBP: minus 5-10 mmHg
DBP: minus 10-15 mmHg

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4
Q

How much does tidal volume increase? How does this affect PAO2 and PACO2?

A

30-40%.

Increases PAO2 (and PaO2) while decreasing CO2

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5
Q

What is the significance of an decreased PaCO2? Due to?

A

Elevated Progesterone increases respiratory system’s responsiveness to CO2. The increased gradient facilitates O2 delivery to fetus (and thus CO2 removal)

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6
Q

% of pregnancies wherein mothers suffer from N&V? What is it due to? When does it resolve?

A

70%. Due to estrogen, progesterone, and B-hCG increases. Resolves by 14-16 wks

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7
Q

What changes contribute to acid reflux and ptyalism (spitting) and constipation?

A

Prolonged gastric emptying, decreased sphincter tone, decreased large bowel motility

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8
Q

% increase in GFR? What is it’s significance?

A

50%. Causes decrease in BUN/Cr by 25%.

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9
Q

% increase in plasma volume? % increase in RBC volume? Significance?

A

50% in plasma, but only 20-30% RBC –> Dilutional anemia

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10
Q

WBC Increase?

A

mean 10.5 mil/mL

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11
Q

Why is pregnancy considered a hypercoagulable state?

A

Elevated fibrinogen and Factors VII –> X
Venous stasis
Endothelial damage

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12
Q

What produces increase in Estrogen?

A

Placenta (and a little bit ovaries)

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13
Q

Describe estrogen production in the ovaries

A

Ovarian theca cells –> estrogen precursors –> transfer to Ovarian granulosa cells

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14
Q

Describe estrogen production in placenta

A

Maternal adrenal glands produce precursors

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15
Q

What is the composition of B-hCG?

A

2 alpha, 2 beta subunits.

alpha subunit = alpha subunit of LH, FSH, TSH (but beta subunit is different)

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16
Q

Describe the role of the placenta.

A

–> B-hCG (which maintains the corpus luteum in early pregnancy).

–> Progesterone (maintain endometrium)

–> Human Placental Lactogen/HPL (induces lipolysis and FA formation for fetal nutrition; insulin antagonist)

17
Q

Describe changes in thyroid hormones during pregnancy, even though pregnancy is considered euthyroid.

A

Estrogen stimulates TBG (total T3 and T4 levels increase but Free T3/T4 stay same)

B-hCG (~TSH) stimulates thyroid (T3, T4 increase slightly)

18
Q

MSK and Derm changes in pregnancy

A

carpal tunnel

back pain

19
Q

Average kcal requirement per day?

Caloric increase requirement if breastfeeding?

A

2000 –> 2500 kcal/d (+300 kcal/day)

If breastfeeding +500 kcal/day

20
Q

Protein requirement?

A

70-75 g/day

21
Q

Recommended calcium intake

A

1.5 g/day

22
Q

Folate requirements

A

400 micrograms/day

4 mg/d if hx. NTDs