Physiology Of Pregnancy

Question 1

What are some heart changes that can occur in the mother?

Answer 1

Innocent systolic murmurs (90%)
Diastolic murmurs (20%)- requires investigations
Heart enlarges by 12%

Question 2

What are some of the effects of CV & Resp changes during pregnancy?

Answer 2

Increased cardiac output- can increase flow in skin aiding heat loss
High blood flow maximises pO2 on maternal side of placenta
Foetal haemoglobin has a higher affinity for O2 compared with HbA

Question 3

What happens to the maternal renal system?

Answer 3

-Kidney increases 1cm in size
-GFR and effective renal plasma flow increases 50+%
-tubular reabsorption capacity unchanged
—leads to a decrease in glucose reabsorption so glycosuria is common

Question 4

What happens to the maternal GI system?

Answer 4

Gastro-oesophageal reflux risk increasesup to 70%

Slowing of gut motility and constipation (progesterone effect)

Question 5

Glucose metabolism

Answer 5

First trimester- increased insulin sensitivity

Second trimester- insulin resistance

Question 6

Why is folate recommended?

Answer 6

DNA synthesis, repair and regulation

RBC development

Question 7

What hormones does the placenta produce?

Answer 7

Protein hormones

• hCG
• hPL
• hPG- placental growth hormone
• CRH- placental corticotrophin-releasing hormone

Steroids

• progesterone
• oestrogen