physiology of pregnancy Flashcards
what is the MAP
CO X SVR cardiac output times systemic vascular resistance
what is Cardiac output?
CO = HR X SV heart rate X stroke volume
what is stroke volume
SV = preload X contractility
what happens to SVR
decreases via vasodilation. more vessels due to the placenta .
MAP in pregnancy?
reduced from baseline
what happens to HR
rises 15%
what happens to contractility of the heart
stays the same; the EF stays the same. you do not get a hyperdynamic heart
what happens to the preload?
Goes WAY up.
what happens to the the number of RBCs?
goes way up
what happens to the O2 stas?
same
what happens to the CO?
goes up
what is hemoglobin?
RBCs/plasma
what happens to plasma?
goes way up so that the vesocity decreases. hemoglobin usually decreases due to the increase in plasma.
IVC syndrome
when the uterus compresses the IVC. this can make her hypotensive due to decreased preload. This can be relieved by laying her on her side.
what happens to the FEV1
nothing
what happens to respiratory rate
nothing
what happens to the PO2
nothing
what happens to the Tidal volue
goes up
what happens to the clotting in pregnancy
increased clotting.
what are the three As for platelets in primary hemostasis
adhesion, activation, aggregation
what is the end point of primary hemostasis
platelet plug with a fibrinogen mesh
what is the main component of secondary hemostasis
factors. Fibrinogen (factor 1) is converted to fibrin which is eventually broken into split products by TPA.
what happens to clotting in pregnancy
increases
what happens to GFR in pregnancy
increases
what happens to creatinine in pregn
goes down
is normal creatinine normal for pregn
NO. this indicates a problem because the creatinine is lower in pregnancy
how much weight should you gain in preg
depends on initial weight <18.5 - 1lb/week; 28-40lbs 18.5-25 -0.75lbs/wk; 25-35lbs 25-30 -0.5lbs/wk; 15-25lbs >30 -0.25lbs/wk; 10-15lbs
what GI issues do we worry about in pregnancy
gallbladder, nausea, GERD, iiron def anemia, constipation
how do we treat nausea in pregnancy
dansitron and pyroxidine
what do we use to treat GERD in pregnancy
PPIs
what do we use to treat constipation
stool softeners and motility agents
what do you always presecribe with iron supplemetns
stool softeners
what do we need to watch out for in pregnancy
DVT/PE
