Physiology of Pregnancy Flashcards
Cardiovascular changes
plasma volume increases 10-15% RBC mass increases 20-30% relative Dilutional Anemia cardiac output increass HR increases SVR decreases increased preload
what is the benefit of dilutional anemia in pregnancy?
reduce blood viscosity to improve placental perfusion
easily tolerate blood loss during delivery
how much blood flow does the uterus get by term?
750cc/min - 12% cardiac output
coagulation changes
hypercoaguability
clotting factors increase - VII, VIII, X, von Willebrand
anti-clotting factors decrease - protein C, protein S, antithrombin III
increase fibrinogen
increase D-dimer
what to worry about if have a normal fibrinogen at delivery?
DIC!
pulmonary changes
increase minute ventilation by 50% via increase tidal volume no change in respiratory rate decreased functional residual capacity (d/t physical compression of baby) FEV1 doesn't change
genitourinary changes
increased GFR -> decreased creatinine
- increased GFR from an overall increased cardiac output and reduced SVR
dilation renal pelvises and calyceal systems
enlarging uterus compresses ureters at pelvic brim
- more common on right
what hormone is responsible for the dilation of renal pelvises and calcyceal systems?
progesterone
what is the right amount of weight gain based on?
BMI
amount of weight gain per week
on average, 0.5-1lb/wk
weight gain per BMI
<18.5 = 28-40lbs (1lb/wk) 18.5-24.9 = 25-35lbs (0.75lb/wk) 25-29.9 = 15-25lbs (0.5lb/wk) >30 = 11-20lbs (0.25lb/wk)
gastrointestinal changes
constipation, GERD, nausea
predisposed to cholelithiasis
what hormone causes changes to LES?
progesterone -> decreased tone of LES -> GERD
treatment of GERD in pregnancy
any PPI - pantoprazole
treatment of constipation in pregnancy
stool softener + motility agent
