Physiology of pregnancy Flashcards
Diagnosis of pregnancy
Based on LMP
Sexual activity
Signs and symptoms
Presumptive - pregnancy
Amenorrhea 4+ weeks fatigue frequency of micturition nausea vomitting
Probable - pregnancy
positive hCG
abdominal enlargement
uterine and cervical changes
What is HCG
Human chorionic gonadotropin
- initially produced by blastocyst
- detected at 6-10 days after conception
- high levels until 60-70 days gestation
- helps maintain production of oestrogen and progesterone
Endocrine System - Thyroid Gland
- enlarges due to hyperplasia
- increased vascularity
Endocrine System - Pituitary Gland
- enlarges
- surpresses LH and FSH
- increases prolactin, cortisol and oxytocin
- the progesterone prevents contractions
Endocrine System - Adrenal Gland
(little changes), increases melatonin (skin and hair)
Endocrine System - Placenta
impacts upon ovarian, uterine, mammary and fetal physiology
Endocrine System - Progesterone
- relaxes smooth muscle
- decreases uterine contractility
- causes symptoms such as low BP (vasodilation), heartburn and SPD
Endocrine System - Oestrogen
levels steadily rise until birth, develops fetal organs, increases uterine blood flow and prepares for lactation
Endocrine System - Relaxin
- Initially produced by corpus lute, then placenta
- Inhibits uterine contractions
- Increases blood flow to kidneys and placenta
- Relaxes joints and ligaments
- Lengthens and softens cervix in labour
The systems - Musculoskeletal
pelvis tilts forward, decreased abdominal muscle tone
The systems - Renal
BP decreases by 10mmHg in 2nd trimester, kidneys increase in length and volume. GFR increases due to pregnancy hormones.
The systems - Respiratory
- maternal 02 requirements increase
- -engorgements of capillaries: voice changes, nasal stuffiness
The systems - Haematological
-increased blood volume,
haemodilution causes Hb to drop (extra iron), platelet count decreases,
increase in coagulation(clotting), immunosuppressed
The systems - Gastrointestinal
- Progesterone triggers increased appetite
- morning sickness due to hCG
- pica
- smooth muscle relaxed
- soft and oedemas gums
- constipation
The systems - Cardiovascular
- size and position of heart changes: pushed up by elevations of diaphragm and rotated forward
- pulse increases by 10-15bpm, palpitations
Reproductive - Uterus
- blood flow increases
- shape and size change
- growth due to hyperplasia
- becomes an abdominal organ at 12/40
Reproductive - Breasts
12/40 growth and darkening of areola
16/40 colostrum
Reproductive - Cervix
- oestrogen increases blood supply
- pulsations
- forms cervical plug
Reproductive - Vagina
- blood flow increases
- soft vaginal tissue
- increased discharge
