Placental and Maternal Physiology

Question 1

Which day does the trophoblast invade the endometrium?

Answer 1

Day 7

Question 2

What decreases contractility of myometrial cells?

Answer 2

Progesterone

Question 3

Opthalmic changes w/ pregnancy

Answer 3

Cornea thickens
Decreased IOP
Diabetic retinopathy can worsen

Question 4

Epulis

Answer 4

Hyperplastic lesion of the mouth, similar to the one seen w/ dilantin.
Referred to as pregnancy tumor
Tumor is red and on gigiva

Question 5

Pregnancy GI changes

Answer 5

Increased risk of GERD
Decreased risk of PUD
Constipation, impaction, NV
Increased portal venous pressure
Gallstones

Question 6

When does morning sickness occur?

Answer 6

first month to 14-16 wks

Question 7

Hyperemesis Gravidarum

Answer 7

Caused by rapidly rising hormone levels
Extreme N/V
May indicate multiple pregnncy

Question 8

Urinary changes

Answer 8

Hydeonephrosis is common
Water retention
UTI’s pyelonephritis
Urinary incontinence

Question 9

Pregnant woman with pyelonephritis must be?

Answer 9

admitted

Question 10

Hyperventilation in pregnancy leads to?

Answer 10

respiratory alkalosis

Causes renal excretion of bicarb

Question 11

Physiologic anemia

Answer 11

Caused by increase in volumes and hemodilution.

Normal in pregnant women

Question 12

Which element is commonly deficient in pregnancy?

Answer 12

Iron

Question 13

CV changes

Answer 13

Stoke volume, HR increase
BP, PVR decrease
Oxygen consumption increases
Heart muscle mass increases

Question 14

Uterine blood flow

Answer 14

700ml/min

Question 15

Coag changes

Answer 15

Hypercoagulable state

Fall in activity of protein C

Question 16

Resp changes

Answer 16

UR tract stuffiness
Nose bleeds
Increased respirations

Question 17

Average weight gain

Answer 17

25 - 35 lbs

Question 18

Common musculoskeletal complaints

Answer 18

Carpal tunnel

Sciatic nerve pain

Question 19

GnRH and CRH are increased or decreased?

Answer 19

Increased

Question 20

Pregnancy state hypercortisolism

Answer 20

Caused by increase in CRH and ACTH

Question 21

Linea nigra and Melasma (pregnancy mask) caused by?

Answer 21

Increased melanocyte stimulating hormone and melanin

Question 22

Change in sensitivity to ADH?

Answer 22

Less sensitive to ADH in pregnancy

Question 23

Glucose metabolism change

Answer 23

Insulin resistance and maternal hyperglycemia have negative effects on fetus

Question 24

Which lipid levels rise in pregnancy?

Answer 24

Triglycerides (300%)

Cholesterol (50%)

Question 25

How much water is retained?

Answer 25

Average of 3 liters

Question 26

How much cardiac output goes to uterus at term

Answer 26

20%

Question 27

Hair and nail changes

Answer 27

May grow faster and be brittle

Hairy face, arms, back

Question 28

Vascular changes

Answer 28

Spider telangectasias
Palmar erythema
Hemorrhoids and varicosities

Question 29

PUPP

Answer 29

Pruritic Urticarial Papules and Plaques of Pregnancy
Most common pregnancy related dermatosis
First appears in abdomen

Question 30

When does PUPP develop

Answer 30

3rd trimester

Question 31

PUPP tx

Answer 31

Antihistamines and topical glucocorticoids

Question 32

Which hormone causes change in breast size?

Answer 32

Chorionic gonadotropin

Question 33

Immune changes

Answer 33

Immunosupression

Suppression of T-cell mediated immunity