Pregnancy Flashcards
What is the duration of pregnancy and from when is it calculated?
40 weeks
Measured from 1st day of last menstrual period
What are the % increases of blood volume and plasma volume during pregnancy?
Blood volume increases 20%
Plasma volume increases 50%
What percentage of women experience oedema?
60-75%
Do blood lipid levels increase or decrease during pregnancy?
Increase
Which maternal organs and tissues show the greatest degree of enlargement?
Heart, Thyroid, Liver, Kidneys, Uterus, Breasts, Adipose Tissue
What changes take place to cardiac output, stroke volume and heart rate during pregnancy?
Cardiac output increases due to
a) increased stroke volume (30-50%)
b) increased heart rate (16% or 6 bpm)
Describe the changes seen in blood pressure throughout pregnancy
Initial decrease in first half of pregnancy (29%) followed by return to non-pregnancy levels for second half
By what percentage does tidal volume increase during pregnancy?
30-40%
What are the 4 main GI issues associated with pregnancy?
Nausea (70%)
Vomiting (30%)
Heartburn
Constipation
What kidney changes take place throughout pregnancy?
50-60% increase in glomerular filtration
Increased sodium conservation
Increased nutrient spillage into urine
Increased risk of UTI
What is the role of Human Chorionic Gonadotropin (hCG)?
a) Stimulates the corpus luteum to produce estrogen and progesterone which maintains early pregnancy (after 2 months placenta takes over)
b) Stimulates growth of the endometrium.
What is the role of Progesterone in pregnancy?
a) Maintains the implant
b) Stimulates growth of the endometrium and its secretion of nutrients
c) Relaxes smooth muscles of the uterine blood vessels and gastrointestinal tract
d) Stimulates breast development
e) Promotes lipid deposition.
What role does oetrogen play during pregnancy?
a) Increases lipid formation and storage, protein synthesis, and uterine blood flow
b) Prompts uterine and breast duct development
What is the role of Human Chorionic Somatotropin (hCS) in pregnancy?
a) Increases maternal insulin resistance to maintain glucose availability for fetal use
b) Promotes protein synthesis and the breakdown of fat for energy for maternal use
What role does leptin play in pregnancy?
May participate in the regulation of appetite and lipid metabolism, weight gain, and utilization of fat stores.
List the increases in weight (kg) for each of the following:
- Foetus
- Placenta
- Uterus
- Amniotic Fluid
- Breast Tissue
- Blood Supply
- Extracellular Fluid
- Maternal Fat Stores
- Total Weight Gain
- Foetus - 3.4kg
- Placenta - 0.7kg
- Uterus - 0.9kg
- Amniotic Fluid - 0.9kg
- Breast Tissue - 0.9kg
- Blood Supply - 1.8kg
- Extracellular Fluid - 1.8kg
- Maternal Fat Stores - 3.2kg
- Total Weight Gain - 13.6kg
Approximately how many grams of protein are accumulated throughout pregnancy?
925g
What is increased cholesterol supply utilised for during pregnancy?
steroid hormone synthesis (placenta)
nerve and cell membrane formation (foetus)
Which hormones stimulate an increase in insulin production in the 1st half of pregnancy?
Oestrogen and Progesterone
In the 2nd half of pregnancy, rising levels of hCS and prolactin inhibit what process?
Conversion of glucose to glycogen and fat
Explain the changes in mineral metabolism during pregnancy
Calcium for bone formation
- maternal absorption of calcium
- the rate of calcium mobilization from bone increases
Sodium metabolism is balanced
Describe the 3 main functions of the placenta
- hormone and enzyme production
- nutrient and gas exchange between mother and foetus
- removal of waste products from the foetus (acts as the lungs, kidneys and digestive system until birth)
What are the additional energy needs for each trimester?
No additional requirements in 1st trimester
+ 1,400kJ per day 2nd trimester
+ 1,900kJ per day 3rd trimester
How many additional grams of protein are recommended per day during pregnancy?
14g
Which foods should be avoided during pregnancy?
Listeria - soft cheeses, unpasteurised dairy products, cold meats, pre-prepared cut fruits and vegetables
Mercury - large, long-living fish, and predatory fish
Other - undercooked fish or meat, soft yolk eggs, raw sprouts
What are the recommendations on cigarette smoking during pregnancy?
Both parents cease smoking prior to conception
What are the general safe levels of recommendations regarding caffeine consumption?
1-3 cups per day (~300mg per day)
What is the optimal age range for pregnancy?
20-25
What are common complications concerning teen pregnancies?
Iron-deficiency anaemia
Prolonged labour and increased chance of caesarean
Higher risk of low birthweight
Pre-eclampsia
higher energy needs if still growing themselves
Reduced financial security
Interruption of schooling/education
Possible time for experimenting with alcohol and drugs
What are common complications concerning older mothers?
Higher risk of caesarean delivery Higher rates of preterm delivery Higher rate of birth defects e.g. genetic abnormalities, such as down syndrome - 1 in 100 for 40 year old - 1 in 300 for 35 year old - 1 in 10,000 for 20 year old Foetal death twice as likely
What are the benefits of exercise whilst pregnant?
Reduce pregnancy discomfort Prevent lower back pain Shorten labour Reduce excess fat mass gains Prevention of gestational diabetes and preeclampsia
What type of exercise should be avoided during pregnancy?
Exercise that can cause impacts such as falling or possible contact with hard objects, or very high intensity activities should be avoided
What are the 3 most common symptoms during pregnancy?
Morning sickness
Constipation/haemorrhoids
Heartburn
What are the risks associated with pre-existing diabetes during pregnancies?
infertility
pregnancy related hypertension
large birth weights
possible infant abnormalities
What percentage of women develop gestational diabetes?
3-8%
What are the risk factors of gestational diabetes?
> 30 y/o
Family Hx
Overweight
What are the common consequences of gestational diabetes?
high infant birth weight complications during labour and delivery birth defects (heart damage, limb deformities and neural tube defects)
What is the OGTT?
75 g oral glucose tolerance test OGTT at 24-28 weeks
Fasting glucose: <95 mg/dL (<5.3 mmol/L)
1-hour postprandial: <140 mg/dL (<7.8/dL)
2-hour postprandial: <120 mg/dL (<6.7 mmol/L)
What are the dietary recommendations for gestational diabetes?
Normal pregnancy guidelines
Regulate blood glucose levels
Monitoring carbohydrate intake (restrict to 35-40% EI)
Eliminate processed high sugar foods and beverages
Limit weight gain, especially if overweight
Moderate exercise
Last line of defence is medication to avoid birth complications
Is sodium restriction recommended to prevent transient hypertension?
Current guidelines do not recommend a sodium restriction during pregnancy to prevent gestational hypertension or the development of preeclampsia
What blood pressure readings are indicative of pre-eclampsia?
≥140 mm Hg systolic
≥90 mm Hg diastolic
What are the warning signs of pre-eclampsia?
headache, blurred vision, abdominal pain, protein in the urine, low platelet count, and weight gain from generalised oedema
Should women with pre-eclampsia take high-dose iron supplements?
Iron supplements, in high doses, may aggravate inflammation by increasing the body’s free-radical load. Women with preeclampsia should not be given high-dose iron supplements
How does alcohol consumption affect foetal development?
The presence of alcohol causes damage in two ways:
- deprives the developing foetus of oxygen from intoxication
- deprives foetus of nutrients from poor dietary habits of drinkers
What are the neurodevelopmental symptoms of FAS?
Prenatal and postnatal growth retardation
Impairment of the brain and central nervous system, with consequent mental retardation, poor motor skills, poor coordination, and hyperactivity
What are the physical symptoms of FAS?
A smooth ridge between the nose and upper lip
Narrow openings between the upper and lower eyelids and drooping eyelids
A thin border on the upper edge of the lip
Underdeveloped jaw and receding chin
Abnormal ear shape and form
