Pregnancy

Question 1

What is the main source of energy for fetus? What about mother?

Answer 1

Fetus: glucose
Mother: free FAs

Question 2

How much weight should a normal weight mother carrying one child gain?

Answer 2

25-35 pounds

Question 3

Estrogen is responsible for what in pregnancy?

Answer 3

Breast tenderness, headache and helps with development of: glands, placenta, fetal adrenal cortex and fetal liver

Question 4

What hormone drives the starvation state?

Answer 4

hPL

Question 5

Cardiovascular changes in pregnancy?

Answer 5

Increased CO and decrease systemic vascular resistance

Question 6

What causes fluid retention?

Answer 6

Adrenal gland increase aldosterone, which causes increased reabsorption Na+= fluid retention

Question 7

Why don’t lay on back when pregnant?

Answer 7

Suppress SVC=decrease venous return, decreased CO, hypotension

Question 8

Obese Pregnant patient with diabetes and chronic HTN presents with facial swelling and BP 162/110. What is the likely diagnosis? Treatment?

Answer 8

Preeclampsia
Treatment: deliver by c-section 37 weeks or more, if less than keep in hospital and treat HTN and give medication to increase fetal surfactant

Question 9

Vaginla delivery requires what?

Answer 9

3 P’s

Power (uterine contractions), big enough Passageway (pelvis), Passenger that fits (fetus)

Question 10

What layer of uterus is responsible for contractions?

Answer 10

Myometrium

Question 11

Name 3 portions of functional uterus

Answer 11

Active segment: generates the force of contractions
Lower (passive) uterine segment: thins during 3rd trimester, incisions in lower uterine segment have much lower risk separation or rupture during subsequent labor
Uterine Cervix: during delivery alter collagen fibrils and increase water content

Question 12

Phase 0

Answer 12

0-36 weeks; Progesterone, inhibits contractions (prostaglandin I-2, relaxin also inhibit)

Question 13

Phase 1

Answer 13

36 weeks-delivery; estrogen, increase contraction-associated proteins (prostaglandin and oxytocin receptors) in myometrium. Gap junction increase connectivity of myometrial cells.

Question 14

Phase 2

Answer 14

Labor; PG (E2 and F2 alpha), oxytocin stimualte uterus to contract

Question 15

Phase 3

Answer 15

Postpartum; oxytocin, stimulate contraction and involution uterus. Contract myometrium constricts spray arterioles which supply placenta bed=limit bleeding