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OB Exam 1 > Pregnancy Adaptations > Flashcards

Pregnancy Adaptations Flashcards

1
Q

Uterus

A
  • Enlargement
  • Braxton Hicks contractions
    > can start at 16wks, don’t usually feel them tho
  • Uteroplacental blood flow
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2
Q

Cervix

A
  • Goodell (softening of cervix) & Chadwick (incr vascularity, violet bluish color of vaginal mucosa)
  • Mucus plug: seals off uterus from vaginal canal
  • Mucus incrs in amnt & thickness
  • Bloody show: usually a sign of cervical changes
  • Friability: bleeds easily when scraped or touched
  • Multipara: some dilation, cervical opening more oval shape
  • Nullipara: no dilation, cervical opening more round shape
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3
Q

Vagina Adaptations

A
  • Leukorrhea: thick, white, acidic discharge; prevents pathogenic infections
    > layer of protection, response to cervical stimulation by estrogen & progesterone
  • Glycogen stores incrd
    > prone to yeast infections
  • Incrd Vasculariry: edema, varicosities of vulva
    > caused by estrogen, painful
  • Perineum: incrd vascularity, hypertrophy of skin & muscles, loosening of connective tissue
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4
Q

Breast Adaptations

A
  • Incr fullness & size due to incr lvls of progesterone & estrogen
  • Pigmentation changes: areola darkening, nipples more erect
  • Montogomery’s tubercles: keeps nipples lubricated for breastfeeding
  • Striae gravidarum
  • Colostrum: thick yellow fluid can be expressed from 2nd trimester on
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5
Q

Cardiovascular System Adaptations

A
  • Slight cardiac hypertrophy
  • Apical pulse shifts
    > uterus pushes organs around
  • Heart rate incrs 10-15bpm btwn 14-20wks
  • Murmurs may be present
    > may now be heard due to movement of heart from uterus pushing it
  • Undiscovered anomalies
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6
Q

Blood Pressure Adaptations - Modifiable Factors

A
  • Anxiety
  • Position
    > supine hypotensive syndrome
    > promotes leakage of fluid from capillaries into intercellular spaces > lower extremity edema in frequent finding in late pregnancy
  • Equipment type
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7
Q

Blood Pressure Adaptations - Trends

A
  • 1st Trimester
    > remains same as pre-pregnancy lvl
  • 2nd Trimester
    > dcr in BP: r/t blood vessel tone dcrd & dcrd peripheral vascular resistance
    > if BP did not dcr = HTN
  • 3rd Trimester
    > returns to 1st trimest lvls
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8
Q

Blood Adaptations

A
  • Physiologic Anemia: hemodilutional effect of incrd plasma
  • Incrd WBCs 2nd & 3rd tri
  • Inrs in clotting factors
    > greater tendency for blood to clot
    > protective func, to combat childbirth blood loss
    > more vulnerable to thrombosis (DVT)
  • Incrs by 1-2 liters
    > buffers circ syst to make up for blood loss during childbirth
    > meets incrd circ needs of maternal/fetal unit during pregnancy (protective mechanism)
  • Cardiac Output incrs
    > 30-50% above baseline
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9
Q

Respiratory Adaptations

A
  • Incr in maternal oxygen requirements
  • Diaphragm displaced (rises ~ 4cm)
  • Dyspnea (physiologic)
  • Incr in vascularity (from estrogen stimulation)
    > nasal & sinus stuffiness, nose bleeds
  • Resp rate slightly incrd (~2 breaths per minute)
  • Incrd oxygen requirement
    > 10-20% as a result of incrd BMR
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10
Q

Renal Adaptations

A
  • Anatomic changes r/t:
    > hormonal activity
    > pressure from growing uterus
    > incr in blood volume
  • Functional changes:
    > incrd GFR
    > results in urinary stasis
    > incrd susceptibility to UTIs
  • Bladder irritability, nocturia, frequency, urgency occurs in early pregnancy & returns near term
  • Bladder has incrd capacity, walls hypertrophy in later pregnancy; more susceptible to injury & trauma at birth
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11
Q

Integumentary Adaptations

A
  • Hyperpigmentation
    > linea nigra (goes away)
    > nipples
    > vulva
    > axillae
  • Accelerated nail growth
  • Palmar erythema
  • Mechanical stretching
    > striae gravidarum: stretch marks, 50-80% of gravidas
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12
Q

Musculoskeletal Adaptations

A
  • Alts in posture (lordosis)
  • Musculoskeletal discomfort
    > uterine ligaments stretching
    > legs cramping
  • Relaxation & incrd mobility of pelvic joints
    > change in gait
    > Relaxin & Progesterone
  • Diastasis recti abdominus
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13
Q

Neurologic Adaptations

A
  • Compression of nerves or vascular stasis sensory changes in legs (sciatica)
  • Dorsolumbar lordosis
  • Carpal tunnel syndrome
  • Acroesthesia (numbness & tingling of hands)
  • Tension headache
  • Lightheadedness, faitness, syncope
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14
Q

Gastrointestinal Adaptations

A
  • Appetite & food intake fluctuate
    > morning sickness, N/V
    > alt in sense of smell & taste
  • Mouth
    > epulis: gum overgrowth
    > pytalism: excessive salvation
  • Esophagus, stomach & intestine
    > incrd progesterone causes dcrd tone & motility (pyrosis, constipation)
    > displaced appendix
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15
Q

Abdominal Discomfort

A
  • Pelvic heaviness or pressure
  • Round ligament tension
  • Flatulence
  • Distention
  • Bowel cramping
  • Uterine contractions
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16
Q

Endocrine Adaptations - Estrogen

A
  • Promotes enlargement of genitals, uterus, breats
  • Incr in size & # of myometrial cells
  • Produced by corpus luteum until ~ 14 days, then the placenta
  • Relaxation of pelvic ligaments & joints
  • Incrs vascularity & vasodilation
  • Water retention
  • Dcrs maternal ability to use insulin
17
Q

Endocrine Adaptations - Progesterone

A
  • Produced by corpus luteum until ~ 14 days, then the placenta
  • Incrs significantly & is essential in maintaining the pregnancy
  • Relaxes smooth muscle
  • Dcrs maternal ability to use insulin
18
Q

Endocrine Adaptations - Relaxin

A
  • Placental hormone
  • Affects tone
19
Q

Endocrine Adaptations - Prolactin

A
  • Produced by the anterior pituitary
  • Begins to riise early in 1st tri, incrs progressively to term
  • Responsible for initial lactation
    > high lvls of progesterone & estrogen inhibit lactation by blocking the binding of prolactin to breat tissue until after birth
20
Q

Endocrine Adaptations - Oxytocin

A
  • Produced by the posterior pituitary
  • Incrs in amnt as fetus matures
  • Stimulate uterine contractions during pregnancy
    > progesterone prevents contractions until near term
  • Stimulates let-down or milk-ejection reflex after birth

OB Exam 1 (9 decks)

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