Pregnancy Changes Flashcards
A blue/purple cervix and vagina
Chadwick’s sign (progesterone vasodilation increases vascularity).
Blotchy pigmentation of the face
Chloasma
Changes in arterial blood pressure (first 20 weeks)
decrease (progesterone is a smooth muscle relaxant).
Changes in arterial blood pressure (after 20 weeks)
increase (but still ends up being less than normal)
Plasma volume changes
increases 50% (makes sense, mom loses blood during delivery, so she should prepare!)
Systemic Vascular Resistance changes/Oncotic pressure changes
decrease (progesterone)/decrease (low albumin).
Cardiac output changes
increase (HR and SV-from increased plasma volume-both go up).
Cardiac output changes with being supine
decrease (uterus compresses the IVC).
RBC mass changes
increase by 30% (O2 carrying capacity goes up).
Hgb/Hct changes
decrease (remember that Hgb is a mass/volume ratio-plasma volume goes up more than RBC mass).
Levels of coagulation factors
increase (pregnancy is a hypercoagulable state).
Gastric motility/gastric emptying time
decrease/increase (predisposes to heartburn from reflux of gastric contents).
Colonic motility/colonic transit time
decrease/increase-again all from progesterone mediated smooth muscle relaxation
Effects of gastric motility/colonic motility changes
gastric reflux (heartburn)/constipation.
Acid base imbalance/Tidal volume change
respiratory alkalosis secondary to hyperventilation (TV increases).
Ureteral size changes
increase (from progesterone vasodilation), causes urinary stasis, increased UTI risk.
Changes in serum BUN/Cr/GFR/Creatinine Clearance-
decrease/decrease/increase/increase.
Glucose and Protein levels in the urine-
increase (glucose transport maximum goes down in the PCT).
Pituitary size changes/possible sequelae of this change
increase (producing more hormones)/Sheehan’s Syndrome.
Thyroid size change/TBG change/Total Thyroid hormone levels/Free thyroid hormone-
first 3 increase/last is unchanged
B-HCG levels
increase for first 10 weeks, then decrease, more HCG = more vomiting (hyperemesis gravidarum).
