Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 repro > pregnancy physiology > Flashcards

pregnancy physiology Flashcards

1
Q

mechanical adaptations to pregnancy

A

centre of gravity is no longer over feet

pregnant person needs to lean backwards and the curves of the spine change along the whole length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

consequences of shift in centre of gravity for pregnanc women

A

more prone to back pain during and after pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is relaxin

A

hormone produced during pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

effects of relaxin, increased levels of oestrogen and progesterone

A

increased pliability and extensibility of connective tissue
ligamentous joints become less stable
symphysis pubis and sacroiliac joints are particularly affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how much does the pubic symphyseal gap increase by

A

normally 4-5mm

increases on avg 3mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is symphysis pubis dysfunction

A

group of symptoms that cause discomfort in the pelvic region

usually occurs during pregnancy, when your pelvic joints become stiff or move unevenly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when does joint loosening occur during pregnancy

A

as early as 10wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when does joint loosening return to normal

A

4-12wks post partum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how much does the load on the hips increase during pregnancy

A

at term there is an increased load on the hip joints 2.8x the normal value when standing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how does the basal metabolic rate change during pregnancy

A

increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why is metabolism altered during pregnancy

A

to ensure adequate nutrition for foetal growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

insulin and pregnancy

A

relative insulin insensitivity

human placental lactogen (from placenta) acts against maternal insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

storage of lipids in pregnancy

A

increased storage of lipids in maternal tissues

FAs are vital for development of foetal organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

normal weight gain during pregnancy

A

10-14kg gain throughout pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is gestational diabetes

A

high blood sugar (glucose) that develops during pregnancy and usually disappears after giving birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

fatigue during pregnancy

A

can be overwhelming during the 1st trimester
tends to get better in the 2nd trimester
often returns towards the end of the pregnancy - increased work load, discomfort and difficulty sleeping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

why does fatigue occur during pregnancy

A

hormonal changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

why does heartburn and reflex occur during pregnancy

A

food moves more slowly into the stomach
delayed gastric emptying
relaxation of lower oesophageal sphincter
mechanical pressure from enlarged uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

why is GA risk higher during pregancy

A

increased risk of gastric reflux

higher risk of aspiration and increases with advancing pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what % of pregnant people develop oedema

A

80% develop some oedema

particularly towards term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

why does oedema develop during pregnancy

A

physiological sodium and water retention
decreased ability to excrete a sodium and water load
increased blood vol and decreased venous returin (IVC compression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what can oedema be a sign of

A

pre-eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is pre-eclampsia

A

a condition in pregnancy characterised by high BP sometimes with fluid retention and proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

breast changes in pregnancy

A 
increase in size and vascularity 
become warm, tense and tender
increased pigmentation of areola and nipple
2y areola appears
montgomery tubules appear on the areola
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when can colostrum like fluid be expressed

A

from the end of the 3rd month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

changes in thryoid hormone levels during pregnancy

A

liver produces more thyroid binding globulin

total level of T4 and T3 also increase so free T3 and T4 stay the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

iodine and pregnancy

A

pregnancy is associated with a relative iodine deficiency

maternal iodine requirements increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

why are maternal iodine requirements increased

A

iodine is actively transported to the fetoplacental unit and urinary iodine excretion is doubled because of an increased glomerular filtration rate and decreased renal tubular reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

why might the thyroid gland hypertrophy during pregnancy

A

gland works harder to increase its’s iodine uptake

may hypertrophy to ensure adequate levels of iodine are trapped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

why is hyperemesis gravidarum associated with biochemical hyperthyroidism

A

the beta sub unit of BHCG is very structurally similar to TSH
betablockers can be used to control tachycardia caused by high T4 levels
biochemical hyperthyroidism will resolve with hyperemesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how common is thyrotoxicosis in pregnancy

A

1/500 pregnancies
most often due to Graves (AI)
TSH receptor antibodies can cross the placenta and cause foetal +/or neonatal hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

how common is hypothyroidism in pregnancy

A

1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

why is good thyroid replacement important in pregnancy for hypothyroidism

A

foetus is dependent on maternal thyroid function until foetal thyroid function begins ~12wks gestation

34
Q

immunosuppression in pregnancy

A

general state of immunosuppression to allow for foetal tolerance
this increases maternal susceptibility to infection
explains why some AI conditions can improve during pregnancy

35
Q

why does the maternal heart have to work harder during pregnancy

A

growing fetus
weight gain associated with pregnancy
increased oxygen requirements of uterus and breasts
also has to pump blood through the utero placental circulation

36
Q

why is cardiac disease important to consider during pregnancy

A

people with cardiac disease can suffer significant complications during pregnancy
can result in maternal and fetal death
previously undiagnosed cardiac disease may come to light

37
Q

by how much does the circulating blood volume increase during pregnancy

A

by 50-70% of the non-pregnant

38
Q

what causes the physiological anaemia during pregnancy

A

RBC mass increases but only by ~40%

causes a relative haemodilution

39
Q

why is EDV increased during pregnancy

A

increase in circulating blood vol
increased L ventricular and EDV
can be seen as early as 10wks on ECHO

40
Q

why can increased circulating blood vol be a problem during pregnancy

A

can cause issues for those w/ dilated cardiomyopathy or other lesions (e.g. mitral stenosis, pulmonary HT)

41
Q

resistance of the the peripheral vasculature during pregancy

A

falls

at its lowest between 20-32wks

42
Q

equation for systemic vascular resistance

A

SVR = (MAP-MVP)/CO

43
Q

changes to SV during pregnancy

A

drops

due to increased circulating vasodilators and diversion of blood into the low pressure uteroplacental unit

44
Q

how does blood flow to the organs change during pregancy

give an example

A

increased
kidneys - increased by 60-80% above non-pregnant state
warm, red hands and feet
increased risk of nose bleeds, sensation of stuffiness/congestion due to increased blood flow to nasal mucosa

45
Q

how does cardiac output change during pregnancy

A

increased as SV is increased

CO = SV X HR
CO increases by ~30-50% by the end of 2nd trimester
people who cannot increase CO (e.g. aortic stenosis) are at risk

46
Q

how does HR change during pregnancy

A

increases
at term ~10-20 beats higher than non-pregnant value
sinus tachycardia isn’t uncommon

other pathologies causing tachycardia (hypovolaemia, pulmonary embolus, sepsis) should be considered depending on clinical context

47
Q

oxygen consumption during pregnancy

A

increases by 20-30% at term
myocardium has to work harder therefore increased oxygen requirements
pregnancy can trigger ischaemic heart disease and MI in those w/ coronary artery disease (older, diabetic, smoker)

48
Q

why can you never lie a pregnant patient flat

A

they will lose 25% of their cardiac output and faint

due to vena caval compression by pregnant uterus

49
Q

in what position must a pregnant patient be resucitated in the event of maternal collapse/cardiac arrest

A

on a left lateral tilt or with the uterus manually displaced

you will not be able resucitate any person with a gravid uterus who is lying flat due to the reduction in CO

50
Q

intrapartum CV changes

A

autotransfusion of contractions - with every contraction another (up to) 500ml is dumped into the circulation
pain - increases circulating catecholamines and increases HR, BP and CO

51
Q

increase in CO during labour

A

can increase by a further 10% and immediately after delivery up to 80% above the already increased CO of pregnancy - due to lack of uteroplacental unit to be supplied and also immediate relief of IVC compression

52
Q

post-partum CV changes

A

most return to normal by 3mths after delivery
3 days - blood volume decreased by 10%
3-7 days - BP initially falls then increases again
6wks - BP returns to pre-pregnancy levels
systemic vascular resistance begins to increase again over first 2wks, HR falls to prepregnancy levels

53
Q

respiratory changes during pregnancy

A

increased oxygen requirements
increased volume of air and gas exchange with each breath - increases oxygen availability and CO2 removal in mother and foetus

54
Q

changes to tidal volume during pregnancy

A

increases

40-50% increase in minute ventilation

55
Q

changes in resp rate during pregnancy

A

increases

can be percieved as SOB

56
Q

hyperventilation in pregnancy

A

relative hyperventilation
PCO2 levels are lower in pregnancy
healthy pregnant person is in a state of compensated respiratory alkalosis

57
Q

changes in the chest during pregnancy

A

enlarging uterus pushes the diaphragm up up to 4cm

increased diameter of lower thorax by 2cm - splaying of lower ribs

58
Q

changes in functional residual capacity during pregnancy

A

decreases ~20-30%

further reduced by supine position

59
Q

asthma and pregnancy

A

improves in some cases

due to the bronchodilator effect of progesterone

60
Q

Hb at 28wks

A

at 28wks a Hb of 105g/L or above is considered normal
non-pregnant range 120-160
this is the physiological anaemia of pregnancy

61
Q

plasma volume and pregnancy

A

increases proportionate to birthweight

relative decrease in platelet count due to this - remains in normal limits for the non-pregnant patient

62
Q

changes in iron levels during pregnancy

A

2-3x increase in requirements

mainly for use by foetus as well as increasing red cell mass

63
Q

what is the most common haematological abnormality of pregnancy

A

iron deficiency anaemia
more common in twin/multiple pregnancies
also associated with intrauterine growth restriction

64
Q

why are some women iron deficient going into pregnancy

A

menorrhagia
inadequate diet
previous recent pregnancies

65
Q

what contributes to iron deficiency postnatally

A

post partum haemorrhage

2-5% of deliveries

66
Q

folate requirements during pregnancy

A

increase 10-20x during pregnancy
2nd most common cause of pregnancy anaemia
serum levels of folate are lower in pregnancy but liver levels are maintained

67
Q

changes in WCC during pregnancy

A

increase - overall WCC and neutrophil

WCC up to 16x109/L is normal

68
Q

changes in coagulation during pregnancy

A

hypercoagulable state

factors which promote clotting increase, factors which prevent decrease

69
Q

what clotting factors increase during pregnancy

A

VII, IX, X

fibrinogen

70
Q

which anti-clotting factors decrease during pregnancy

A

protein S and C
anti-thrombin 3

fibrinolytic activity decreases

71
Q

DVT risk and pregnancy

A

increased risk

also increased by venodilation and reduced venous return - increased venous stasis in lower limbs

72
Q

pulmonary embolus and pregnancy

A

one of the main causes of direct maternal mortality in UK
6-15 people killed p/a in pregnancy or puerperium

pregnancy increases risk of thromboembolism by 6x

73
Q

when do changes in coagulation occur

A

from very early in pregnancy
can persist up to 6wks after delivery
1/2 of all clots associated with the antenatal period occur in first 15wks

74
Q

why does the urinary system significantly dilate during pregnancy

A

relaxation of smooth muscle of ureter - caused by progesterone
mechanical compression of the growing uterus

75
Q

hydronephrosis and pregnancy

A

physiological hydronephrosis can be seen

usually more pronounced on the R side

76
Q

changes in renal blood flow during pregnancy

A

increase in circulating blood vol and reduction in systemic vascular resistance
increase in renal plasma flow by up to 60-80% in 2nd trimester
settles to 50% increase through 3rd trimester

77
Q

GFR and creatinine clearance during pregnancy

A

increase by ~50%

normal levels of urea and creatinine are much lower during pregnancy

78
Q

changes in excretion and secretion in the kidneys during pregnancy

A

excrete more protein
retain more sodium (and water)
increased secretion of vit D, renin and erythropoetin

79
Q

haematuria in pregnancy

A

microscopic haematuria is more common
if there is no proteinuria, no infection and renal US and function is normal - likely due to bleeding from the small vessels in the dilated renal function

glycosuria is also common

80
Q

UTI in pregnancy

A

more common

should be treated w/ abx safe in pregnancy promptly

81
Q

kidney disease and pregnancy

A

any underlying kidney disease is likely to worsen during pregnancy
due to additional work being done by the renal system

Y3 repro (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions