Pregnancy Physiology Flashcards

1
Q

Why do pregnant people get more ascid reflux?

A

There is relaxation of their lower oesophageal sphincter

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2
Q

What happens to metabolism in pregnancy?

A

Increases

->need to produce energy for a second person

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3
Q

Summarise the changes to the CVS in pregnancy.

A

Increased circulating blood volume
Increased blood flow to all organs
Increased HR
Increased O2 consumption

->one of the most leading indirect causes of maternal mortality is cardiac disease

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4
Q

What happens to the CVS when a pregnant person lies down?

A

They lose 25% of cardiac output or venous return

->if unconscious and trying to do PCR on a pregnant person, don’t while they are supine won’t work, supine uterine displacement is required to move the uterus up. Two people will need to be involved in this CPR.

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5
Q

If a pregnant women has not been resuscitated after four minutes, what do you need to do?

A

Empty the uterus

->does not matter gestation, 25wks, 35wks etc.

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6
Q

What happens to BP in the first and second trimester?

A

Drops

->rises again in third

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7
Q

If a pregnant person’s BP doesn’t drop during the first two trimesters, what are they at a higher risk of?

A

Pre-eclampsia

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8
Q

Why do people with cardiac problems struggle in delivery?

A

Heart is under huge amount of pressure, cardiac output increases by 10% in labour and 80% in 1st post delivery hour

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9
Q

Summarise the respiratory changes which occur in pregnancy.

A

Significant increase in oxygen demand
Increased respiratory rate (just a little, not to pathological levels e.g. 24 breaths/min)
40-50% increase in minute ventilation
Decreased functional residual capacity

->just for interest, some women find pregnancy helps their asthma due to effect of progesterone but some notice no change

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10
Q

What changes in the acid-base balance are observed in pregnancy?

A

Oxygen levels go up
Carbon dioxide levels go down
Bicarb drops
Compensated metabolic alkalosis

->these changes are to allow oxygen to move more quickly and efficiently across the placenta to the baby

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11
Q

Summarise the changes to the renal system in pregnancy.

A

-Dramatic dilatation of the urinary collecting system
-Increased renal plasma flow
-GFR increases and creatinine clearance increases by up to 50%
-Increased protein excretion
-Microscopic haematuria may be present
-Oedema (80% of women get this)

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12
Q

Which common renal condition is even more common in pregnancy?

A

UTI

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13
Q

Summarise the haematological changes which occur in pregnancy.

A

-Plasma volume increases
-Greater iron and folate requirements
-WCC increases
-Hypercoagulable

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14
Q

What is the most common haematological disorder in pregnancy?

A

Iron deficiency anaemia

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15
Q

Why do pregnant people need to take folate supplements before getting pregnant and for the first 12wks of pregnancy?

A

To reduce risks of neural tube defects

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16
Q

What deficiency must you check for before giving folate supplements?

A

Vitamin B12 deficiency

->remember B before F, B comes before F in the alphabet

17
Q

Key symptom of PE in pregnancy?

A

Shortness of breath
Increased HR

->these both increase physiologically in pregnancy but always important to have a PE in mind

18
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to haemoglobin levels in pregnancy?

A

Decreases

->physiological anaemia

19
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to WCC levels in pregnancy?

A

Increases

20
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to platelet levels in pregnancy?

A

Decrease

21
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to CRP levels in pregnancy?

A

Stays the same

22
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to ESR levels in pregnancy?

A

Increases

->never do ESR in pregnancy

23
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to urea levels in pregnancy?

A

Decreases

->GFR increases

24
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to creatinine levels in pregnancy?

A

Decreases

25
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to urate levels in pregnancy?

A

Increases

->increases as pregnancy progresses. Higher in multiple pregnancy or larger BMI

26
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to 24hr protein levels in pregnancy?

A

Increases

->protein excretion increases

27
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to total protein levels in pregnancy?

A

Decreases

28
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to albumin levels in pregnancy?

A

Decreases

29
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to LFT’s levels in pregnancy?

A

Mostly stay the same

30
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to alkaline phosphate levels in pregnancy?

A

Increase, sometimes dramatically

31
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to bile acid levels in pregnancy?

A

Stays the same

32
Q

Okayyyy, let’s see if you have been paying attention with some lab values.

What happens to D-dimer levels in pregnancy?

A

Increases

33
Q
A