Summary of A&P and Physiological changes during Pregnancy

Question 1

Increased CSF pressure
Engoregement of epidural veins
Decreased MAC
Decreased LA volumes required

Answer 1

Neurological

Question 2

Increased MV (Increased TV and Increased RR)
Decreased PaCO2
Increased PaO2
Decreased FRC

Answer 2

Respiratory

Question 3

Increased ligamentous laxity
Increased risk of dislocation
Increased lumbar lordosis

Answer 3

MS

Question 4

Increased CO
Increased SV
Increased HR
Left ventricular hypertrophy
Regurgitant murmurs
Decreased SVR

Answer 4

Cardiac

Question 5

Decreased lower esophageal sphincter tone
Reflux
Increased risk of aspiration
Decreased liver enzymes (AST, ALT, GGT)
Increased ALP

Answer 5

GI

Question 6

Increased renal blood flow
Increased GFR
Decreased plasma urea and creatinine
Increased urinary protein and glucose
Increased risk of UTI

Answer 6

Renal

Question 7

Increased progesterone and estrogen
Placenta secretes relaxin, hyman placental lactogen, and human chorionic gonadotropin
Thyroid hyperplasia
Transient hyperthyroidism
Insulin resistance
Increased cortisol secretion by adrenal glands

Answer 7

Endocrine

Question 8

Blood volume 30-45%
Plasma volume 45%
Red cell mass 33%
Clotting factors (I, VII, VIII, X, XII, prekallikrein, von Willebrand factor, thrombin, APTT time, prothrombin time)
Fibrinogen levels 50-80%
Renal EPO/reticulocyte count
RBC 2,3-diphosphoglycerate (rightward shift to oxygen-hemoglobin dissociation curve)
Serum albumin concentration
Venous hydrostatic pressure
Erythrocyte sedimentation ratio
Serum lipids 40-60%

Answer 8

Increased - Alterations in the hematological sys at term preg

Question 9

Mean corpuscular hemoglobin concentration
lymphocyte/T-cell (although func reduced)
Bleeding time

Answer 9

Unchanged - Alterations in the hematological sys at term preg

Question 10

Hematocrit 35-45%
Plasma protein 10-14%
Plasma oncotic pressure (hemodilution)
Antithrombin III
Platelets

Answer 10

Decreased - Alterations in the hematological sys at term preg