Week 1- Intro to pregnancy Flashcards
What are the four types of female pelvis structures?
Gynacoid- round most common
Android- smaller, not as ideal for child b birth
Arthropoid- elongated
Platepelloid- squished oval
What is pubic symphisitis?
Loosing of the ligaments allow for more movement in the joint cause pain and discomfort in the pelvic area which can radiate into things or peritenium
Occurs in 2-3 trimester
What is lighting crotch?
A pelvic related pregency condition where there is pain felt in the vagina, rectum or pelvis that is sharp and shooting.
What is the average onset of menstration and menopause?
12-15 years
44-55 years
What is the length of an average menstral cycle?
26-34 days
What is the average amount of blood lost per menstral cycle?
30-80ml
What is a haploid cell?
has only a single set of chromosomes ie a sore or egg cell
What is a diploid cell?
Contains a full set of chromosomes
What is a zygote?
a genetically distinct cell containing all the genetic information required to from a new individual (fertilised egg)
How long after fertilisation of the egg dose implantation occur?
Approximately 7 days
When does the placenta begin to form, become established and reach full size?
in the second week of gestation
fully established by 8-10 weeks and full size by month 4
What is the main site of hormonal production after 8-10 weeks?
The placenta which has seperate circulation
What does the placenta look like?
Flattered discoid organ about 20cm in diameter with a dark red maternal surface and a shiny grey foetal surface which is also connected to the umbilical chord
How much blood is transported into and out of the intravillious space during pregnancy?
First 8-10 weeks about 50ml/min
Buy the end of pregnancy 600-800ml/min
What are the four main function of the placenta?
Transport: respiratory gases, nutrients, hormones, waste products
Immunological: Barrier agains larger bacteria, maternal antibodies cross through
Endocrine: HPL, oestrogen, progesterone Beta-HGC
Metabolic: synthesis glycogen, cholesterol, fatty acids and enzymes used by the foetus and placenta
How many artier/veins does the placenta have and what is the flow rate of blood?
2 arteries to placenta- deoxygenated
1 vein to baby via chord -oxygenated
blood flow approx. 500ml/min
What does the umbilical chord look like?
2-3cm diamater
30-90cm long
2 arteries and one vein wrapped in collagenous wartons jelly
What are the two membranes of the placenta?
Chorion
- outer layer which is adhered to the decider, stores hormones
Amnion
Inner membrane, tough, smooth and tranluscent. Continuous with the outer layer of the chord with 200ml of fluid between the layers
What are the characteristics of amniotic fluid?
98% water, 2% glucose, proteins, sodium, urea and creatine
500-1500ml replenishing itself every 3 hours.
Charictatistically sweet odour
How is the amniotic fluid produced?
Formed by secretions of amniotic cells, foetal lungs and skin
what is the purpose of the amniotic fluid?
Protects foetus from changes in pressure and tempretue.
When do most congenital problems with a foetus occur?
During the first 8-9 weeks
What roles dose progesterone play in pregnancy?
Decreases smooth muscle contractility inhibits lactation Supresses maternal immunological respones to fetal antigens prepare uterus for implantation Drop- onset of labor
What is the role of oestrogen in pregnancy?
Breat grow, uterine growth, vaginal wall thickning, vaginal lubrication, increase coagulability, decreases bowl motility
What is the role in betaHCG
stimulates corpus lute to continue relating hormones
allows pregnancy to establish and continue without menses occurring
What is the role of HPL?
Insulin antagonist, growth promoting affects carbohydrates metabolisim
What is the role of relaxin during pregnancy?
causes relaxation of ligaments
What changes does the uterus undergo during pregnancy?
increases in size from about 60g to 1kg
oestrogen stimulates muscle cell hypertrophy
capacity increases from 10ml to 5L
all three layers increase in all directions
What changes does the cervix undergo during pregnancy?
Cell number increases due to oestrogen
secretes thick, sticky mucous plug
soften during labour “goodelles sign”
What changes do the ovaries undergo during pregnancy?
Follicles do not matte and no ovulation
corpus lute produces progesterone until 10 weeks
What changes does the vagina undergo during pregnancy?
Loosing of connective tissue
increase in secretions
increase of glycogen in cells
What changes do the breast undergo during pregnancy?
Enlagment of breast and areola
Production in 3rd trimester of colostrum - antibody rich fluid for initial breast feeding
What changes does the cardiovascular system undergo during pregnancy?
Increased output, SV and blood volumes
decreases systemic vascular resistance and BP
Increase in HR: pronounced in later pregnancy
What is supine hypotension in pregnancy?
occurs in later pregnancy where there is compression of the aorta and vena cave by the enlarging uterus decreasing preload and BP
What are the haematological changes that occur during pregnancy?
Red blood cells
Increase in blood volume 30-50%
Increase in red blood cell mass 18-20%
increased plasma 50%
- leading to heamodilution and physiological anaemia
What are the haematological changes that occur during pregnancy?
White blood cells
Number increases from about 8/40-30/40 weeks
relative state of immune suppression increasing susceptibility to infection
What are the haematological changes that occur during pregnancy?
coagulation factors
platelets decreases number in circulation but increased platelet aggravation and coagulation factors V11
in late pregnancy fibrinogen increase by 100% which assists in combating haemorrhage but predisposes to thromboembolic episodes
What anatomical changes does the respiratory system undergo during pregnancy?
diaphragm rises 4cm
transverse diameter of ribs increases 2cm
pressure on diaphragm from enlarging uterus- ribcage flares and chest circumference rwidens
Oedema and vascular congestion of nose due to oestrogen
What biochemical changes does the respiratory system undergo during pregnancy?
decreased CO2 from 35-40mmhg to 30mmhg
increased PO2
increasing inspiratory capacity 300ml
expository reserve volume decreases 200ml
Total volume increases from 500ml to 700ml
O2 consumption increase by 15%
What are the changes in the gastro-intestinal system in pregnancy?
Progesterone relax tone an mobility of smooth muscle causing constipation
Increases size of uterus raises the intra-gastric pressure delaying gastric emptying- causing people to feel more full
Avoid secretion increases in second trimester causing heart burn and reflux
What Genito-urinary changes are undergoe during pregnancy?
bladder increases size but compression from fungus makes it hard to fully empty
ureter and vladder real and dialte- increase UTI risk
Renal blood flow increases and glomerular filtration increases
Increasing excretion of cglucoes, proteins, amino acid and water soluble vitamin
Reduced ability of tubules to reabsorbs glucose
What endocrine changes occur duringg pregnancy?
Pituitary gland
Posterior: oxytocin stimulates uterine contractions
ANterior- prolactin responsible for initial milk production , FSH and LH suppressed to prevent menstral cycle
Thyroid gland: slightly enlarged- increase capacity to bind to thyroxin for fatal development
What changes does the muscle-skeltal system undergo during pregnancy?
Relaxin- general ligamentous relaxation
Pressure or static nerve
Curve in lumbar spine increases ‘lordosis’
dislocations and subluxations more likely t occur
What changes does the muscle-skeltal system undergo during pregnancy?
Relaxin- general ligamentous relaxation
Pressure or static nerve
Curve in lumbar spine increases ‘lordosis’
dislocations and subluxations more likely t occur
What changes does the skin undergo during pregnancy?
natural hair loss delayed
increase in melanocyte producing horse- stretch marks, line migration, chloasma
Describe the gynaecoid pelvis
Brim rounded Forepelvis- generous side walls- straight Ischial spines- blunt sciatic notch- rounded sub-pubic angle- 90 degrees Incidence- 50%
Describe the android pelvis?
Brim- Heart shaped Forepelvis- narrow side walls convergent Ischial spines - prominent sciatic notch- rounded sub-pubic angle <90% Incidence 20%
Describe the arthropod pelvis?
Brim- long oval Forepelvis- narrowed side walls- divergent Ischial spines- blunt sciatic notch- wide sub-pubic angle>90 degrees Incidence- 25%
Describe the playpelloid pelvis type?
Brim - Kidney shaped Forepelvis- wide side walls- Divergent Ischial spines- blunt sciatic notch- wide sub-pubic angle >90 degrees Incidence - 5%
