Week 3 Pregnancy (Q. 16) Flashcards
True or False
Mild Ischemia is a common symptom with cardiovascular changes in pregnant women?
ECG changes show a Left Axis Deviation and flattening of t waves suggestive of mild ischaemia - seen in 15% of women
There is a rapid increase in CO and HR of approximately 15bpm.
There is a rapid increase in CO and HR by 15bpm. This is due to neuron-hormonal influences, increases in ______ _____, decreased peripheral _______ and the fact that the feto-placental units acts like an arterio-venous fistula
A. Blood Volume; resistance
B. HR; constriction
C. Blood Volume; constriction
D. HR; dilation
A. Blood Volume. Resistance
Progesterone relaxes vascular smooth muscle = vasodilation –> decrease PVR
Oestrogen Stimulates angiogenesis and collagen in tunica media of veins = increased distensibility –> decrease PVR
What is not a cardiovascular sign and symptom of pregnancy changes
a. Increased BV 35-45%
b. Vasodilation in skin for temp control
c. Decreased Heart Size to decrease SBP
d. Oedema (decrease venous return from extremeties)
e. Changes to heart sounds - murmur may develop
C. Decreased Heart Size to decrease SBP
Heart increases in size by 12%
Respiratory Symptoms
Due to the increased red blood cell count, we can expect to see respiratory changes. What is not an expected change
a. Increased TV, Rate and Alveolar Ventilation
b. Increased oxygen consumption
c. Carbon dioxide content increases
d. Hyperaemia and oedema of the respiratory tract
c. Carbon dioxide content Increases
When Carbon Dioxide actually decreases
Hyperaemia and oedema of nasal, sinus, nasopharyngeal and lower respiratory tract =
- Nosebleeds common
- Increased nasal stuffiness
- Decreased hearing
The profound effect of _________ on the smooth muscle in the GI causes reflux, constipation and bloating?
A. Progrestrone
B. Testostrone
C. Prolactin
D. Estrogen
A. Progesterone
Hormones cause relaxation of the esophageal sphincter. This is a tight circular band of muscle at the top of the stomach. This allows partially digested food and stomach acids to backflow, or reflux, into the esophagus. In addition, progesterone also slows the digestive process
What is the role of lactogen (released from the placenta)?
A. Increase in glucose production in the fetus
B. Increase glucose delivery to the fetus
C. decrease glucose and increase ketones for energy
D. protect the developing fetus from diabetes
B. Increase glucose delivery to the fetus
Fetus require 3x glucose compared to adult
Lactogen has an anti-insulin effect that prevents glucose uptake in the mother –> more glucose to the fetus –> mother has glycosuria
Overall is the metabolism of pregnancy in an anabolic or catabolic state?
Pregnancy in general is an anabolic state.
Food intake and appetite increases
Activity decreases
The first half of pregnancy is primarily anabolic
The second half of pregnancy has some catabolic states
Overall = Anabolic
What is colostrum milk?
Colostrum is the first form of milk produced by the mammary glands;
Rich in Vitamin A, Protein, Minerals and IgA
Released 2 - 3 days
Followed by normal milk production
Why must Gestational Hypertension Headaches be investigated in pregnant women?
Gestational hypertension can lead to a serious condition called preeclampsia, also referred to as toxemia.
Other Headache causes are;
- Brain Tumours (often 1st trimester)
- Spontaneous Subarachnoid Haemorrhage
- Muscle Contractions
What is Hyperemesis Gravidarum?
Hyperemesis can be defined as intractable vomiting resulting in 5% loss in pre-pregnancy weight, dehydration, disturbance of electrolytes, ketosis and need for admission to hospital.
When is the common time frame for pregnancies to fail?
A. 3 - 6 Weeks
B. 6 - 9 Weeks
C. 9 - 12 Weeks
D. 12 - 15 Weeks
B. 6 - 9 Weeks
Approximately 20% of clinically recognized pregnancies end in miscarriage and this increases to nearly 50% aged over 40 yrs
Vaginal bleeding, closed cervical os and fetal cardiac activity are associated with which type of miscarriage?
A. Threatened B. Missed C. Inevitable D. Incomplete E. Complete
A. Threatened
When your body is showing signs that you might miscarry, that is called a ‘threatened miscarriage’. You may have a little vaginal bleeding or lower abdominal pain. It can last days or weeks and the cervix is still closed.
The pain and bleeding may go away and you can continue to have a healthy pregnancy and baby. Or things may get worse and you go on to have a miscarriage.
There is rarely anything a doctor, midwife or you can do to protect the pregnancy.
‘Vaginal bleeding, dilated cervical os and some products of conception expelled and some remain.’
These signs/symptoms are associated with which type of miscarriage?
A. Threatened B. Missed C. Inevitable D. Incomplete E. Complete
D. Incomplete
Sometimes, some pregnancy tissue will remain in the uterus. Vaginal bleeding and lower abdominal cramping may continue as the uterus continues trying to empty itself. This is known as an ‘incomplete miscarriage’.
Your doctor or midwife will need to assess whether or not a short procedure called a ‘dilatation of the cervix and curettage of the uterus’ is necessary to remove any remaining pregnancy tissue.
Vaginal bleeding;
Dilated cervical os;
Products of conception seen/felt at or above cervical os
These signs/symptoms are associated with which type of miscarriage?
A. Threatened B. Missed C. Inevitable D. Incomplete E. Complete
C. Inevitable
Inevitable miscarriages can come after a threatened miscarriage or without warning. There is usually a lot more vaginal bleeding and strong lower stomach cramps. During the miscarriage, your cervix opens and the developing fetus will come away in the bleeding
No vaginal bleeding;
closed cervical os;
no fetal cardiac activity or an empty sac
These signs/symptoms are associated with which type of miscarriage?
A. Threatened B. Missed C. Inevitable D. Incomplete E. Complete
B. Missed (Baby has died but stayed in uterus)
If you have a missed miscarriage, you may have a brownish discharge. Some of the symptoms of pregnancy, such as nausea and tiredness, may have faded. You might have noticed nothing unusual. You may be shocked to have a scan and find the baby has died.
