11. Changes of Pregnancy Flashcards
(36 cards)
Estrogen effects on reproductive organs
Increase blood flow to uterus; Inhibit ovulation; Promote ductal development of breasts
Systemic effects of estrogen
Decreased PVR; Renal retention of Na+; Increase in fibrinogen; Softening of fibrous connective tissue
Progesterone effects on reproductive organs
Decreased uterine contractility; Stimulates alveolar breast development; Inhibits ovulation
Systemic effects of progesterone
Elevated basal body temp; Decreased smooth muscle activity; Increases Na+ excretion; Increased aldosterone production; Increased sensitivity to CO2; Neuroendocrine/behavioral effects
Human Placental Lactogen
FEED THE BABY!!! Decreases materinal insulin sensitivity to increase glucose levels; Decreased maternal glucose utilization to feed fetus; Increased lipolysis to fuel fetal growth; Potent lactogenic properties
Syncytiotrophoblast
Causes elevation of HCG; maintains function of corpus luteum early in preg
Relaxin
Produced by corpus luteum; softens & ripens cervix; softens ligaments and pubic symphysis; Mediates uterine quiescence; Mediates hemodynamic changes of preg;
In males, enhances sperm motility
Uterine changes
Blood flow increases from 50cc/min to 500 cc/min; Wt increases from 70g to 1100 g; Volume increases from 10cc to 5000g
Hagar’s sign
Softening of the uterus
When is the maximal functional period of the corpus luteum?
1st 4 wks after conception
Vaginal changes
Increased vascularity/mucosa thickness/discharge/acidity
Breast changes
Breast enlargement; Increased size of nipples & aerola/pigmentation; Enlargement of Montgomery’s glands;
Hematologic changes
Plasma volume increase (50%); RBC mass increase (18%); Physiologic anemia; Increase in WBC; Increase in clotting factors; Bleeding time & clotting time unchanged.
Daily iron supplement requirement for pregnant women
300 mg of ferrous sulfate = 60 mg elemental iron
Cardiovascular changes
Increased CO; SV; HR (^10-15 beats/min)
Normal Heart Tone Changes
Split S2 with inspiration; Low-grade systolic ejection murmur d/t increased volume; Third heart sound after mid-pregnancy
Abnormal Heart Tone Changes
Diastolic murmurs
Heart position during pregnancy
Upward and to the left
GI changes
Decrease intestinal motility & gallbladder emptying
Pulmonary changes
Increased O2 consumption; Increased Tidal volume; Decreased residual volume. RESPIRATORY RATE IS UNCHANGED! Dyspnea experienced by 2/3 of women starting in late 1st trimester.
Thyroid changes
Moderate thyroid enlargement; Free T3 & T4 unchanged.
Pancreas changes
Hyperinsulinemia; Hypertriglyceridemia; Reduced tissue response to insulin. Changes d/t increased HPL (feed the baby!)
When does a fetus start synthesizing & secreting insulin?
9-11 wks gestation
hCG effects on blood
hCG & estrogen lead to increased levels of thyroid hormone in blood; hCG has mild stimulatory effects on thyroid; Estrogen produces higher levels of thyroid binding globulin
