190- normal pregnancy Flashcards
chadwick sign
increased vaginal vascularity causes darkening during pregnancy
Normal CV changes: heart, blood, BP
enlarged silhouette, increased circulating blood volume accompanied by lesser increase in RBC so you get decreased hct. Slight leukocytosis (not due to infection). Increased HR, CO. BP decreases in 2nd trimester, normal in other two
respiratory normal changes
Increased minute ventilation due to increased TV to lower pCO2 so fetal CO2 can diffuse. Respiratory alkalosis with increased bicarb excretion to compensate. No increase in RR
what causes the smooth muscle relaxation necessary to accomodate weight gain and uterus size increase
progesterone
normal hepatic lab changes
increase in most clotting factors (hypercoag state).
normal renal changes
increased GFR (decreased serum Cr)
thyroid changes in pregnancy
increased t4 and t3 and TBG (no change in free T4). dependent on maternal until 10 wks
How much should caloric intake increase
300 kcal/day max
fetal circulation: pathway and what causes change
ox blood thru umbilical vein to ductus venosus to IVC to RV thru FO to pulm trunk thru ductus arteriosus to aorta to body. When alveoli expand the pAO2 increases, decreasing PVR which causes decreased RA pressure. Backflow thru duct art. changes the sensitivity to prostaglandins and vasoconstriction occurs
how is fetal Hg different
two alpha and two gamma chains (increased 02 affinity leads to left shift in curve)
why are fetal fats high and why does the adrenal weigh so much
need to make lots of steroids. Fetal zone will involute
Tetrology of fallot and tx
VSD, overriding Ao, pulm stenosis, PDA. Give PGE-1 to maintain PDA
three mechanics of labor
power (only one we can change), passenger, passage
Stages of labor and their duration
Stage 1: Latent (not much change, 14-20 hrs), active (rapid cervical change)
Stage 2: B/w full dilation and delivery (2-4 hours)
Stage 3: B/w delivery and placental delivery (10-30 min)
