Physiology of Pregnancy

Question 1

Blood volume in pregnancy increases to what %

Answer 1

150% of normal

Question 2

Why should pregn women avoid lying supine

Answer 2

Compresses IVC - decreases BP substantially

Question 3

How does BP change during normal pregnancy what is the main reason for this

Answer 3

Progesterone - smooth muscle relaxant - reduces vascular resistance.
BP drops in first 24 weeks, then returns to near normal
Only rises in pre-eclampsia, not a good sign

Question 4

What is the reason for oedema in pregnancy (2)

Answer 4

Incr blood vol

Inc RAAS - h20 retention

Question 5

What would you expect to see in following in pregnancy - with what consequence:
Platelets
Ferritin
Hct & Hb

Answer 5

They all drop - so watch for anaemia

Question 6

What happens to Protein C and Protein S, and Fibrinogen factors - what is the consequence

Answer 6

Prot C and S reduce, fibrinogen factors incr - risk of clotting and thrombus formation

Question 7

Do kidneys increase or decrease in size in pregnancy - why

Answer 7

Increase to accomodate incr blood flow

Question 8

Why might some preg women get urinary incontinence (2)

Answer 8

Ureters obstructed at pelvic brim by abdom contents, progesterone relaxes smooth muscle

Question 9

Why might preg women get joint pain esp hips

Answer 9

hormones esp. progesterone relax ligaments - SI joints. Combined with extra weight carried.

Question 10

What is normal change to TSH and T4 in early weeks of preg - why

Answer 10

TSH drops
T4 increases - transient hyperthyroidism
Reason: HCG binds to TSH receptor on thyroid - stimulates increase T4 prod