A&P changes within the body during pregnancy

Question 1

What are the main hormones involved in pregnancy?

Answer 1

Progesterone, Oestrogen, HCG & HPL (human placental lactogen), Relaxin

Question 2

Which week of pregnancy does progesterone rapidly increase?

Answer 2

10 weeks

Question 3

What role does Oestrogen play during pregnancy?

Answer 3

Promotes maternal blood flow to the uterus and placenta

Question 4

What is the role of HPL?

Answer 4

HPL stimulates fetal tissues and reduces the risks of fetal rejection by the maternal body

Question 5

In which trimester do HCG levels usually begin to decrease?

Answer 5

2nd trimester

Question 6

What is the role of Relaxin during pregnancy?

Answer 6

It is responsible for relaxing the ligaments within the body, particularly in the pelvis to accommodate for the growing fetus.

Question 7

In which trimester is relaxin at its highest?

Answer 7

1st trimester

Question 8

What symptoms can relaxin have on the body?

Answer 8

Relaxin can cause a woman to have pelvic girdle pain and back ache

Question 9

Maternal blood flow progressively increases during pregnancy by what percentage?

Answer 9

30% in early pregnancy upto 50% In the third trimester

Question 10

Why can maternal blood flow be heard via auscultation?

Answer 10

Maternal blood flow can often be heard via auscultation due to the enlarging of the blood vessels to accommodate for the extra blood flow.

Question 11

Why is the ovoid shape of the uterus favourable for the fetus?

Answer 11

The ovoid shape of the uterus encourages the fetus to present in the cephalic position at term.

Question 12

Why does the uterus need more blood volume during pregnancy?

Answer 12

The uterus needs a rich blood supply during pregnancy to aid the stretching of the tissues and to supply the fetus with enough blood, oxygen and nutrients.

Question 13

Braxton hicks can occur during pregnancy. These do not dilate the cervix but they can…
A) Stretch the uterus
B) Increase blood circulation across the uterus and Placenta
C) Encourage the fetus to take a cephalic position

Answer 13

B) Increase blood circulation across the uterus and Placenta

Question 14

What is the role of the cervix during pregnancy?

Answer 14

To hold the contents of the uterus
Remains firmly closed during pregnancy to provide a tight seal against contamination.
The endocervical cells produce large amounts of tenacious mucus which acts as an antibacterial cervical plug

Question 15

How long is the cervix throughout the majority of pregnancy?

Answer 15

2.5cm but becomes softer and swollen under the influence of hormones

Question 16

What is the role of the vagina during pregnancy?

Answer 16

Alters PH levels under the influence of oestrogen and thus has an Increased volume of vaginal secretions known as leucorrhoea to help keep the vagina clean and free of infections

Question 17

Why is an increase in lactic acid in the vagina beneficial for pregnancy?

Answer 17

Lactic acid allows the vagina to remain in a favourable condition during pregnancy as it inhibits inflammation and inactivates potentially pathogenic bacteria and viruses

Question 18

What are the changes to the cardiovascular system during pregnancy?

Answer 18

The heart increases in size and moves upwards and to the left
Progesterone levels relax the smooth muscle and causes vasodilation in veins and arteries to increase blood flow
Increased permeability in capillaries
Haemoglobin levels decrease in the maternal blood due to the increase in blood plasma – this causes haemodilution to occur which comes with an increased risk of blood clots

Question 19

What symptoms can a woman experience as a result of the cardiovascular changes during pregnancy?

Answer 19

Increased blood pressure due to increase in blood circulating volume
Increase in resting heart rate

Question 20

Why must women not lie supine during late pregnancy?

Answer 20

The growing uterus can compress the inferior vena cava which can reduce the blood flow by roughly 80%. The vena cava is the largest vein in the body – carrying blood from the pelvis and abdomen, legs and feet.

Question 21

The effects of progesterone and relaxin on the smooth muscles on the vein walls, along with the increased weight of the growing fetus can contribute to what symptoms for the woman?

Answer 21

Oedema and varicosities which commonly appear on the legs but can also appear on the vulva or as haemorrhoids in the anal area.

Question 22

What effects can pregnancy have on a woman’s respiratory system?

Answer 22

The respiratory rate can increase by 18-20 breaths per minute by the third trimester
Progesterone increases sensitivity to co2 and initiates hyperventilation – causing breathlessness
Total lung capacity decreases by 5-7%

Question 23

What effects can pregnancy have on the renal system?

Answer 23

Enlarged kidneys due to the increase in blood flow
Bladder capacity increases to 1L – however this can come with an increased risk of infections due to the lax tone

Question 24

What gastrointestinal changes can occur during pregnancy?

Answer 24

Constipation – due to reduction in gut mobility as a result of increased progesterone levels, reduction in fibres/fluid intakes through diet, reduction in physical activity.
Gastric reflux/heartburn – caused by decreased oesophageal sphincter tone and upwards constrictive pressure of growing fetus and abdominal organs.

Question 25

What effects does pregnancy have on the breasts?

Answer 25

Pigmentation of skin can appear darker on the nipple and areola due to oestrogen and progesterone
Montgomery glands increase in size and begin to protrude in preparation for lactation
Breast can become larger and feel fuller as lactogenesis begins to take place and colostrum is developed from roughly 16 weeks

Question 26

What effects can pregnancy have on the skin?

Answer 26

Oestrogen and Progesterone can cause skin/melanin pigmentation – causing the linea nigra, facial chloasma (mask of pregnancy) and striae gravidarum (stretch marks)
Glossier and thicker hair

Question 27

What hormones are known to affect the immune system?

Answer 27

HCG and prolactin