Haematological Changes In Pregnacy Flashcards
(48 cards)
What is the effect of pregnancy on blood volume?
Maternal blood volume increases by 30-45% due to an increase in both plasma and erythrocytes
Increase in plasma volume is about 55%, and erythrocytes increase by about 33%
What happens to haemoglobin and hematocrit levels during normal pregnancy?
Hb and Hct levels fall during normal pregnancy, with Hb typically falling below 11g/dl
This is due to the marked increase in plasma volume causing dilution.
What is the primary reason for increased blood volume during pregnancy?
To meet the demands of the growing uterus and to protect against impaired venous return
It also safeguards the mother against adverse effects of blood loss during parturition.
What haematologic changes are observed in pregnancy regarding white blood cells?
WBC count increases, leading to leukocytosis
This includes a left shift and toxic granulation in neutrophils.
What is physiological thrombocytopenia in pregnancy?
A decrease in platelet count to 80-150 x 10^9/L, especially in the third trimester
This is mainly due to activation and consumption in the uteroplacental unit.
What are some causes of thrombocytopenia in pregnancy?
Causes include hypertension (eclampsia), HELLP syndrome, DIC, HUS, TTP
These conditions are considered medical emergencies.
What changes occur in coagulation factors during pregnancy?
Increased levels of fibrinogen, factor II, factor VIII, and factor X
Overall, there is an increase in coagulation, especially in the third trimester.
What is the role of the placenta in haemostasis during pregnancy?
The placenta maintains haemostatic balance and requires functioning regulatory molecules for coagulation
It has both pro-coagulant and anticoagulant mechanisms.
What is the significance of increased plasma volume in pregnancy?
It provides a physiological advantage by modifying responses to hypotension and blood loss at delivery
Hypervolaemia is protective.
Fill in the blank: The daily iron requirement during pregnancy is _______ mg.
6-7 mg
True or False: Antithrombin levels decrease during pregnancy.
True
What is the physiological requirement for oxygen consumption in a mother during pregnancy?
4 ml O2/kg/min
The foeto-maternal unit consumes 12 ml O2/kg/min.
What factors contribute to increased blood volume in pregnancy?
Factors include increased sodium retention and decreased plasma oncotic pressure
These changes lead to hypervolaemia.
What are the basic tests emphasized in pregnancy for haematologic changes?
CBC, ESR, Coagulation/haemostasis tests (PT/APTT, BT, D-dimers, etc.)
ABO/Rh blood groups testing is also important.
What is the impact of oral contraceptives on DVT risk?
Oral contraceptives increase the risk of DVT during pregnancy
This is an important consideration in managing pregnant patients.
What is the relationship between pregnancy and venous thromboembolism?
Pregnancy increases the risk of venous thromboembolism, especially peripartum
This is due to changes in coagulation and blood flow.
What are the potential complications of haemostasis in pregnancy?
Complications include bleeding, venous thromboembolism, and fetal/pregnancy loss
These risks are heightened during the peripartum period.
What is the role of fibrinolysis in pregnancy?
Fibrinolysis is involved in preventing excessive clotting and maintaining blood flow
Factors such as plasminogen and tissue plasminogen activator play key roles.
What is the effect of plasminogen levels during pregnancy?
Increased levels
Decreased uterine destruction and increased uterine production
What happens to tissue plasminogen activator levels in pregnancy?
Increased
What is the effect of plasminogen activator inhibitor during pregnancy?
Markedly increased
What are the two types of plasminogen activator inhibitors mentioned?
- PAI-1 (endothelial cells)
- PAI-2 (placenta)
What happens to urokinase type plasminogen activator levels in pregnancy?
Increased
How does TAFI change during pregnancy?
Unchanged
