Maternal Changes In Pregnancy Flashcards Preview

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Flashcards in Maternal Changes In Pregnancy Deck (50)
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1

What are the reasons for changes in pregnancy?

→ High levels of fetal steroids
→ Mechanical displacement
→ Fetal requirements

2

What kind of an event is pregnancy?

→ Physiological

3

What can pregnancy do physiologically to existing conditions?

→ Exacerbate an existing condition
→ uncover a hidden or mild condition

4

What are 6 changes that occur during pregnancy?

→ Increase in uterus size
→ Increase metabolic requirements of the fetus
→ Structural and metabolic requirements of the fetus
→ Removal of fetal waste products
→ Prevision of amniotic fluids
→ preparation for delivery and puerperium

5

In what systems do pregnancy changes occur?

→ Respiratory system
→ Cardiovascular system
→ GI
→ Urinary
→ Endocrine

6

What are the three placental peptides?

→ hCG, hPL, GH

7

What takes over progesterone production?

→ Corpus luteum

8

What is the corpus luteum kept alive by?

→ hCG

9

What are the placental and fetal steroids?

→ Progesterones
→ Estradiol
→ Estrogen

10

What 4 hormones induce insulin resistance?

→ Growth hormone
→ Corticotropin releasing hormone
→ Estrogen
→ Human placental lactogen

11

Why do you want the myometrium to be quiescent?

→ Contractions would cause miscarriage

12

What is the total weight gain during pregnancy?

→ 12.5 - 13kg

13

What is the breakdown of the weight gain during pregnancy?

→ Fetus + placenta - 5kg
→ Fat and protein - 4.5kg
→ Body water 1.5kg
→ Breasts - 1kg
→ Uterus 0.5-1kg

14

Where is fat mainly laid down?

→ Anterior abdominal wall

15

What does the basal metabolic rate rise by in mid and late gestation?

→ 350kcal/day - mid
→ 250kcal/day - late

16

How does glucose get to the fetus?

→ Facilitated diffusion across the placenta

17

Where does the fetus store glucose?

→ in the liver

18

Describe what happens to maternal glucose reserves in the first trimester

→ Pancreatic ß cells increase in number
→ plasma insulin increases
→ Fasting serum glucose decreases (laid down as stores and used by muscle)

19

Describe what happens to fetal glucose reserves in the second trimester

→ hPL causes insulin resistance
→ less glucose into stores
→ increases availability in serum glucose so more crosses the placenta

20

Describe how gestational diabetes occurs?

→ Hormones antagonise the effects of insulin
→ Insulin increases
→ Beta cells become hypertrophied
→ Glucose is going into cells to be stored
→ insulin resistance gets higher due to hPL
→ The body makes more insulin to overcome the resistance
→ if you are already obese and insulin resistant you get gestational diabetes

21

Describe how water gain occurs in pregnancy

→ Estrogen and progesterone activate the RAAS system
→ Sodium is retained
→ Plasma volume increases by 40-50%
→ A litre of amniotic fluid is made

22

Why do you breathe quicker and deeper during pregnancy?

→ Estrogen and progesterone increase respiratory sensitivity to CO2

23

What does the minute volume increase by?

→ 40%

24

What is gas transfer like between mother and fetus

→ high O2 in mothers blood it favors transfer to the fetus
→ high CO2 in fetus it goes to the mother

25

What does the plasma volume increase by?

→ 40-50%

26

How does Hb concentration change in pregnant women?

→ it decreases
→ Red cell count goes up by 20% but the plasma goes up by 40% so the Hb is more diluted

27

How is more iron absorbed?

→ Transferrin

28

Why do you become hypercoagulable?

→ clotting factors increase

29

What does smoking do to fetal blood?

→ Increases maternal carboxy-Hb which reduces binding of O2
→ fetal hypoxia

30

How is blood transferred from the mother to the fetus?

→ Fetal blood has increased Hb
→ Increased O2 binding
→ Oxygen is given up by maternal Hb