Maternal Physio - GIT Flashcards Preview

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Flashcards in Maternal Physio - GIT Deck (12):

Organs displaced upward by the enlarging uterus

The stomach, appendix, and intestines


Appendix position and implication

  • Displaced upward and laterally
  • Pain from appendicitis may occur much higher in the abdomen because the gravid uterus pushes the appendix up


Gastric emptying time

  • During pregnancy
  • During labor

  • During pregnancy
    • Unchanged
  • During labor
    • Prolonged during labor and administration of analgesic agents


Gum changes

  • May be hyperemic and softened
  • Epulis of pregnancy
    • focal, highly vascular swelling of gums but regresses spontaneously after delivery


Effects of progesterone in GIT

  • ↓ lower esophageal sphincter tone → heartburn
  • ↓ bowel peristalsis → constipation → hemorrhoids


Memory aid:

  • Progesterone has a somehow relaxing effect
    • Relaxed ES tone
    • Relaxed bowel → ↓ bowel peristalsis


Mechanism for hemorrhoid development

Constipation and elevated pressure in veins below the level of the uterus


Liver enzyme(s) with increased activity

  • Alkaline phosphatase activity in serum almost doubles during pregnancy
  • Total albumin
  • Serum globin


Liver enzyme(s) with decreased activity

  • ALT
  • AST
  • GGT
  • Bilirubin
  • Serum albumin


Albumin levels in pregnancy

Serum albumin ↓, but total albumin ↑ because of a greater volume of distribution


Liver size in pregnancy

Remains the same


Why are pregnant women prone to cholestasis?

  • Progesterone inhibits CCK-mediated smooth muscle stimulation → impairs gallbladder contraction → increased residual volume and cholestasis
  • Estrogen inhibits intraductal transport of bile acids → contributes to cholestasis


Memory aid:

  • Progesterone – relaxing effect – inhibits CCK – impaired GB contraction


Cholestasis with increased lipids and cholesterol leads to

Higher incidence of gallstones, cholecystitis, and biliary obstruction