Maternal Physio - GIT Flashcards Preview

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Flashcards in Maternal Physio - GIT Deck (12):
1

Organs displaced upward by the enlarging uterus

The stomach, appendix, and intestines

2

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

3

Gastric emptying time

  • During pregnancy
  • During labor

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

4

Gum changes

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

A image thumb
5

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

6

Mechanism for hemorrhoid development

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

7

Liver enzyme(s) with increased activity

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

8

Liver enzyme(s) with decreased activity

  • ALT
  • AST
  • GGT
  • Bilirubin
  • Serum albumin

9

Albumin levels in pregnancy

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

10

Liver size in pregnancy

Remains the same

11

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

12

Cholestasis with increased lipids and cholesterol leads to

Higher incidence of gallstones, cholecystitis, and biliary obstruction