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Reproductive System > Maternal Physiological Adaptations To Pregnency > Flashcards

Maternal Physiological Adaptations To Pregnency Flashcards

0
Q

What changes occur in the cardiovascular system?

A
  • Increased blood volume
  • Increased cardiac output
  • Increased stroke volume
  • Increased heart rate
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1
Q

Physiological changes occur to which maternal systems?

A
  • CVS
  • Urinary system
  • Respiratory system
  • GI system
  • Immune system
  • Metabolic system
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2
Q

What happens to BP in T1&2, and why?

A

Reduced blood pressure due to effects of progesterone systemic vascular resistance

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3
Q

Why does BP return to normal in T3?

A

Reduced return to heart due to aortocaval compression by gravid uterus

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4
Q

What changes occur in the urinary system?

A
  • Increased renal plasma flow
  • Increased GFR
  • Urinary stasis
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5
Q

Why does urinary stasis occur?

A

Progesterone relaxes smooth muscles in the wall of the ureters

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6
Q

What are the consequences of urinary stasis?

A
  • UTI

- Pyelonephritis

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7
Q

What is the danger of pyelonephritis in pregnancy?

A

Can induce pre-term labour

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8
Q

What anatomical changes occur in the respiratory system?

A
  • Diaphragm is displaced

- A-P and transverse diameters of thorax increase

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9
Q

What physiological changes do/do not occur in the respiratory system?

A
  • Increased Oxygen consumption
  • Increased increased tidal volume
  • Decreased functional residual capacity
  • Vital capacity, FEV1 and Resp rate do not change
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10
Q

What drives physiological hyperventilation!

A

Progesterone

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11
Q

What does physiological hyperventilation result in?

A

Respiratory alkalosis with compensation

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12
Q

How does progesterone affect carbohydrate metabolism?

A

Stimulates maternal appetite in the first half of pregnancy and diverts glucose into fat synthesis

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13
Q

How does oestrogen affect carbohydrate metabolism?

A

Stimulates a rise in prolactin, leading to maternal insulin resistance

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14
Q

How do changes in carbohydrate metabolism benefit the fetus?

A
  • Mother uses less glucose
  • Gluconeogenesis increases
  • This maximises glucose available to the fetus
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15
Q

What is gestational diabetes?

A
  • Carbohydrate intolerance first recognised in pregnancy and not persisting after delivery
  • Loss of control of metabolism leading to hyperglycaemia
16
Q

Why does gestational diabetes occur?

A
  • Endocrine pancreas is unable to respond to high metabolic demand of pregnancy
  • Leading to a failure to release increased amount of insulin required
17
Q

What changes occur in the thyroid?

A
  • Increased thyroid binding globulin
  • Increased T3 and T4
  • Reduced TSH
18
Q

What stimulates the thyroid gland in pregnancy?

A

hCG

19
Q

Why can anaemia occur in pregnancy?

A
  • Mismatch between plasma volume and haemocrit (physiological)
  • Iron and folate deficiencies
20
Q

Why does physiological anaemia occur?

A
  • Plasma volume increases

- RBC mass does not increase to same degree

21
Q

What anatomical changes occur in the GI system?

A

Appendix moves to LUQ as uterus enlarges

22
Q

What physiological changes occur in the GI system and why?

A
  • Delayed emptying
  • Biliary tract stasis
  • Due to relaxation of smooth muscle by progesterone
23
Q

What changes occur to the immune system?

A
  • Non-specific suppression of local immune response at materno-fetal interface as fetus is an allograft
  • Haemolytic disease ➡️ ABO and rhesus antibodies do not cross the placenta
24
Q

What are the features of a pre-eclamptic woman?

A
  • Vasoconstricted
  • Plasma-contracted
  • Raised BP
  • Proteinuria
  • Pitting oedema

Reproductive System (12 decks)

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