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OBSTETRICS > Maternal Physiology > Flashcards

Maternal Physiology Flashcards

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1
Q

In early pregnancy, what causes the increase in the size of the uterus?

A

Estrogen and progestrone

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2
Q

After 12 weeks, what causes the increase in uterine size?

A

enlarging product of conception

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3
Q

thickening is most marked on which part of the uterus

A

fundus

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4
Q

when does the uterus become palpated suprapubically

A

12 weeks

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5
Q

by the 20th week, the fundus can be palpated where?

A

umbilicus

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6
Q

by the 36th week, the fundus of the uterus has reached where?

A

Xyphoid process

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7
Q

3 layers of the uterine musculature

A

outer hood like layer
thick middle layer composed of muscles perforated by blood vessels
inner layer with sphincter like fibers around the cervical os the fallopian tube orifices

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8
Q

What is the shape of the uterus at the start of the pregnancy?

A

pear shaped

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9
Q

at 12 weeks, the uterus will be shaped as

A

spherical

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10
Q

at term what is the shape of the uterus

A

ovoid

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11
Q

the enlarged uterus, when supine rests upon what great vessel?

A

inferior vena cava and aorta

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12
Q

early in the pregnancy (before 12 weeks) where can the uterus be palpated?

A

Pelvis

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13
Q

cervical wall thickens during pregnancy? t or f

A

true

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14
Q

what causes cyanosis and softening of cervix during pregnancy?

A

increased vascularity, edema hypertrophy and hyperplasia of cervical glands

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15
Q

eversion of the endocervical glands result into?

A

prolapsed cervical cavities and seen as reddish growth on the cervical os or squamocolumnar junction

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16
Q

this serves as a a mechanical plug that serves a barrier of the cervix from infection coming from the vagina

A

cervical mucus (rich in Ig and cytokines)

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17
Q

the cervical mucus of pregnant women when spread on a glass slide would show what pattern?

A

Beaded due to progesterone

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18
Q

if there is amniotic fluid leakage, what would be the pattern of the cervical mucus when spread on a glass slide?

A

fern due to estrogen

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19
Q

the endocervical gland hyperplasia and hypersecretory appearance is called

A

Arias Stella reaction

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20
Q

Arias stella reaction can be mistaken as what under pap smear?

A

atypical glandular cells

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21
Q

the corpus luteum produces progesterone up to how many weeks of pregnancy?

A

6-7 weeks

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22
Q

after the corpus luteum stops production of progesterone, what replaces it?

A

Placenta - from 8 weeks onward

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23
Q

besides progesterone, what other substance is produced by the corpus luteum to remodel the cervix and accommodate parturition

A

relaxin

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24
Q

a benign solid ovarian tumor due to exaggerated luteinization of normal ovary

A

pregnancy luteoma

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25
benign ovarian tumors resulting from exaggerated follicle stimulation by high levels of HCG
theca lutein cysts
26
the increased vascularity of the vagina results in a violaceus color, this is called
Chadwick sign
27
what bacteria causes the vaginal ph to be acidic especially when pregnant
Lactobacillus acidophilus
28
breast tenderness and paresthesia is normal early in the pregnancy? t or f
true
29
when can colostrum start to be expressed
2nd trimester
30
scattered around the areola are sebaceous glands called
Montgomery glands
31
where does most of the weight gain obtained during pregnancy come from?
uterus and its contents, the breast, increase in blood volume and extravascular extracellular fluids
32
how many additional kcal per day is needed by the pregnant
300 k/cal per day
33
what is the total weight gain during pregnancy?
12.5 kg
34
water retention caused fall in plasma osmolality is about 6.5 liters, how many liters is retained by the fetus, placenta and the amniotic fluid?
3.5L the other 3L comes from the increase in blood volume, increased size of the uterus and breast
35
amino acid concentrations are higher in fetal or maternal?
fetal
36
With regard to carbohydrate metabolism, the normal pregnancy is characterized by,
mild fasting hypoglycemia, postprandial hyperglycemia and hyperinsulinemia
37
when does maternal hyperlipidemia take place?
3rd trimester
38
How is increased demand for calcium by the fetus met?
by doubling calcium absorption in the intestines
39
sodium and potassium concentrations are increased or decreased?
Decreased due to increase in plasma volume
40
serum phosphate levels are increased, decreased or unchanged?
Unchanged
41
the blood volume increase by how many percent after the 32-34th week?
40-45%
42
Which shows a greater increase during pregnancy? erythrocytes or plasma?
Plasma
43
The much greater increase in plasma than erythrocytes results to?
Dilutional anemia
44
Hemoglobin at term should be?
12-16g/dL
45
a hemoglobin concentration of lower than __ is considered as iron deficiency anemia
11 g/dL
46
What Ig are elevated in the mucus?
IgA and IgG
47
coagulation factors during pregnancy are elevated except?
factors XI and XIII
48
spleen enlarges during pregnancy? t or F
true
49
there is a decrease in the platelet concetration? t or f
true
50
Placenta transfers iron to the fetus even when there is marked iron deficiency of the mother? t or f?
true
51
The heart moves to what direction during pregnancy?
Upwards and laterally
52
The displacement of the heart during pregnancy is caused by
the diaphragm elevating progressively
53
What happens to the first heart sound during pregnancy?
There is splitting of the heart sound and an easily heard third heart sound
54
On chest exam, the mother exhibits cardiac murmurs, is this normal during pregnancy? y or n
Yes and this disappears after delivery
55
when does the cardiac output peak? Give all three
at 28 weeks (40%), during labor and right after delivery of placenta
56
what happens with mean arterial pressure and systemic vascular resistance? increases or decrease?
Decrease
57
stroke volume elevates by how many during pregnancy?
30%
58
what is the effect on cardiac output when the gravid uterus compresses on the inferior vena cava?
Decrease due to decreased venous return
59
which position causes a higher blood pressure in pregnant women? sitting or left lateral decubitus position?
left lateral decubitus position
60
At supine position, a pregnant women may experience hypotension? t or f?
true
61
prostaglandins in pregnancy are increased and can cause increase in blood pressure? t or f
true
62
this substance comes from endothelial and vascular smooth muscles which is a potent vasoconstrictor. It is stimulated by angiotensin II
Endothelin 1
63
this is a potent vasodilator from endothelial cells
Nitric Oxide
64
the diaphragm elevates by how many during pregnancy?
4cm
65
During pregnancy, respiratory rate increases? t or f?
false
66
the increased respiratory effort experienced in pregnancy is caused by?
progesterone
67
this is the shift to the left of the oxygen dissociation curve which increases affinity of maternal hemoglobin for oxygen
Bohr effect
68
mechanical obstruction caused by the uterus results in hydronephrosis? t or f
True
69
Glomerular filtration rate increases by 50% during pregnancy? t or f?
True
70
BUN and creatinine clearance is lower in the pregnant women? t or f?
False
71
What substance may be responsible for the increase in renal blood flow?
relaxin by nitric oxide production and vasodilation
72
glucosuria may be normal during pregnancy because there is no glucose resorption increase? t or f?
True
73
ureter compression is greater on which side? left or right?
right left is cushioned by the sigmoid colon
74
What hormone can possibly also cause ureteral dilatation?
Progesterone
75
Ureteral elongation causes what to show on xray?
Folds
76
During pregnancy, bladder pressure, increase or decrease?
increase
77
bladder capacity, increase or decrease?
decrease
78
what cause gum bleeding during pregnancy?
Gums become soft and hyperemic
79
what do you call the vascular swelling of the gums?
Epulis
80
the enlarging uterus pushes the intestines and stomach upward causing?
frequent heartburn and decreased gastric emptying time
81
What GI abnormalities are common during pregnancy?
constipation hemorrhoids bile stasis gallstones
82
the appendix is displaced where during pregnancy?
Superiorly
83
what happens to the endocrine system and hormones increase during pregnancy?
Basal metabolic rate increases thyroid gland can become enlarged protein bound iodine increases parathyroid gland size increases and PTH increases Adrenal gland hormones increase Pituitary gland size increases and may cause visual disturbances
84
The placenta produces what enzyme for the degradation of inuslin?
insulinase
85
slightly depressed lines or streaks in the abdomen and thighs seen during pregnancy?
Striae gravidarum
86
Strongest risk factors for striae gravidarum?
younger maternal age, family history and prepregnancy weight and weight gain during pregnancy
87
- brownish-black pigmented line in | the middle of the abdomen
Linea Nigra
88
pigmented spots on the face
Chloasma or “mask of pregnancy”
89
vascular elevation on | the neck, chest, abdomen, legs and arms
Spider nevi or angiomas
90
During pregnancy, the mother may experience lordosis or jyphosis?
lordosis
91
Separation of the recti muscles because of the | abdominal distention
diastasis recti
92
neurological condition common in the 1st and 2nd trimester, due to tension and increasing hormone levels.
Mild frontal headaches
93
Give common neurological changes during pregnancy
headaches due to tensin and increasing hormone levels dizziness due to hypotension or hypoglycemia tingling sensation due to hyperventilation leading to decreased pCO2 difficulty falling asleep

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