Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Reproductive systems > Maternal physiology > Flashcards

Maternal physiology Flashcards

(59 cards)

Start Studying
1
Q

What does the body need to adapt to pregnancy?

A
  • Volume support (volume expansion and vasodilation)
  • Nutrition (increased respiration, insulin resistance, increased absorption)
  • Waste clearance (increased GFR and hepatocellular stimulation)
  • Pregnancy maintenance (uterine quiescence and immunologic sequestration)
  • Childbirth (MSK and clotting)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What drives the adaptations of the human body during pregnancy?

A
  • Hormones e.g.
  • hCG
  • oestrogen
  • progesterone
  • relaxin
  • hPL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why does immunity change in pregnancy?

A
  • Baby is a foreign object in mother’s body
  • Need to avoid body rejecting baby
  • Allows baby to thrive but as a parasite
  • Allows mother to be a good host
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is meant by the statement: the foetus is a hemi-allograft?

A
  • Recognised by maternal immune system
  • Half of foetus is foreign to mother (1/2 mum’s genes and 1/2 dad’s
  • SO incited allo-response is not cytotoxic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens to immunity in pregnancy?

A
  • Immunosuppressed state
  • Higher attack rate and severity of certain viral pathogens i.e. varicella
  • May improve certain autoimmune conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does mum need from respiration in pregnancy?

A
  • Continued O2 delivery to her organs and periphery
  • Increased O2 supply to meet metabolic demand
  • Increased CO2 clearance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does baby need from respiration in pregnancy?

A
  • Oxygen delivery
  • Carbon dioxide removal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How are the respiratory needs of mum and baby met during pregnancy?

A
  • Increased ventilation
  • Tidal volume increases by ~30-40%
  • Minute ventilation increases by ~40-50%
  • Increase PaO2, decrease PCO2
  • pH change (respiratory alkalosis, compensated by renal bicarb excretion)
  • Expiratory reserve volume decreases by ~20%
  • Total lung capacity decreases by ~5%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the clinical consequence of respiratory changes that occur in mum during pregnancy?

A
  • Dyspnoea of pregnancy occurs in 60-70% of patients
  • Multifactorial
  • Most likely due to hyperventilation and decreased PaCO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What else could cause dyspnoea in a pregnant woman?

A
  • Cardiac pathology
  • Anaemia
  • DVT/PE
  • Asthma
  • Pneumonia/ARDS
  • Pulmonary oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does baby need from the cardiovascular system and the blood?

A
  • Delivery of nutrients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does a pregnant mum need from the cardiovascular system and the blood?

A
  • Needs to fill utero-placental-foetal circulation
  • Oxygenate growing uterus - very vascular and high demand
  • Protect from impaired venous return
  • Prepare for potential blood loss during delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are the changes to the cardiovascular system and the blood achieved during pregnancy?

A
  • Volume expansion
  • Clotting mechanisms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is volume expansion of the cardiovascular system during pregnancy achieved?

A
  • In early pregnancy volume increases
  • In late pregnancy heart rate increases
  • Progesterone causes smooth muscle relaxation
  • Decreased systemic vascular resistance
  • Drop in BP (but then returns to pre-pregnancy level)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is increased clotting of the cardiovascular system during pregnancy achieved?

A
  • Increased procoagulants (fibrinogen, factor VIII, vWF)
  • Decreased anticoagulants (e.g. Protein S)
  • Reduced fibrinolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is stroke volume increased in pregnancy?

A
  • Oestrogen and progesterone activates RAAS
  • Oestrogen also activates release of angiotensin from liver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the consequences of pregnancy on the cardiovascular system?

A
  • Increased RAAS leads to peripheral oedema
  • Change in plasma volume leads to change in RBC volume
  • Dilutional oedema
  • Clotting leads to hypercoagulable state - increased number of thromboembolic events
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the values that define anaemia in pregnancy?

A
  • 1st trimester Hb <110 g/l
  • 2nd and 3rd trimester: <105 g/l
  • Postpartum <100 g/l
  • Normal Hb: 115-165 g/l
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why does anaemia of pregnancy occur?

A
  • Red cell mass increases by 25-30%
  • Not enough to counter dilutional increase in plasma volume
  • Iron deficiency is a problem despite relative macrocytosis
  • Most common cause of anaemia in pregnancy is iron deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the complications of anaemia of pregnancy?

A
  • Increased morbidity for mum and baby
  • Preterm delivery
  • Maternal fatigue
  • Infant iron deficiency anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does the baby need from the renal system during pregnancy?

A
  • Remove waste
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does the mum need from the renal system during pregnancy?

A
  • Increase clearance of waste at the kidneys
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What changes occur to the renal system during pregnancy?

A
  • Increased glomerular filtration rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do renal haemodynamics change in pregnancy?

Study These Flashcards
A
  • Systemic vasodilation leads to increased renal blood flow
  • This increases GFR by 50%
  • Afferent and efferent arteriole vasodilation
  • Decreases serum urea and creatinine
25
How does tubular function change in pregnancy?
- PCT absorption decreases - Leads to increased glycosuria - Increased Ca2+ excretion - Increased glycosaminoglycans - Decreased reabsorption of uric acid
26
What systemic changes occur to the kidney in pregnancy?
- Decreased sensitivity to RAAS - Increased water retention (hypothalamus has a lower threshold for vasopressin) - Decreased plasma osmolality
26
What systemic changes occur to the kidney in pregnancy?
- Decreased sensitivity to RAAS - Increased water retention (hypothalamus has a lower threshold for vasopressin) - Decreased plasma osmolality
27
What structural changes occur to the kidney during pregnancy?
- Increased size of kidneys and ureters - Right > left - Decreased speed of urine passage - Hydronephrosis
28
What does baby need from the GI system during pregnancy?
- Nutrients
29
What does mum need from the GI system during pregnancy?
- Feed herself and her baby - Increase absorption of minerals and vitamins
30
What adaptations occur in the GI system during pregnancy?
- Slow transit time
31
What are the effects of progesterone on the GI system?
- Decreased lower oesophageal sphincter tone - leads to GORD and aspiration - Decreased gallbladder contractility - leads to gallstones - Decreased large and small bowel motility - leads to increased mineral absorption, constipation and increased water absorption
32
What structural changes occur to the GI system in pregnancy?
- Gravid uterus displaces bowel - Can cause mechanical obstruction
33
How do LFT values change during pregnancy?
- ALP levels increased due to placental synthesis
34
What does baby need from the endocrine system during pregnancy?
- Nutrients - A good environment
35
What does mum need from the endocrine system during pregnancy?
- A way to give glucose to baby - A lot of calcium - Keep metabolism under control
36
How does the endocrine system change during pregnancy?
- Thyroid regulation - Parathyroid activation - Insulin resistance
37
How does the thyroid gland adapt to pregnancy?
- Pregnancy is considered a euthyroid state - Imbalanced levels can affect foetal development - Oestrogen stimulates liver to produce Thyroid Binding Globulin - Need to increase thyroxine production - hCG has a similar alpha subunit to TSH - So it has a weak stimulating effect on thyroid
38
How do PTH and calcium levels change in pregnancy?
- Increased PTH leads to increased active vitamin D - Increases Ca2+ and phosphorus absorption from gut during pregnancy - Bones do not resorb Ca2+ and phosphorus - Decreased PO4 excretion by kidneys and increased Ca2+ absorption at kidneys - Due to increased 1 alpha-hydroxylase
39
What are the pre-pregnancy determinants of insulin resistance?
- Ethnicity - Physical inactivity - Obesity - Dietary composition - Polycystic ovarian syndrome - Hypertension
40
What causes insulin resistance in pregnancy?
- Tumour necrosis factor a - Placental lactogen - Placental growth hormone - Oestrogen - Progesterone - Cortisol
41
What are the risk factors for gestational diabetes mellitus?
- BMI above 30 kg/m2 - Previous macrosomic baby weighing 4.5kg+ - Previous gestational diabetes - Family history of diabetes - Ethnicity with high prevalence of diabetes
42
What are the investigations/diagnosis of gestational diabetes mellitus?
- Oral glucose tolerance test to test for gestational diabetes in women with risk factors - Blood glucose or OGTT if previous gestational diabetes mellitus - Diagnose if plasma glucose 5.6 mmol/l or above - A 2 hour plasma glucose level of 7.8 mmol/l or above
43
What are the potential complications of gestational diabetes for the mother?
- Increased risk of pre-eclampsia, polyhydramnios, premature labour - Shoulder dystocia - Failure for labour to progress - Increased risk of developing Type 2 diabetes mellitus
44
What are the potential complications of gestational diabetes for the baby?
- Macrosomia - Congenital abnormalities (cardiac, renal, neural tube defects) - Hypoxia and sudden intrauterine death after 36 weeks gestation - Hypoglycaemia - Respiratory distress - Jaundice
45
What changes occur in MSK and skin during pregnancy to help the baby?
- Room to grow - A way out
46
What changes occur in MSK and skin during pregnancy to help the mum?
- Cope with additional weight - Cope with change in centre of gravity - Prepare body for childbirth
47
How does MSK and skin change during pregnancy?
- Everything becomes loose and stretchy
48
What MSK-related symptoms does a woman experience during pregnancy?
- Back pain - Shoulder pain - Tension headaches - Pelvic pain
49
What adaptations occur to the MSK system during pregnancy?
- Change in centre of gravity due to increased lordosis and kyphosis and forward flexion of neck - Stretching of abdominal muscles impede posture and strain paraspinal muscles - Increased motility of sacroiliac joints and pubic symphysis causes anterior tilt of pelvis
50
What changes can be seen in the skin during pregnancy?
- Chloasma - Palmar erythema - Vascular spiders - Linea nigra
50
What changes can be seen in the skin during pregnancy?
- Chloasma - Palmar erythema - Vascular spiders - Linea nigra
51
What is pre-eclampsia?
- Pregnancy-induced hypertension with proteinuria +/- maternal organ dysfunction after 20 weeks
52
What is the NICE definition of pre-eclampsia?
- New onset of hypertension (>140/90) after 20 weeks - And the co-existence of 1 or more of the following new-onset conditions: - Proteinuria - Other maternal organ dysfunction - Uteroplacental dysfunction
53
What is severe pre-eclampsia?
- Pre-eclampsia with severe hypertension that does not respond to treatment
54
What is the pathogenesis of pre-eclampsia?
- Impaired invasion of trophoblast leading to shallow invasion of spiral arteries - Remain small calibre and of high resistance - Leads to hypoperfusion and ischaemia - Systemic endothelial dysfunction
55
What are the symptoms of pre-eclampsia?
- Headache - Vision disturbance (blurring/flashing) - Epigastric pain - Swelling of hands, feet, face - Vomiting - SOB
56
What are the maternal complications of pre-eclampsia?
- Seizure - Cerebral haemorrhage - Renal failure - Pulmonary oedema - HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) - DIC
57
What are the foetal complications of pre-eclampsia?
- Growth restriction - Oligohydramnios - Placental infarct - Foetal distress - Premature delivery - Stillbirth

Reproductive systems (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions