Maternal Physiology Flashcards by Arielle Dellosa

Uterine enlargement is primarily stimulated by ___ and also by ___

ESTROGEN

Progesterone

How well did you know this?

Not at all

Perfectly

Uterine enlargement causes the ___ and ___ of muscle cells

Stretching

Hypertrophy

How well did you know this?

Not at all

Perfectly

Other accumulation in part of the uterine enlargement

Accumulation of fibrous tissue

Increased in elastic tissue

How well did you know this?

Not at all

Perfectly

The production of new myocytes are ___

LIMITED

How well did you know this?

Not at all

Perfectly

The weight of a nonpregnant uteus and its capacity

70 grams

10ml or less

How well did you know this?

Not at all

Perfectly

The weight of a prenant uterus and its capacity

1100 gram at term

5-20 liters

How well did you know this?

Not at all

Perfectly

The position of a pregnant uterus

Dextrorotated

How well did you know this?

Not at all

Perfectly

Layer of the uterus which is composed of dense muscle fibers perforated in all direction by blood vessels

Middle layer

How well did you know this?

Not at all

Perfectly

The layer of uterus which consist of sphincter like fiber around the fallopian tube and internal os of the cervix

Inner layer

How well did you know this?

Not at all

Perfectly

Irregular, painless contractions which is unpredictable, sporadic, nonrhythmic and intensity varies

Braxton hicks

How well did you know this?

Not at all

Perfectly

Braxton hicks approximates __ mmhg

15-25 mmHg

How well did you know this?

Not at all

Perfectly

The uteroplacental blood flow near tearm

450-650ml/min

How well did you know this?

Not at all

Perfectly

Vasodilation in the maternal placental blood flow is mediated by?

Estrogen
Progesterone
Nitric oxide

How well did you know this?

Not at all

Perfectly

Increased in fetal-placental blood flow happens on the ___ weeks were uterine artery doubles

How well did you know this?

Not at all

Perfectly

Changes in the cervix during pregnancy

Increased vascularity and edema

Hypertrophy and hyperplasia of cervical gland

How well did you know this?

Not at all

Perfectly

Copius amount of a tenacious mucus that obstruct the cervical canal soon after conception

Mucus plug

How well did you know this?

Not at all

Perfectly

Only a __ corpus luteum of pregnancy can be found in the ovaries of a pregnanct women

SINGLE

How well did you know this?

Not at all

Perfectly

Corpus luteum functions maximally during the first ___ weeks of pregnancy

6-7 weeks

How well did you know this?

Not at all

Perfectly

The ovarian pedicle increases in about __ cm at term

2.5 cm

How well did you know this?

Not at all

Perfectly

This is secreted by the corpus luteum, placenta, decidua and also be expressed by the heart, brain, kidney

Relaxin

How well did you know this?

Not at all

Perfectly

Functions of relaxin:

☑️ Remodelling of the reproductive tract tissue during pregnancy
☑️ Initiation of AUGMENT renal hemodynamics and DECREASE osmolality

How well did you know this?

Not at all

Perfectly

Solid ovarian tumor composed of large acidophile luteinized cells

Pregnancy luteoma

How well did you know this?

Not at all

Perfectly

Solid, complex appearing UNILATERAL mass, with cystic features that correspond to areas of hemorrhage

Pregnancy luteoma

How well did you know this?

Not at all

Perfectly

Pregnancy luteoma can cause ___ virilization only

Maternal

How well did you know this?

Not at all

Perfectly

This is a self limited, due to exaggerated physiological follicle stimulation (hyperreactio luteinalis)

Theca lutein cyst

This is usually BILATERAL and associated with gestational trophoblast disease

Theca lutein cyst

Theca lutein cyst is also associated in large palacentas such as those found in patients with _ and in patients with _

DM, D-isoimmunization, Multiple fetuses | Chronic renal disease, Hyperthyroidism

What are the three change in the fallopian tubes?

☑️ Undergoes little hypertrophy during pregnancy ☑️ Epithelium of tubal mucosa flattened ☑️ Decidualization may be seen

Vaginal and perineal changes on labor and delivery:

✔️ Increased in the thickness of the mucosa ✔️ Loosening of the connect tissue ✔️ Hypertrophy of the smooth muscle cells

What is the vaginal pH?

3.5 - 6.0

Two changes in the skin:

Striae gravidarum | Diastasis recti

Hyperpigmentation cause __ and __ this is due to __

Linea negra Chloasma or Melasma gravidarum Increase MSH

Vascular changes are due to ___ examples are __ and __

Hyperestrogenemia Vascular spiders, angioma, nevus os telangiectasia Palmar erythema

Breast will have HYPERTROPHIC sebaceous gland formation called __

Galnds of montgomery

Weight gain in pregnant women is attributed to:

Uterus and its content Breast Blood volume Extravascular extracellular fluid

What is the approximate weight gain during pregnancy:

12.5 kg or 27.5 lbs

Maternal reserve is attributed to ___ and ___

Increased in water and deposition of new proteins and fats

Total water retention during pregnancy ___, divided into two parts with their corresponding volumes

6.5 liter Fetus, placenta, amniotic fluid (3.5 liters) Increased in plasma volume, uterine, and breast size (3.0 liters)

Pitting edema in pregnancy is due to?

Partial vena cava occlusion | Decreased in interstitial colloid osmotic pressure

Protein metabolism: Grams contained in the fetus and placenta Grams added to the uterus, breast, maternal blood

500 grams | 500 grams

CHO metabolism in normal pregnancy:

Mild fasting hypoglycemia Post prandial hyperglycemia Hyperinsulinemia

Insulin resistance is ___ in pregnancy to about ____

INCREASED | 45-70%

Insulin resistance is mediated by:

Estrogen Progesterone Human Placental Lactogen

This is the most consistent change in lipid metabolism durinjg pregnancy

Maternal hyperlipidemia

Maternal hyperlipidemia is due to:

✔️ Decreased circulating levels and activity of lipoprotein lipase ✔️ Estradiol and Progesterone hepatic effects

Leptin and Ghrelin serum levels are ___ and these are mainly secreted by ___

INCREASED | Adipocytes

How many mEq of sodium is retained? How many in potassium?

1000 mEq | 300 mEq

``` Increased or decreased or Unchanged: Ionized calcium Total calcium Magnesium Phosphate GFR of Na and K Reabsorption of electrolytes Excretion of electrolytes ```

``` Unchanged Decreased Decreased Unchanged Increased Increased Unchanged ```

Fetus accumulates __ grams of calcium at term which is met by:

30 grams ☑️ Doubling maternal calcium intestinal absorption ☑️ Dietary intake of sufficient calcium

Hypervolemia accounts for:

☑️ To meet metabolic demands of the enlarging uterus ☑️ To provide abundant nutrients and elements to support the growing fetus and placenta ☑️ To protect mother and fetis against deleterious effects of impaired venous return in the supine and erect position ☑️ To safeguard the mother against the adverse effect of blood loss associated in parturition

___ in both RBC and Plasma begins within the ____ and expans rapidly in the ___

Increased 1st trimester 2nd trimester

Total iron requirement during pregnancy: _____ mg To the fetus and placenta: ___ mg Lost portion: ___ mg To 450 ml of circulating erythrocytes: ___ mg

1000 mg 300 mg 200 mg 500 mg

Blood volume increased at near term by ___%

40-45%

Rate of increase in iron requirement

6-7 mg/day

``` Increased or decreased or unchanged: Iron requirement Blood volume Hgb Hct ```

Increased Increased Decreased Decreased

``` Increased or decreased or unchanged: All clotting factors except XI and XIII Platelets Anti-thrombin levels Clotting time Fibrinogen Thromboxane A2 Activated C protein resistance Protein S Protein Z Clotting factors XI and XIII ```

``` Increased Decreased Unchanged Unchanged Increased Increased Decreased Decreased Increased Increased ```

Increased or decreased or unchanged: T helper 2 cells suppresion CD4 T lymphocytes Monocytes

All are decreased

``` Increased or decreased or unchanged: T helper 1 cells suppression T cytotoxic 1 cells Interleukins 4,6,13 IgA and IgG Leukocyte counts CD8 T lymphocytes CRP, ESR, C3, C4, leukocyte alkaline phosphatase ```

All are INCREASED

``` Increased or decreased or unchanged: Systemic vascular response ECG CO HR Plasma volume Pulmonary vascular resistance A2 and P2 Preload MAP Pulmonary capillary wedge pressure ```

``` Decreased Unchanged Increased Increased Increased Decreased Unchanged Unchanged Increased Decreased ```

``` Increased or decreased or unchanged: S1 splitting BP on sitting CVP Antecubital venous pressure S3 sound Basal metabolic rate ```

``` Increased Decreased Unchanged Unchaged Increased Increased ```

10% if women have this due to supine compression of great vessels that may affect directly the fetal heart rate patterns

Supine hypotension syndrome

Increased or decreased or unchanged: Renin Aniotensin Plasma volume

ALL are INCREASED

Renin is produce by:

Maternal kidney and Placenta

Angiotensinogen is produced by:

Maternal and Fetal liver

There is an ___ refractoriness in angiotensin II refractoriness in normal pregnancy and lost immediately after delivery of the placenta

Increased

Increased or decreased or unchanged: ANP BNP

ALL are UNCHANGED

Diaphragm rises about ___ during pregnancy Subcostal angle widens appreciably as the transverse diameter of the thoracic cage increase about ___ Thoracic circumference increases about ___

4cm 2cm 6cm

``` Increased or decreased or unchanged: Tidal volume FRC Maximum breathing capacity Minutes Ventilatory colume Residual volume Timed vital capacity Minute oxygen uptake Peak expiratory flow Total pulmonary resistance Lung compliance Airway conductance Critical losing volume Total oxygen carrying capacity ```

``` Increased Decreased No change Increase Decrease Unchange Increased Decreased Decreased Unchange Increased Increased Increased ```

Urinalysis: Glucosuria Proteinuria Hematuria

Normal Abnormal Contamination

Increased or decreased or unchanged: | Gastric emptying time

Increased

Common during pregnancy and is mostblikely caused by reflux of acidic secretions into the lower esophagus

Pyrosis

Increased or decreased or unchanged: | Lower esophageal tone

Decreased

Increased or decreased or unchanged: Intraesophageal pressure Intragastric pressure

Lower | Higher

Increased or decreased or unchanged: | Esophageal peristalsis have: speed and amplitude

Decreased | Decreased

``` Increased or decreased or unchanged: Serum aspartate transaminase Alanine transaminase Glutamyl transaminase Leucine aminopeptidase Bilirubin Gall bladder contractility Alkanine phosphatase Serum albumin ```

``` Decreased Decreased Decreased Increased Decreased Decreased Increased Decreased ```

The unchanged level in endocrine in pregnancy:

Growth hormones | TRH

The decreased level in endocrine pregnancy:

Dehyroepiandrosterone sulfate

IOP in pregnancy is ___ Vitreous outflow is ___ Corneal sensitivity ___

Decreased Increased Decreased

Brownish red opacity on the posterior surface of the cornea

Krukenberg spindles