Maternal Physiology Flashcards Preview

Life Cycles > Maternal Physiology > Flashcards

Flashcards in Maternal Physiology Deck (38):
1

How does TBW change in pregnancy?

Increase- 6.5 L to 8.5 L
Chronic volume overload

2

Increase in what blood components lead to increased TBW?

Plasma volume
RBC mass

3

What happens to serum sodium levels during pregnancy?

Decrease
Water retention > Na retention

4

What is the lower limit for normal serum Na?

135 mmol
131 in pregnancy- drops 3-4 mmol

5

ANP/BNP become elevated during pregnancy, can BNP still be used to screen for CHF?

Yes
Increases is much greater in CHF than the normal physiologic response to pregnancy

6

What accounts for the dilutional anemia seen in pregnancy?

Plasma volume increases more than RBC mass

7

What is responsible for decreased systemic vascular resistance in pregnancy?

Progesterone

8

In what position is a pregnant woman's CO greatest?

Left lateral position

9

Low birth weight is associated with women who do large amounts of standing work, what is this attributed to?

Decreased CO

10

Blood flow increases to what organs during pregnancy?

Kidneys
Uterus, breast
Skin

11

What changes are seen on CXR in a pregnant woman?

Flattened left heart border
Prominent pulmonary vasculature
Heart position more horizontal
Elevation of diaphragm

12

What changes does pregnancy have on pulmonary gas exchange?

RR no change
TV increase
Hyperventilation- progesterone
PaCO2 decreases
PaO2 increases
pH increases
Bicarb decreases

13

What does increased TV during pregnancy result in?

Increased O2 uptake
Increased minute ventilation = RR*TV

14

What happens to forced viral capacity during pregnancy?

Remains unchanged

15

What happens to ERV during pregnancy?

Decreased
Due to elevated diaphragm

16

A pregnant woman has a PCO2 of 40, what is this a sign of?

Impending respiratory failure
Should be low due to hyperventilation

17

What term is used to describe the physiologic urinary tract changes during pregnancy?

Relative hydronephrosis of pregnancy- vasculature, interstitial volume, urinary dead space (dilation of renal pelvis, calyces, ureters)

18

When does relative hydronephrosis resolve?

Week 6 postpartum

19

What hormone is responsible for relative hydronephrosis of pregnancy?

Progesterone- SM relaxation

20

Aside from progesterone what else cause relative hydronephrosis of pregnancy?

Mechanical compression due to enlarging uterus

21

How can relative hydronephrosis of pregnancy make interpretation of urinary images difficult?

More difficult to evaluate urinary tract obstruction
(Ultra sound)

22

Define calculus.

Stone

23

Relative hydronephrosis increases the risk of what infection?

Pyelonephritis- urinary stasis

24

What is a normal GFR?

100 mL/min

25

What measurement approximates GFR?

Creatinine- slight overestimate

26

What is the lower limit of normal for CRCL?

97 M
88 W

27

What changes do you expect to see in a pregnant woman's BUN and Cr?

Both decreased
Result of increased GFR + increased plasma volume

28

A woman has chronic renal insufficiency, what effect can a pregnancy have on her disease?

1/3 in women may have worsening

29

What is physiologic anemia of pregnancy?

Hemodilution
Plasma volume>RBC mass

30

What causes increased risk for intravascular coagulation during pregnancy?

Virchow's triad
(stasis, endothelial damage, changes in clotting factors)

31

What effect does pregnancy have on PT/PTT/thrombin time?

Drop slightly (still normal range)

32

Where do most DVTS occur? Where does most pyelonephritis occur? (During pregnancy)

DVT- 90% L
Pyelonephritis- 90% R

33

What is the standard of care for diagnosis DVT?

Doppler US

34

What is the treatment for DVT during pregnancy?

LMW heparin

35

Nausea and vomiting of pregnancy complicates 70% of pregnancies. There are many medicines and alternative therapies, what vitamin seems to benefit women?

Vitamin B6

36

What is hyperemesis gravidarum?

Refractory nausea/vomiting
Associated with:
Weight loss
Dehydration
Ketonemia
Electrolye imbalances

37

What is hyperemesis gravidarum associated with?

Increased levels of hCG
Hyperthyroidism

38

Hyperpigmentation is seen in 90% of pregancies, what hormone is responsible for these changes?

hCG
(linea nigra, areolae, nipples, genital skin, axillae, melasma)