misc- physiology of pregnancy

Question 1

Chadwick’s Sign

Answer 1

bluish discoloration of the cervix, vagina

Question 2

linea nigra

Answer 2

seen in dark women-

Question 3

cholasma/Melasma

Answer 3

blotchy pignmemtation of face

women on OCP

Question 4

Cardiovascular Physiology

Answer 4

arterial and venous BP both fall until the 24th wk of pregnancy then it returns to baseline BP

• INCREASED venous return can cause varicose veins and hemorrhoids
• INCREASED plasma volume (5–> 7.5L blood)–> HR, SV, CO all increase–> systolic ejection murmur
• DECREASE systemic vascular resistance to

Question 5

are diastolic murmurs normal in pregnancy?

Answer 5

never

-only normal is systolic ejection murmur no greater than 3+

Question 6

Hematologic changes in pregnancy - volume expansion will dilute the blood. Hb WILL BE between

Answer 6

10-12 –> not anemic

Question 7

high white count, high ESR

Answer 7

normal in pregnancy

Question 8

GI - Physio

Answer 8

decreased tone–> decreased emptying time constipation

Question 9

Resp - Physio

Answer 9

INCREASE in minute ventilation –> DECREASE pC02–> Resp Alkalosis–> –> SHORTNESS OF BREATH during pregnancy
—->urine pH will INCREASE (alkaline or neutral) –> —>increased risk of UTI

Question 10

Urinary tract - Physio

Answer 10

increased blood flow–>kidneys increase length and width (hypertrophy until 3 month postpartum)…more so on the R. side–> can lead to stasis of flow-> pyelonephritis

…reason is that the kidneys have to discard two blood toxins

Question 11

Endocrine- Physio

Answer 11

Estrogen increases TBG and total Thyroxine (T4) and total T3.
Free T3 and free T4 do not change
–normal lab values–
-Pituitary Gland increases 100%–> makes it susceptiple to postpartum hemorrhage–>Sheehan’s Syndrome –>
NO PROLACTIN: decrease or absent breast engorgement
NO FSH/LH engorgement–> secondary amenorrea
Adrenal Gland–> increased cortisol which increases sugar–> gestational diabetes

Question 12

Which vessel will give you a sense of how the baby is doing?

Answer 12

Umbilical artery (2) - bc it takes blood from the fetus to the placenta

Question 13

Fetal circulation - three shunts

Answer 13

1. ductus venosus (becomes ligamentum venarum)
2. foramen ovale (RA–>LA bypass lungs)
3. ductus arteriosus

Question 14

Expected Resp labs

Answer 14

increase minute ventilation, tidal volume and inspiratory capacity with DECREASED residual volume

Question 15

What causes a pregnant woman to develop pulmonary edema?

Answer 15

During pregnancy, plasma osmolarity is decreased increasing the susceptibility to pulmonary edema.
–can occur with tocolytics, heart disease, preeclampsia

Question 16

Pregnant woman w. R. flank pain, colicky present for two weeks. No dysuria etc.

Answer 16

R. ureter dilated > L. ureter due to cushioning of the sigmoid colon to the L. ureter while the R. ureter is compressed due to uteral dextrorotation.