physiological changes

Question 1

Blood plasma

Answer 1

increase due to oestrogen and progesterone resulting in water and salt retention via RAAS activation

Question 2

RBC change

Answer 2

increase - not completely in proportion to plasma

Question 3

Maternal anaemia

Answer 3

as a result of not complete proportional increase in RBC production alongside plasma v

Question 4

blood volume change?

Answer 4

overall increase to prepare for blood loss during delivery

Question 5

is there a change in the oxygen carrying capacity of the blood

Answer 5

yes - increase

Question 6

HCT change?

Answer 6

overall decrease as RBC increase is less than PV increase

Question 7

signs of hypovolaemic shock

Answer 7

tachycardia and hypotension - watch out for DIC

Question 8

preload

Answer 8

increase

Question 9

stroke volume

Answer 9

increase

Question 10

CO

Answer 10

increasE

Question 11

PVR

Answer 11

decrease to facilitate vasodilation - this results in a decrease in BP in the first trimester

Question 12

when does BP return to normal aka prepregnancy

Answer 12

second trimester

Question 13

what causes decrease PVR

Answer 13

oestrogen and progesterone

Question 14

cause of maternal hypotension in second trimester

Answer 14

baby compressing aorta

Question 15

coagulatbility unchanged t or f

Answer 15

hypercoagulable due to high levels of oestrogen

aids haemostasis during delivery and minimises PPH

Question 16

protein S

Answer 16

decreased

Question 17

protein C and antithrombin III

Answer 17

no change

Question 18

which clotting factors are increased

Answer 18

ANY THAT WILL IMPROVE HAEMOSTASIS - minus plasminogen - but this should assist in fibrinolysis when needed during delivery

Question 19

anabolic phase when

Answer 19

first twenty weeks

Question 20

respiratory rate

Answer 20

increase

Question 21

peak flow

Answer 21

no change

Question 22

oxygen conc of arteries

Answer 22

increase

Question 23

CO2

Answer 23

decrease

Question 24

tidal volume

Answer 24

the tide is high and I’m holding on (increase) just like their belly

Question 25

minute volume

Answer 25

increase

Question 26

vital capacity

Answer 26

unchanged

Question 27

functional residual capacity

Answer 27

decreased - less functional residual capacity because they got a belly - happens at the third trimester as the uterus is sitting underneath the diaphragm

Question 28

progesterone is responsible for which changes in the respiratory system of mothers

Answer 28

stimulates the respiratory centres increases the sensitivity of chemoreceptors to CO2, leading to a small increase in resp rate promotes relaxation of the bronchial smooth muscle

Question 29

2,3-DPG increase of decrease during pregnancy

Answer 29

increase as this will increase oxygen transfer in the periphery will shift the oxygen dissociation curve to the right favouring unloading of oxygen int he periphery and aiding placental oxygen transfer

Question 30

GFR

Answer 30

increase

Question 31

serum creatinine and urea

Answer 31

fall due to increased blood flow resulting in increased filtration and excretion

Question 32

extra cals needed

Answer 32

in third trim you need an extra 300 cals cause its catabolic