Physiological Changes In Pregnancy

Question 1

Factors affecting maternal adaptation to pregnancy

Answer 1

1. Availability of hormones and their precursors
2. Improved transport capacity
3. Maternal fetal exchange
4. Removal of additional waste products

Question 2

Causes of fluid retention during pregnancy

Answer 2

1. Na retention
2. Osmostat reset
3. Decrease in thirst threshold (thirstier faster)
4. Decrease in plasma oncotic pressure

Question 3

Consequences of fluid retention

Answer 3

1. Decrease in Haemoglobin conc.
2. Decrease in hematocrit
3. Dec in serum albumin
4. Inc stroke volume
5. Inc renal blood flow

Question 4

Causes of physiological anaemia during pregnancy

Answer 4

1. Inc in plasma volume.
2. Increase in rbc mass
3. decrease in harm conc.
4. Transfer of iron to fetus

Question 5

Normal haem conc during pregnancy @ 36 wks

Answer 5

Normal haem conc during pregnancy @ 36 wks 10-11 (10.9g/dL)

Question 6

Hamatocrit levels during pregnancy

Answer 6

Hamatocrit levels during pregnancy 32-34%

Question 7

Why are pregnant women given iron supplements?

Answer 7

To avoid decrease of iron in bone marrow which would cause a decrease in rbc volume and ferritin levels post pregnancy

Question 8

What happens to folic acid during pregnancy?

Answer 8

Increase in folic acid clearance causes decrease in plasma folate If she has adequate folic acid intake in diet, supplement not necessary

Question 9

Hypercoaguble state in pregnancy caused by

Answer 9

Increase in factors 7,8,9,10,12
Increase in fibrinogen by 50%
Von willerbrand factor increase

Question 10

Why is the use of a d-diner test not used for suspected thromboembolism in pregnant women?

Answer 10

Maternal D-dimes increases progressively so d dimer test would not be indictave of thromboembolism (useless test)

Question 11

How does body of pregnant woman counter increase in coagulation?

Answer 11

Increase in plasminogen
Decrease in alpha 2 antiplasmin
Causes increase in fibronlytic activity which counters coagulation

Question 12

Venous thromboembolism occurrence in pregnancy

Answer 12

5 times greater

Question 13

Lab findings that decrease physiologically in pregnancy

Answer 13

Haem conc
Haematocrit
Plasma folate
Protein S
Creatinine

Question 14

Lab tests that increase during pregnancy

Answer 14

ESR
Fibrinogen
Factors 7,8,9,10,12
Active c protein resistance
D dimer
Alkaline phosphatase

Question 15

Haem concentration normal vs pregnancy (term)

Answer 15

Normal 13.3g/dL
Pregnancy 11g/dL

Question 16

Haematocrit normal vs preg at term

Answer 16

Normal 38-45 Pregnant 32-34

Question 17

Plasma folate

Answer 17

Normal 5.4 - 20 ng/mL
Preg 1.4-20 CHECK

Question 18

Creatinine normal vs pregnancy

Answer 18

Normal 73
Pregnancy 64

Question 19

Fibrinogen Normal vs pregnancy

Answer 19

Normal 300 Pregnancy 450

Question 20

Alkaline phosphatase normal vs Preg

Answer 20

Normal 30-130
Pregnancy 133-418

Question 21

Respiratory changes in pregnancy

Answer 21

Diaphragm elevation
Change in chest wall
Increase in lung volume
Increase in minute ventilation
Increase in tidal volume
Physiological dyspnea
Decrease in functional residual capacity and residual volume

Question 22

Causes of physiological dyspnea in pregnant women

Answer 22

Decrease in functional residual capacity
Decrease in residual volume.

Question 23

Blood gas changes in pregnancy

Answer 23

Decrease in pCO2
Increase in p02
Slight change in pH
Increase in bicarb excretion
Increase in o2 availability

Question 24

Causes of physiological dyspnea in pregnant women

Answer 24

Decrease in functional residual capacity
Decrease in residual volume.

Example sentence: Physiological dyspnea in pregnant women is caused by a decrease in functional residual capacity and residual volume.

Question 25

Blood gas changes in pregnancy

Answer 25

Decrease in pCO2 Increase in pO2 Slight change in pH Increase in bicarb excretion Increase in O2 availability ## Footnote No additional information

Question 26

Cardio changes in pregnancy

Answer 26

Increase in HR Increase in stroke volume Increase in cardiac output Decrease in mean arterial pressure Decrease in pulse pressure Decrease in peripheral resistance ## Footnote No additional information

Question 27

GIT changes in pregnancy

Answer 27

Gingivitis due to decreased immune resistance Increased gastric activity (acid reflux) Constipation ## Footnote No additional information

Question 28

Renal changes

Answer 28

Increase in: Kidney size Renal blood flow Glomerular filtration rate Renal plasma flow Clearance of most substances (glycosidic normal in pregnancy) Dilation of renal pelvis and ureters Decrease in Plasma creatinine ## Footnote No additional information

Question 29

Source of estrogen and progesterone in pregnancy

Answer 29

Corpus luteum then placenta ## Footnote No additional information

Question 30

Hormonal changes in pregnancy

Answer 30

HCG produced Increase in prolactin concentration due to progesterone and estrogen Increase in corticosteroids concentration Increase in angiotensin 2, renin, and aldosterone Insulin resistance develops Decrease in TSH early pregnancy and T4 late pregnancy ## Footnote No additional information

Question 31

Skin changes in pregnancy

Answer 31

Striae gravidarum Increase in sebaceous activity Hirsutism Hyperpigmentation ## Footnote No additional information

Question 32

Uterus changes in pregnancy

Answer 32

Decidua develops Increase in vascularity Formation of lower segment later in pregnancy Hypertrophy of muscular coat ## Footnote No additional information

Question 33

Cervix changes in pregnancy

Answer 33

Softer Cervical os closed Cervical ectropion (turns outwards) common Increase secretion mucus plug ## Footnote No additional information

Question 34

Symptoms of pregnancy

Answer 34

Amenorrhea Morning sickness Breast symptoms Increase in abdomen size Fetal movement ## Footnote No additional information

Question 35

Test to confirm pregnancy

Answer 35

B-HCG in urine or serum ## Footnote No additional information

Question 36

Pregnancy sac visibility via US

Answer 36

4-5 wks ## Footnote No additional information

Question 37

Yolk sac visible in US

Answer 37

5 wks ## Footnote No additional information

Question 38

Fetal heart activity at

Answer 38

6-7 wks ## Footnote No additional information

Question 39

Morphology of fetus clear at

Answer 39

9 wks ## Footnote No additional information