Physiological changes in pregnancy Flashcards
What are the changes to the breasts?
Increased size and vascularity
Increased pigmentation of areola
Montgomery tubercles on areola
Colostrum like fluid can be expressed from end of 3rd month
What do the breasts feel like during pregnancy?
Warms
Tense
Tender
When are significant CV changes seen in pregnancy?
early in first trimester
What are the CV changes during pregnancy?
Increased circulating blood volume
Systemic vascular resistance falls
Increased blood flow
Increased CO, HR and O2 consumption
What are the CV changes during labour?
Autotransfusion of contractions
Increased catecholamines from pain
CO increases 10%
What are the CV changes postpartum?
CO increases 80% 1 hour post delivery then falls over 24 weeks
Blood volume decreases by 10% 3 days post delivery
Initial fall in BP, then rises to normal after 3-7 days
Systemic vascular resistance increases over 2 weeks
HR returns to pre pregnancy level within 2 weeks
Return to normal by 3 months
What are the resp changes?
20% increase in O2 demand
40-50% increase in minute ventilation
Increased RR and tidal volume
Decreased residual functional capacity
What are the changes in the GI system?
Oesophageal peristalsis reduced
Gastric emptying slows
Cardiac sphincter relaxes
GI motility reduced
Why is GI motility reduced in pregnancy
Increased progesterone
Decreased motilin
What are the functional changes in the kidneys during pregnancy?
Dramatic dilatation of urinary collecting system
Increased renal plasma flow
GFR and creatinine clearance increase
Urea and creatinine decrease
What are the changes in urine during pregnancy?
Microscopic haematuria
Glycosuria common
Increased protein
Where is urinary collecting system dilatation most pronounced?
right side
What are the haematological changes in pregnancy?
Plasma volume increases
Decreased haemoglobin, haematocrit, RCC
WCC increases
What are the changes in requirements in iron and folate in pregnancy?
Iron- 2-3 fold increase
Folate- 10-20 fold increase
What happens to the level f haemoglobin in pregnancy?
Decreases
