Physiology in Pregnancy Flashcards
What breast changes are seen in pregnancy?
Increased size, vascularity (warmer, tender)
Increased nipple pigmentation
Montgomery tubercules appear on areola
Colostrom at 3months
What Cardiovascular changes are seen in pregnancy?
50-70% increased circulating volume Vascular resistance falls 20-32 weeks Increased blood flow/CO/SV Increased Heart rate Decreased cardiac output in supine position
How do you resuscitate pregnant women?
NEVER ON BACK
Left lateral tilt
Elevate patients side
Cardiovascular changes during childbirth?
Autotransfusions of contractions
Pain - circulating catecholamines
10% increase in CO
How does cardiac output increase post delivery?
Increased by 80% for 1hr
What are the postpartum cardiovascular changes?
Return to normal by 3 months BP falls then returns to normal at 6 weeks post SVR increase over first 2 weeks CO continues to fall over next 24 weeks
What respiratory changes are seen in pregnancy?
20% increase in O2 demand 40-50% increase in ventilation Increased RR/TV Decreased residual capacity PEFR + FEV1 unchanged Decreased PCO2
What renal changes are seen in pregnancy?
Dilation of urinary collecting system 60-80% increased renal plasma flow GFR increases by up to 50% Protein excretion increased Microscopic haematuria Glycosuria common Increased Urates Decreased Urea, Creatinine
What haematological changes are seen in pregnancy?
Plasma volume increased Decreased Hg, Hcrit, RCC Decreased platelets 2-3x increased iron requirements 10-20 increased folate requirements WCC increases Hypercoagulable state
How does Hg change in pregnancy?
Decreased
How does WCC change in pregnancy?
Increased
How does platelets change in pregnancy?
Decreased/normal
How does CRP change in pregnancy?
no change
How does ESR change in pregnancy?
Increased
How does Urea change in pregnancy?
Decreased
