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Repro > Physiology in Pregnancy > Flashcards

Physiology in Pregnancy Flashcards

1
Q

Genera changes in pregnancy (9)

A 
Mechanical - backpain
Metabolism
Fatigue
Oedema
Heartburn/reflux
Breasts
Thyroid
General state of immunosuppression
Weight gain
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2
Q

Why does oedema occur in pregnancy?

A

Tendency for sodium and water retention

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3
Q

Why does heartburn or reflux occur in pregnancy?

A

Softening of oesophageal sphincter

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4
Q

What changes are seen in thyroid hormones during pregnancy?

A

TBG, T3 and T4 increase
Levels of free T3 and T4 remain the same
TSH decreases

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5
Q

What can occur as a result of iodine deficiency seen in pregnancy?

A

Iodine deficiency can be exacerbated by the diet

Thyroid will increase in size to increase uptake

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6
Q

What are the consequences for baby should the pregnant mother have Grave’s disease?

A

Antibodies can cross the placenta

Baby will be hypothyroid

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7
Q

How must AI hyperthyroidism be treated in a pregnant woman?

A

NOT ANTITHYROIDS

Use propanolol

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8
Q

Describe six breast changes seen in pregnancy

A 
Increased size
Increased vascularity
Increased pigmentation of areola and nipple
Secondary areola forms
Montogomery tubercle forms on areola
Colostrum fluid can be expressed
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9
Q

From which month in a pregnancy may colostrum start to be expressed?

A

3rd month

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10
Q

What is colostrum and what other applications might it have if harvested?

A

‘First milk’
Contains antibodies
Treat cleft palate, premature babies and babies of a low weight for gestation

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11
Q

In which trimester do cardiovascular changes occur in pregnancy?

A

First trimester

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12
Q

List some of the cardiovascular changes seen in pregnancy

A

Circulating blood volume increases - 50-70% non-pregnant
Systemic vascular resistance falls
Increased blood flow and blood pressure
Increased cardiac output - stroke volume increases
Heart rate increases
Increased oxygen consumption

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13
Q

What intrapartum cardiovascular changes occur?

A

Autotransfusion of contracttions - pain increases amount of catechoamines
Increases cardiac output

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14
Q

How large is the increase in cardiac output during and after labour?

A

10% during labour

80% 1 hour post-delivery

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15
Q

How long after pregnancy before CV function returns to ‘normal’?

A

3 months

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16
Q

What is the increase in oxygen demand during pregnancy?

A

20%

17
Q

List some respiratory changes in pregnancy

A

Minute ventilation increased by 40-50%
Increased tidal volume
Increased respiratory rate
Decreased functional residual capacity

PEFR and FEV1 unchanged

Decreased PCO2

18
Q

What changes are seen in renal plasma flow during pregnancy?

A

Increases

60-80% by end of second trimester

19
Q

Does protein excretion increase or decrease in pregnancy?

A

Increases

20
Q

What signs and symptoms are common in pregnancy in relation to renal changes?

A

Oedema
Microscopic haematuria
Glycosuria
Urate incraeases as gestation increases

21
Q

What are the changes in urate, urea and creatinine during pregnancy?

A

Urate increases as gestation increases

Urea and creatinine decrease

22
Q

Describe changes in iron and folate requirements during pregnancy

A

2-3 fold increase in iron requirements

10-20 fold increase in folate requirements

23
Q

How does haemoglobin, haematocrit and red cell count change with pregnancy?

A

All decrease

24
Q

How does platelet count change with pregnancy?

A

Decreases

25
Q

Does white cell count increase or decrease in pregnancy?

A

Decreases

26
Q

There is a 6-fold increase in risk/occurrence of PE in pregnancy due to the reduction in natural anticoagulants and hypercoagulable state. What can be used to treat this risk and why?

A

Dalteparin - doesn’t cross placenta

27
Q

Why is D-dimer value not significant in pregnancy?

A

Increased - but don’t know normal

28
Q

What investigations are used for PE and DVT in pregnancy?

A

DVT- Doppler

PE- CTPA ; low threshold for investigation in pregnancy

29
Q

Why does insulin resistance occur in pregnancy?

A

Human placental lactogen produced - anti-insulin

30
Q

What screening is provided for gestational diabetes?

A

13 weeks - HbA1c

28 weeks - OGTT

Repro (12 decks)

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