Physiology of Pregnancy Flashcards Preview

OBGYN Clerkship > Physiology of Pregnancy > Flashcards

Flashcards in Physiology of Pregnancy Deck (37)
1

What at what point does an embryo become a fetus

8 weeks (cardiac activity?)

2

Defn of grand multip

parity >/= 5

3

What is Charwicks sign

blue discoloration of cervix (early sign of preg)

4

What is goodell sign

softening of cervix (early sign of preg)

5

What is hegar/ladin sign?

softening of uterus

6

What is naegele's rule

EDC = LMP + 1yr -3m + 7d

7

What are indications for US

uncertain gestational age
size/date discrepencies
multiple gestations

8

uterus at
pubic symphysis = __ wks
umbilicus = ___ wks
xiphoid process = ___ wks

12
20
36

9

How can heart sounds change in preg?

split S1
S3
systolic murmur (2/2 inc BV)

10

What is avg materanl HR when baby is at term

108 bpm

11

how does BP change in preg

dec 2/2 to dec in scr (2/2 effecrts of progesterone/vasodil substances being produced)

12

acid base state in preg + why?

compensated repiratory alkalosis

Bohr effect, inc RR inc CO2 gradient to inc gas exchange with fetus

13

Tidal volume inc or dec in preg

increase (dec in FRC) (also dec FRC due to elevated diapragm)

14

What is the cause of morning sickness?

elevated E/P/hCG

15

how do kidneys change in pregnancy?

they enlarge, ureters dilate (R>L), hydronephrosis, GFR increased by 50%

16

what causes ureters to dilate/hydronephrosis

progesterone and compression by enlarging uterus

17

is preg a hypercoagulable state?

yes! inc E2

18

why are preg women anemic

dilutional,there is an inc in plasma volume > inc RCV
** but still need inc Fe bc they are making more RBCs

19

What is the signaling for increased intravascular volume during pregnancy

inc renin --> inc angiotensin --> inc Na retention --> retain fluid to inc intravascular volume

20

when does hCG peak?

~10 weeks (doubles every 48 until this point)

21

What is responsible for maintianing fetal nutrition? Effects on mom?

hPL: inc maternal lipolysis and dec glc uptake by mom (anti-insulin effect) which allows for more glc to be available for fetus

--> mom in diabetogenic state with glucosuria and ketonuria

22

change in posture late in preg

hyperlordosis

23

Skin changes in preg? cause?

spider angiomata and palmar eryethema (2/2 inc E)
linea nigra and melasma/chlosasma (2/2 inc MSH)

24

How does PTH change in preg? Why?

increases, to cause inc Ca abs and vit D for growing fetal bones

25

changes in TSH, T3/4 during preg

transient dec TSH nc hCG is structurally similar to TSH tp the pit gland dec production
Total T3/4 increases because thyroid binding globilin increases, howevere free T3/4 remains normal

26

vits/minerals/diet changes needed in preg

inc kcal, folate, iron, vit C, omega 3 FA
dec vit A (teratogenic), calcium (still need but it chalates Fe)

27

what are braxton-hicks contractions?

irreg contractions w/o cervical dilation

28

how to manage GERD in preg

antacids , PPIs or H2 blockers if severe

29

What is round ligament pain + Tx?

shooting pelvic pain due to round ligament stretching, Tx is tylenol + warm compress

30

Tx for varicose veins in preg

elevate legs + compression stockings

31

management for hyperemesis gravidarum

NPO x 3 days, IVFs + anti-emics, if very severe give doxylamine/unisom (1st gen antihistamine)+ vit B6

32

management of hemorroids in preg

topical steroids, fiber, stool softeners, sitz baths

33

how often should preg pt be seen in office during preg

1x in first trimester
q4wk until 28 weeks
q2wks until 36
qwk until delivery

34

When is Rh status checked? how it it interpreted

before 28 wks, if Rh- give rhogam at week 28 and postpartum (if baby Rh+)

35

how to manage baby if mom is HBsAg +?

infant HBIG anf HBV vaccine

36

What is the biobyphysical profile (BPP)? What are the components? How it scored/interpreted?

prenatal US evaluation to assess baby"

The BPP has 5 components: 4 ultrasound things +NST.
The NST evaluates fetal heart rate and response to fetal movement.

The five discrete biophysical variables:
Fetal movement
Fetal tone
Fetal breathing
Amniotic fluid volume
Fetal Heart Rate

BPP >8: normal
BPP =6: get CST** see next card
BPP <4: deliver

37

What is CST/OCT

CST/OCT (ctx stress test/oxytocin challenge test): give oxytocin, look for 3 ctx/10 min w/o late decels

**assessed if baby can tolerate labor