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Reproductive > Physiology of Pregnancy Delivery > Flashcards

Physiology of Pregnancy Delivery Flashcards

1
Q

Mechanical respiratory changes in pregnancy

A

chest circumference increases (5-7cm), subcostal angle increases, transverse diameter increases, level of diaphragm rises

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2
Q

URT changes in pregnancy

A

hyperemia and edema from estrogen + nasal stuffiness and epistaxis

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3
Q

What change in pregnancy? residual volume

A

diminished

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4
Q

What change in pregnancy? expiratory reserve

A

no change

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5
Q

What change in pregnancy? tidal volume

A

increases

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6
Q

What change in pregnancy? inspiratory reserve

A

diminished

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7
Q

What change in pregnancy? total lung capacity

A

reduced

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8
Q

Hyperventilation leads to _____ PCO2 and ____ PO2 driving the gradient at the level of placenta

A

decreased and increased

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9
Q

What change in pregnancy? minute ventilation

A

increase

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10
Q

dyspnea of pregnancy

A

60-70% of women complain in late first or early second trimester –> reduced pco2 levels, awareness of increased tidal volume of pregnancy

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11
Q

Cardiac output

A

sv X hr

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12
Q

Stroke volume

A

amount of blood ejected from each ventricle with a contraction

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13
Q

What change in pregnancy? heart

A

bigger on CXR, but just because of rotation

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14
Q

What change in pregnancy? cardiac output

A

increase –> 4.5 L/min to 6 L/min –> uterus gets 17% of CO –> reduction in maternal CO doesnt change except for skeletal muscle and splanchnic bed

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15
Q

What change in pregnancy? heart rate

A

increase as early as 5 weeks

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16
Q

T/F maternal position can impact CO

A

T –> compression of IVC by large term gravid uterus can decrease cardiac output by 25% if supine

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17
Q

What change in pregnancy? peripheral vascular resistance

A

decrease due to progesterone –> fall in systemic arterial pressure with nadir at about 24 weeks

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18
Q

Drop in _____ helps the maternal cardiovascular system accommodate the increased blood volume in pregnancy

A

vascular resistance

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19
Q

T/F diastolic ejection murmurs occur in over 90% of pregnant women due to increased cardiac output

A

F –> this is true of systolic murmurs…diastolic murmurs are NOT normal

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20
Q

What change in pregnancy? body water

A

increase from 6.5L to 8.5L

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21
Q

In pregnancy _____ exceeds Na retention decreased plasma osmolality

A

water retention

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22
Q

What change in pregnancy? Na

A

decreased by 3-4

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23
Q

What change in pregnancy? blood volume

A

increases from 6-8 weeks gestation

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24
Q

What change in pregnancy? red cell mass

A

increases by term

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25
Q

Physiologic anemia of pregnancy

A

plasma volume increase > rbc volume increase –> dilution –> reduce blood viscosity, increased EPO, helps in perfusion and maternal/fetal exchange

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26
Q

What change in pregnancy? blood viscosity

A

decrease due to physiologic anemia

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27
Q

What change in pregnancy? coagulation cascade

A

increase in 1, vii, viii, ix, x –> hypercoagulable and decrease in fibrinolysis

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28
Q

What change in pregnancy? venous flow

A

increased stasis + vessel wall injury + hypercoagulability –> thromboembolism risk increases

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29
Q

What change in pregnancy? thromboembolic risk

A

increase

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30
Q

What change in pregnancy? bleeding and clotting times

A

no change

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31
Q

What change in pregnancy? kidneys

A

hypertrophy + dilation of renal pelves/calyces

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32
Q

What change in pregnancy? ureters

A

dilation due to increased progesterone –> right side is more affected due to mechanical effects of uterus

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33
Q

What change in pregnancy? renal plasma flow

A

increased

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34
Q

What change in pregnancy? gfr

A

increased

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35
Q

What change in pregnancy? creatinine

A

reduced

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36
Q

What change in pregnancy? stomach emptying time

A

decreased

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37
Q

What change in pregnancy? GI tone

A

decreased –> acid reflux

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38
Q

What change in pregnancy? small bowel motility

A

decreased –> more constipation

39
Q

What change in pregnancy? portal venous pressure

A

increased –> hemorrhoids

40
Q

What change in pregnancy? gallbladder emptying

A

slowed –> increased cholesterol saturation –> increased stone formation

41
Q

What change in pregnancy? liver

A

increased production of fibrinogen, binding proteins (steroids and thyroid hormone), clotting factors (7, 8, 9, 10)

42
Q

What change in pregnancy? AST/ALT

A

no change

43
Q

Hyperemesis in pregnancy

A

likely impact of hCG –> supportive care, ginger, vit b6, unisom, antiemetics

44
Q

What change in pregnancy? caloric requirements per day

A

increased

45
Q

gravid

A

woman who has been pregnant before

46
Q

nullipara

A

women who has never completed a pregnancy beyond 20 weeks

47
Q

primipara vs multipara

A

woman who has delivered one fetus>20 weeks vs multiple fetus > 20 weeks

48
Q

“looking down” presentation

A

occiput anterior

49
Q

“looking up” presentation

A

occiput posterior

50
Q

Smallest dimension of babies head

A

suboccipitobregmatic

51
Q

Round pelvis

A

gynecoid

52
Q

Pelvis with AP>transverse

A

android

53
Q

Pelvis with AP~transverse

A

anthropoid

54
Q

Pelvis with AP<transverse

A

platypelloid

55
Q

Regular uterine contractions leading to cervical dilation

A

labor

56
Q

Which prostaglandins are involved in uterine ctx?

A

prostaglandins E2 and F2alpha

57
Q

What causes uterine ctx?

A

prostaglandins E2 and F2 alpha, things that increase intracellular Ca, gap junctions, increased oxytocin receptors

58
Q

What causes cervical ripening?

A

collagenase, elastase (metalloproteases)

59
Q

In cervical effacement, collagen chains are broken down and hydrophobic glycosaminoglycans are replaced by hydrophilic _______

A

hyaluronic acid

60
Q

Cervical smooth muscle contraction causes cervical tissue to be pulled upward and incorporated into the lower segment of the ____

A

corpus

61
Q

Prostaglandin receptors for uterine ctx are found in _____

A

decidua and myometrium

62
Q

Oxytocin gene is upregulated by ____

A

estrogen

63
Q

Oxytocin receptors for uterine ctx are found in ____

A

myometrium, fetal amnion, decidua

64
Q

Term

A

> 37 weeks

65
Q

Mean duration of pregnancy

A

40 weeks from first day of last menstrual period

66
Q

Stages of labor

A

1: closed-fully dilated, 2: fully dilated-delivery, 3: placenta

67
Q

2 phases of stage 1 labor

A

latent and active

68
Q

Latent phase

A

onset of labor with slow cervical dilation to ~4cm and variable duration

69
Q

Active phase

A

faster rate of cervical change, regular uterine contractions

70
Q

Round pelvis

A

gynecoid

71
Q

Pelvis with AP>transverse

A

android

72
Q

Pelvis with AP~transverse

A

anthropoid

73
Q

Pelvis with AP<transverse

A

platypelloid

74
Q

Regular uterine contractions leading to cervical dilation

A

labor

75
Q

Which prostaglandins are involved in uterine ctx?

A

prostaglandins E2 and F2alpha

76
Q

What causes uterine ctx?

A

prostaglandins E2 and F2 alpha, things that increase intracellular Ca, gap junctions, increased oxytocin receptors

77
Q

What causes cervical ripening?

A

collagenase, elastase (metalloproteases)

78
Q

In cervical effacement, collagen chains are broken down and hydrophobic glycosaminoglycans are replaced by hydrophilic _______

A

hyaluronic acid

79
Q

Cervical smooth muscle contraction causes cervical tissue to be pulled upward and incorporated into the lower segment of the ____

A

corpus

80
Q

Prostaglandin receptors for uterine ctx are found in _____

A

decidua and myometrium

81
Q

Oxytocin gene is upregulated by ____

A

estrogen

82
Q

Oxytocin receptors for uterine ctx are found in ____

A

myometrium, fetal amnion, decidua

83
Q

Term

A

> 37 weeks

84
Q

Mean duration of pregnancy

A

40 weeks from first day of last menstrual period

85
Q

Stages of labor

A

1: closed-fully dilated, 2: fully dilated-delivery, 3: placenta

86
Q

2 phases of stage 1 labor

A

latent and active

87
Q

Latent phase

A

onset of labor with slow cervical dilation to ~4cm and variable duration

88
Q

Active phase

A

faster rate of cervical change, regular uterine contractions

89
Q

0 station

A

after engagement of the fetus with the pelvis, can palpate for presentation right below ischial spines

90
Q

Passive response of fetal head to soft tissues of the pelvis

A

flexion

91
Q

Downward passage of fetus presenting part

A

descent

92
Q

T/F there is an increase in cardiac output during labor

A

T (especially in second stage of labor) –> pain + uterine ctx transfer blood from uterus to general circulation –> increases venous return to heart

93
Q

Shoulder dystocia

A

anterior shoulder stuck behind mother’s pelvic bone –> usually with large baby –> can stretch brachial plexus

Reproductive (38 decks)

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