Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

SA reproductive > S6) Maternal Physiological Adaptations in Pregnancy > Flashcards

S6) Maternal Physiological Adaptations in Pregnancy Flashcards

1
Q

Identify the 3 types of changes in maternal physiological adaptation to pregnancy

A
  • Biochemical changes
  • Physiological changes
  • Structural changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why do maternal physiological adaptations to pregnancy occur?

A
  • Provide a suitable environment for the nutrition, growth and development of the foetus
  • Prepare the mother for birth
  • Prepare the mother for support of the new born
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Identify the 6 hormones which orchestrate maternal physiological adaptations to pregnancy

A
  • hCG
  • Progesterone
  • Oestrogen
  • Relaxin
  • hPL
  • Inhibin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

hCG is released from the synctiotrophoblast.

What role does it have in early pregnancy?

A

hCG mimics the action of LH and maintains the corpus luteum so it can produce oestrogen and progesterone until the placenta can take over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

hCG reduces the maternal levels of IgA, IgG and IgM.

Why is this beneficial to the foetal-placental unit?

A

The maternal antibodies do not attack the foetus as a foreign antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hCG reduces the maternal levels of IgA, IgG and IgM.

What consequence does this have on the mother?

A

The mother becomes slightly immunodeficient and is at increased risk of developing infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Progesterone relaxes smooth muscle.

Identify 4 effects of increasing progesterone levels on the GI tract function which the mother may complain of?

A
  • Vomiting
  • Constipation
  • Heartburn
  • Indigestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which oestrogen level in the maternal serum/urine best indicates foetal progress and why?

A

Oestriol (E3) as it shows the development of the liver and has its own singular pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Identify 3 hormones which stimulate breast growth

A
  • Oestrogen
  • Progesterone
  • Prolactin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does inhibin (from the corpus luteum and placenta) prevent further pregnancies from occuring in the pregnant state?

A

Inhibin prevents follicular development by inhibiting FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Glucose and amino acid metabolism are altered in pregnancy to favour the nutritional supply to the foetus.

Identify 4 of these changes

A
  • Reduction in maternal [blood glucose] and [amino acid]
  • Diminished maternal response to insulin in second ½ of pregnancy
  • Increased maternal free fatty acid, ketone and triglyceride levels
  • Increased insulin release in response to a normal meal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Identify the 4 hormones which orchestrate the changes in glucose and amino acid metabolism in pregnancy

A
  • Prolactin
  • Oestrogen
  • Progesterone
  • hPL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What effect does progesterone have on glucose metabolism?

A

Progesterone stimulates appetite in the first half of pregnancy and diverts glucose into fat synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What effect does oestrogen have on glucose metabolism?

A

Oestrogen stimulates an increase in prolactin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Identify the 3 main hormones responsible for maternal resistance to insulin

A
  • Prolactin
  • hPL
  • Cortisol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the significance of maternal decline in glucose usage

A
  • Gluconeogenesis increases, maximising the availability of glucose to the foetus
  • Maternal energy demands are met by fatty acid metabolism (later in pregnancy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the benefit of increased maternal deposition of fat by progesterone?

A

Prepares for higher energy demands from the foetus later in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which hormone is primarily responsible for changes in maternal carbohydrate metabolism during pregnancy?

A

Human placental lactogen (hPL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

As pregnancy progresses, the foetal-placental unit’s increasing nutritional needs aren’t met via maternal vascular-neogenesis.

Describe 2 changes which accomodate this

A

Changes in the function of maternal baroreceptors and volume receptors:

  • Increased blood flow to the growing breasts, kidneys and Gi tract
  • Plasma volume increases while peripheral vascular resistance falls
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Identify 2 changes to the maternal heart which can be observed on examination

A
  • Hypertrophy (eccentric)
  • Upward displacement of flow murmurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Plasma volume increases by 50% in pregnancy due to increased cardiac output. However, progesterone constantly increases too and relaxes smooth muscle.

What overall effect does this have on maternal BP?

A

BP = CO x TPR

  • CO increases
  • TPR decreases
  • Notable increases/decreases in BP (fluctuations)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Identify 3 signs and symptoms of fluctuations in maternal BP

A
  • Hot flushes
  • Increased venous pooling
  • Cankles (oedema in the feet)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which 2 factors contribute to venous engorgement and distension seen in later pregnancy?

A
  • Gravity increases venous pooling
  • TPR decrease as less pressure pushes venous blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Identify the 2 long-term sequelae that are attributed to a longer period of venous distension

A
  • Varicose veins
  • Haemorrhoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Identify 3 major complications in pregnancy
- Gestational diabetes - Anaemia - Pre-eclampsia
26
What is Gestational diabetes?
- **Gestational diabetes** is high blood sugar that develops during pregnancy due to insufficient insulin production for pregnancy demands - It commonly occurs in the second ½ of pregnancy and usually disappears after giving birth
27
If gestational diabetes is not controlled, how will the sustained hyperglycaemia affect foetal glucose levels?
**Baby grows larger than normal resulting in:** - Difficulties pushing the baby through the birth canal - Presdisposition of neonate to Type II diabetes
28
State 3 complications associated with poorly controlled maternal diabetes
- Jaundice - Hypoglycaemia after birth - Increased risk of birth defects to brain, heart & spinal cord
29
What is iron deficiency anaemia?
**Iron deficiency anaemia** is the reduction in the amount of healthy RBCs in blood due to a lack of iron
30
Identify 3 clinical features of blood which increase during pregnancy
- Plasma volume - Blood volume - Red cell mass
31
Which foetal demand does a high plasma flow meet?
Increased plasma flow provides high nutritional flow for foetus
32
Which foetal demand does a high blood volume and high red cell mass meet?
The following provides increased O2 supply: - Increased red cell mass (stimulated by erythropoietin) - Increased haemoglobin flow (blood volume)
33
Why does anaemia occur during pregnancy?
- More iron is used for haemoglobin to transfer O2 to foetus - **High iron turnover** due to haemoglobin breakdown \> production
34
State 3 signs and symptoms a mother would experience if she has anaemia
- Fatigue - Pallor - Dizziness
35
What treatments can be given to alleviate the symptoms of anaemia in pregnancy?
- Iron supplements - Folate supplements (helps with iron absorption)
36
Predict 2 consequences of poor foetal-placental perfusion associated with anaemia in pregnancy
- Under-development issues: poor neurodevelopment & poor growth - Anaemia/hypoxic baby
37
What effect does smoking during pregnancy have on the foetus?
- Tar accumulates and reduces ventilation ability - Alveoli cannot diffuse enough O2 into blood - Results in poor foetal-placental perfusion
38
What is pre-eclampsia?
**Pre-eclampsia** is a rapidly progessive disorder occuring only during pregnancy and the postpartum period characterized by hypertension and usually the proteinuria
39
What are the diagnostic criteria for pre-eclampsia?
- Systolic BP of 140/more - Diastolic BP of 90/more
40
Other than proteinuria and hypertension, identify 5 other symptoms of pre-eclampsia
- Oedema - Headache - Nausea/vomiting - Changes in vision - Poor tendon reflexes
41
What signs or symptoms suggest that a mild pre-eclampsia is worsening in severity?
- **Decreased kidney function:** increased creatinine, urea, urate and creatine clearance **- Decreased liver function:** increased AST and gamma-GT
42
Identify 2 examinations performed on a patient with suspected pre-eclampsia
- Examination of optic fundi - Examination of tendon reflexes
43
Why would diseases of the respiratory system be more severe in pregnancy?
There is an increased oxygen requirement in gestation
44
Describe the changes in respiratory function which occur in pregnancy
- RR changes little - Increased tidal volume and oxygen uptake
45
What is the effect of the increased tidal volume and oxygen uptake that is seen in pregnancy?
- Increased awareness of the desire to breathe (interpreted as dyspnoea) - Lower pCO2
46
What role does progesterone have in the changes in respiratory function observed in pregnancy?
Progesterone acts on the chemoreceptors in the respiratory centre to induce increased respiratory effort and reduction in pCO2
47
What anatomical/mechanical effect does the expanding uterus have on the maternal respiratory system?
The expanding uterus pushes up on the **xiphoid process** and reduces room for lung expansion, hence reducing respiratory function
48
How does the renal function change during pregnancy?
- Increased renal blood flow raises GFR to 160% of normal - Increased secretion of renin, aldosterone, angiotensin II compensate for expected sodium loss * systemic vasodilation * decreased PCT absorption * smooth muscle relaxes (progesterone) so increases size of the kidney and ureters * decreased speed of urine passage
49
What effect does the gravid uterus have on renal function?
- The gravid uterus rises from the pelvis and rest upon the ureters - This compresses the ureters above the pelvic brim causing **renal congestion**
50
Pregnancy may be associated with increased urinary incontinence. Why is this?
Gravid uterus places **increased pressure** on the bladder therefore the mother urinates more frequently
51
Why is there an increased risk of urinary tract infections in pregnancy?
- Progesterone dilates smooth muscle in the nephrons - Results in pooling of urine in the distended parts of the urinary system
52
The placenta also contributes to the maternal synthesis of DHCC (calcitriol). How does this active form of Vitamin D3 contribute to foetal growth?
Calcitriol in mother increases calcium reabsorption for the foetus to use for bone growth
53
what is the foetus seen as inside the mother
* it is seen as a parasite so immune regulation allows mum to be a good host
54
what are changes in respiration during pregnancy
* ventilation increase → mum can meet 02 demands and remove C02 at a fast rate * Tidal volume → * Pa(02) increases and Pa(Co2) decreases * dysponea - shortness of breath due to hyperventilation
55
what changes are there in haematology/ CVS
* volume expansion: progesterone → smooth muscle relaxation so reduced SVR and drop in BP * clotting mechanisms: more procoagulants, reduced anticoagulants and fibrinolysis * Mum needs to fill utero-placental-fetal circulation, oxygenate the growing uterus and prepare for blood loss during delivery * Dilutional anemia → Increase in space but not an increase in RBC
56
how does the body increase SV
* RAAS, drop in BP so increases BP * oestrogen also stimulates RAAS
57
anemia in pregnancy
* red cell mass increases but not enough to counter the dilutional increase in PV * most common cause is iron deficiency in pregnancy * leads to: * increase morbidity for mum and baby * preterm delivery * maternal fatigue
58
how does the GI tract change
- slower transit time - increased absorption of nutrients and vitamins - BUT: uterus can displace bowel and cause obstruction - decreased bowel motility: more water absorption BUT constipation - decreased gall bladder contractivity → gallstones
59
adaptations in the thyroid and parathyroid
* oestrogen stimulates Thyroid binding globulin * increases thyroxine production * parathyroid stimulates more calcium and phosphorus absorption
60
glucose metabolism in pregnancy
* fat is laid down in the first half of the pregnancy to help the fetus and its needs later on down the line * reduction in maternal blood glucose and amino acids * diminished insulin responsiveness in second half of pregnancy so more nutrients can reach the baby * increase in maternal fatty acids and ketones for fuel * increased insulin response to a meal * HpL - is a hormone that causes resistance to insulin
61
what are some risk factors for gestational diabetes
* previous birth of a large baby * previous gestational diabetes * family history of diabetes
62
investigations and diagnosis if gestational diabetes
* oral glucose tolerance test * diagnose if fasting plasma glucose is 5.6 mmol/L above or 2 hour plasma glucose is above 7.8
63
what is the mother at risk of if she has gestational diabetes
* preeclampsia * premature labor * shoulder dystocia → when the babies shoulder is stuck behind the pubic bone * increase risk of developing type 2 DM
64
what are the risks of the baby if the mother has gestational diabetes
* macrosomia * cardiac, renal, neural tube * hypoxia and sudden death * hypoglycaemia * jaundice
65
what are some MSK adaptions
* centre of gravity changes: - forward flex of neck - more lordosis and kyphosis * stretching of abdominal muscle: * - impede posture - strain on paraspinal muscles * increase of sacroiliac joints and pubic symphysis = these can cause shoulder, back and pelvic pains and headaches
66
what is pre eclampsia
* new onset hypertension after 20 weeks * proteinuria * organ dysfunction * uteroplacental dysfunction * severe does not respond to treatment
67
what are some risk factors of pre eclampsia
* above 40 years * pregnancy interval of more than 10 years * family history * multiple pregnancy * pre existing renal disease
68
what is the pathogenesis of pre eclampsia
* impaired invasion of trophoblasts → Shallow invasions of spiral arteries * hypoperfusion and ischemia and systemic endothelial dysfunction

SA reproductive (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions