Week 8.1 - Maternal problems in Pregnancy Flashcards
Describe the cardiovascular changes which occur in pregnancy
-Blood Volume increases (upto 50%) therefore CO, SV and HR all increase
What happens to BP during pregnancy?
-Decreases in T1/T2 normal in T3 (systolic never increases)
What effects will pregnancy have on preload and afterload and why?
- Preload will increase as CO is increased, increased vol of blood returning to heart
- Afterload should decrease if BP decreases as TPR will decrease
Why is hypotension experiences in T1 and T2?
-Progesterone causes relaxation of smooth muscle in BVs therefore decreasin TPR
What could be a potentially dangerous cause of hypotension in T3?
-Aortocaval compression by enlarged uterus reducing venous return to the heart
Name one possible outcome of the bvs not vasodilating during pregnancy
-Pre-eclapsia -> uncontrolled hypertension with endothelial dysfunction
What changes occur in the urinary system during pregnancy?
-Glomerular filtration rate increases thus renal plasma flow increases and functional renal reserve decreases
What causes the increase in GFR during pregnancy?
-Progesterone
What happens to creatinine clearance during pregnancy? Why?
- Increases
- Because GFR has increased
What happens to urea excretion during pregnancy? Why?
- Increases
- Because GFR increases
\Why is it important to know the normal for pregnancy range of creatinine and urea?
-May look like they are in the normal range when they are in fact high for pregnancy as more urea and creatinine should be excreted, therefore there may be a problem with the kidneys
What is the range of creatinine clearance during pregnancy?
-40-50%
What is the approximate value of urea during pregnancy?
-~3.1mmol/L
Why is it significant that bicarbonate decreases during pregnancy?
-Reduced buffering capacity of the kidney
What is a potential problem which progesterone can place on the urinary system?
-Increasing GFR so much that hydroureter develops
Name a common cause of urianry stasis during pregnancy?
-Obstruction of ureter by gravid uterus
Why are UTIs concering during pregnancy?
-Possible to develop to pyelonephritis and cause pre-term labour
Name the anatomical changes which occur within the respiratory system during pregnancy
- Diaphragm displaced
- AP and transverse diameters of the thorax increase
Name the physiological changes which occur in the respiratory system during pregnancy
-Physiological hyperventilation due to increased CO2 production and increased respiratory drive effect of progesterone
How is physiological hyperventilation of pregnancy compensated for?
-Increased bicarb excretion to compensate for the respiratory alkalosis
What are the changes in the capacities of the lungs during pregnancy?
- Reduced functional residual capacity but total lung capacity remains unchanged
- Increased TV with RR unchanged
What happens to O2 consumption during pregnancy?
-Increases by 20%
Why is vital capacity unchanged during pregnancy?
-VC = TV+IRV+ERV
although TV increases ERV volume decreases so VC remains unchanged
What happens to carboydrate metabolism during pregnancy?
- Increased peripheral resistance to insulin by hPL and the body switched to gluconeogenesis and alternative fuels to spare glucose for fetus
- Decreased fasting blood glucose
- Increased post-prandial blood glucose
