Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
|
How does blood volume change with pregnancy? Why does this happen?
|
There is an increase in blood volume as a method of protection against PP hemorrhage
|
|
|
In what situations is there a lack of plasma volume expansion?
|
When mom is hypertensive and when there is IUGR
|
|
|
What is the physiology behind increased plasma osmolality?
|
Plasma osmolarity is reset to a lower value
Estrogen increases plasma renin activity, angiotensin, and aldosterone Increased aldosterone increases Na+ uptake and water follows |
|
|
What does the role of volume expansion play in birth weight?
|
Increased plasma volume = increased plasma birth weight
|
|
|
What happens to RBC volume during pregnancy? What affect does this have on Fe?
|
Expands after the plasma volume expands; this will require greater levels of Fe (fetus robs mom of RBC's)
|
|
|
Describe the physical changes that the heart undergoes in preg.
|
Heart is larger (myocardial hypertrophy): increased LV mass and increased L/R EDV
|
|
|
How does the position of the heart change in pregnancy?
|
1. Displacement of the PMI
2. Enlarged on CXR 3. Slight left deviation may be seen but for the most part EKG is normal |
|
|
How does CO, SV, and HR change?
|
Increased CO --> 6L/min instead of 4.5-5L; increased SV, increased HR
Starts at 10-12 weeks |
|
|
How is the heart affected intrapartum and postpartum?
|
Intrapartum: CO is increased even more due to contractions, valsalva, and anxiety
Postpartum: despite blood loss during delivery, CO still increases (release of IVC from uterine compression) |
|
|
How does the distribution of flow change during pregnancy?
|
-Increase CO to the uterus
-increased uteroplacental flow -increased RBF and GFR -increased pulmonary blood flow |
|
|
How does vascular resistance change?
|
Decreased SVR and pulmonary vascular resistance
|
|
|
How does oncotic pressure change during pregnancy? How does this effect the body?
|
Oncotic pressure decreases (less drawing of fluid into the vessel) and hydrostatic pressure increases (more drawing the fluid out) and this causes more fluid to be in the interstitium and more edema
|
|
|
What are the factors that remain unchanged in pregnancy?
|
MAP
capillary wedge pressure central venous pressure LV stroke work index |
|
|
How does BP change throughout pregnancy? What is responsible for the change in BP?
|
Decreases with its lowest point being in the 2nd trimester and then increases to baseline levels by term
BP decreases due to the decrease in the SVR |
|
|
How does oxygen consumption change?
|
Increases by 20-30% by term (increases gradually as opposed to CO which increases dramatically over the first and second trimester)
|
|
|
This is the MC finding upon physical examination of the CV system.
|
systolic flow murmur
then: split S1, S3 heard, tricuspid regurg |
|
|
What is Supine hypotensive syndrome?
|
Where the increased size of the uterus compresses the IVC and decrease venous return, leading to decreased CO and symptoms of weakness and dizziness
|
|
|
What are 3 conditions of the heart that can increase maternal mortality
|
-Increased pulmonary HTN
-Eisenmenger's syndrome -Marfan's syndrome -Complicated coarctation of the aorta |
|
|
Explain the physiology behind Eisenmeinger's syndrome and pulmonary HTN
|
Eisenmerger's: decreased SVR increases R --> L shunt and decreases the pulmonary flow & increases hypoxemia
Pulmonary HTN: same mechanism increased pulmonary resistance |
|
|
How does mitral stenosis affect pregnancy?
|
Tight mitral valve= decreased LV filling = decreased LV EDV= decreased CO
AVOID INCREASES IN HR and Decreasing venous return |
|
|
How does the state of coagulation change in pregnancy
|
Pregnancy is a hypercoagulated state increased fibrinogen, decreased fibrinolysis, increase in 7,9,10, 12
|
|
|
How does strenuous exercise affect pregnancy?
|
W/ HR's >148 bpm there are fetal decelerations
|
