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48 Cards in this Set
- Front
- Back
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In pregnancy, systemic vascular resistance ______________. Blood pressure _____________, leading to an __________ in cardiac output. Heart rate ______________ and stroke volume ______________ |
In pregnancy, systemic vascular resistance decreases. Blood pressure decrease, leading to an increase in cardiac output. Heart rate increases and stroke volume increases. |
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In the third trimester, the ___________ falls back on the ________ and ________ ___________ is thus decreased. |
In the third trimester, the uterus falls back on the IVC and venous return is thus decreased. |
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In labour, _________ _________ increases significantly, stroke volume and _______ _______ increase as well as the circulating volume. Blood pressure ______________ during contraction and then __________ to ____________. |
In labour, cardiac output increase significantly, stroke volume and heart rate increase as well as the circulating volume. Blood pressure increases during contraction and then returns to baseline in between. |
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In pregnancy, haematologic changes lead to the woman being in a state of ___________ ______________. |
Physiologic Anemia. |
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Haemodilution is... |
The dilution of blood in a pregnant women. Occurs due to a 50% increase in plasma (hypervolaemia), and only an 18% increase in red blood cells. This leads to a decrease in hematocrit and haemoglobin levels and thus an anaemic state. |
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Red Blood Cell production is stimulated by ________________________ (___), which is secreted due to the hormones _________, _______________ and ________. |
Red blood cell production is stimulated by Erythropoietin (Epo), which is secreted due to the hormones prolactin, progesterone and hPL. |
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In labour, haemaglobin _____________ due to __________ and ______________. Red blood cell volume ___________ by __%, which is lost at delivery. |
In labour, haemaglobin increases due to stress and dehydration. Red blood cell volume increases by 50%, which is lost at delivery. |
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Anatomical changes in the respiratory system include movement of the ___________ up about 4cm, and the subcostal angle ____________ from _____degrees to ____________degrees. |
Anatomical changes in the respiratory system include movement of the diaphragm up about 4cm, and the subcostal angle increases from 68 degrees to 103 degrees. |
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Women in pregnancy will be in a state of respiratory ________________ due to the _________ sensetivity to ___________ in the respiratory centre and ___________ amounts of CO2. |
Women in pregnancy will be in a state of respiratory alkalosis due to the increased sensitivity to carbon dioxide in the respiratory centre and decreased amounts of C02. |
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Progesterone causes _____________ pulmonary ______________ ______________, __________ tidal volume, decreased ___________ residual ___________, ______________ ventilation and _____________ minute volume. |
Progesterone causes decreased pulmonary vascular resistance, increased tidal volume, decreased functional residual capacity, increase ventilation and increased minute volume. |
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Total lung capacity in pregnancy _________ _________. |
remains stable. |
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__________ occurs in the mouth of pregnant women in 30 to ___% of women due to the effects of ____________ and ____________. |
Gingivitis occurs in the mouth of pregnant women in 30 to 80% of women due to the effects of progesterone and estrogen. |
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In the esophagus, _________ _________ ___________ and pressure decrease due to _______________. |
In the esophagus, lower sphincter tone and pressure decrease due to progesterone. |
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Stomach tone and motility ___________ and gastric emptying time is __________. Gastric ___________ is also decreased, and thus the pH is __________. Gall bladder tone and __________ decreases all due to _______________. |
Stomach tone and motility decrease and gastric emptying time is delayed. Gastric acidity is also decreased, and thus the pH is increased. Gall bladder tone and motility decreases all due to progesterone. |
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Intestinal tone and motility ___________ and transit time ____________ due to ___________. Height of the _____________ _______________ increases and brush border enzyme activity _________. |
Intestinal tone and motility decreased and transit time increases due to progesterone. Height of the duodenal villi increases and brush border enzyme activity increases. |
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Basal metabolic rate ______________ as well as ________________ and _______________ metabolism. ____________ metabolism ___________ for the first half of pregnancy and then ___________ for the second half. These changes are due to an interplay between __________, _______________, ________ and ___________. |
Basal metabolic rate increases as well as carbohydrate and lipid metabolism. Protein metabolism increases for the first half of pregnancy and then decreases for the second half. These changes are due to an interplay between estrogen, progesterone, hPL and leptin. |
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Glucose tolerance _________ due to an increase in _________. Insulin resistance is due to _________________ in _____________. |
Glucose tolerance increases due to an increase in hPL. Insulin resistance is due to increase in prolactin. |
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Changes in the integumentary system in pregnancy include... |
- Hyperpigmentation mostly in the genital skin, axillae, thighs, areolae and linea nigra. - Melasma (a mask like pigmentation) around the chin, cheeks and nose. - Striae gravidarum (or stretch marks), mostly over the abdomen. These are tears in dermal collagen. - Spider nevi due to increasing estrogen levels - Non-pitting edema mostly in the face, hands and feet due to increased vascular permeability. |
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Eccrine sweat glands... |
increase in pregnancy to assist with thermoregulation |
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Hair growth.. |
increases in pregnancy due to increasing estrogen levels. |
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Musculoskeletal system changes in pregnancy include.. |
The relaxation of cartilage and connective tissues of the sacro iliac joints and symphysis pubis. External rotation of the femurs leads to the pregnancy "waddle" The pelvis is tilted forward due to the distension of the abdomen and the centre of gravity is shifted. Women compensate for this with lordosis or curvature of the spine. |
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A split rectus is.. |
The splitting of the rectus abdominus muscles with the growing uterus and distended abdomen. These muscles often will not go completely back to their pre pregnant state. |
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Changes in the renal system during pregnancy include.. |
increased intravascular and extracellular volume and increased metabolic waste products The changes are related to hormones, particularly progesterone, pressure from the uterus and cardiovascular changes. |
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Structural changes of the renal system include... |
dilation of the renal pelvis and elongation of the ureters increase in kidney length by 1cm increase in renal volume (30%) and displaced bladder in late pregnancy |
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Bladder changes include |
decreased tone and increased capacity |
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Renal Blood Flow... |
increases by 50 to 80 percent by the middle of the 2nd trimester, and then decreases to term. |
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Glomerular Filtration Rate... |
increases 40 to 60 percent absorption of Na and H20 increases serum blood urea nitrogen, creatinine and uric acid levels decrease |
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Renal Vascular Resistance |
decreases due to decreased systemic vascular restistance |
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Renal tubular function... |
increases solute reabsorption increases secretino of glucose, proteins, amino acids, urea, calcium, hydrogen ions, bicarbonate. |
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Renin-Angiotensin-Aldosterone System (RAAS) |
increases in all components and thus increases activity. continues to increase and change further in labour. |
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Changes in the Central Nervous System in pregnancy include __________, _______________ and ___________. |
Changes in the Central Nervous System in pregnancy include ocular, otalaryngeal and sleep. |
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Ocular changes include... |
mild corneal edema - cornea becomes slightly thicker and refractory power is affected. |
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Otalaryngeal changes include... |
- congested and hyperemic nasal mucosa - increased sensation to smell
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Pregnancy rhinitis is... |
nasal congestion that lasts up to 6 weeks with no sign of infection or allergy, due to increased estrogen levels. |
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Estrogen causes mucous changes that lead to... |
nasal stuffiness and congestion, ear stuffiness and blocked ears. |
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Changes in sleep include.. |
insomnia and decreased sleep quality. as gestation increases, sleep levels decrease. sleep can be interrupted by dyspnea, heart burn, uterine activity, nasal congestion, muscle ache, stress, fetal movements and anxiety. |
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Progesterone has a ________________ effect and leads to ___________ ____sleep. |
Progesterone has a sedative effect and leads to increased NREM sleep. |
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Estrogen and ____________ have an opposite effect to progesterone and lead to ___________ ___ sleep. |
Estrogen and cortisol have an opposite effect to progesterone and lead to decreased REM sleep. |
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External changes to the breast in pregnancy include... |
- increase in size - hyperpigmentation - increase in sensitivity - striae gravidarum |
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Internal changes to the breast in pregnancy include... |
- erect nipples - montgomery glands increase in size - double amount of blood flows to the breasts. |
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Changes to the breast in the first trimester include |
- proliferation of the ductile system due to estrogen - proliferation of alveoli by prolactin, hPL and hCG - formation of lobes due to progesterone - lymphocytes and blood cells go into the interstitial tissues |
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Changes to the breast in the second trimester include |
- lobular growth - formation of new alveoli and ducts - colostrum starts to accumulate in ducts |
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Changes to the breast in the third trimester include |
- the epithelial cells in the alveoli differentiate into secretory cells - the number of secretory cells increase - distention of the alveoli with colostrum |
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Changes to the endocrine system include changes in the __________, _____________, __________ ________, and ____________. |
Changes to the endocrine system include changes in the pituitary, thyroid, adrenal glands and pancreas. |
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The pituitary gland undergoes changes such as... |
- enlargement by over 100% - increased prolactin levels by term (10 times higher) |
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The thyroid undergoes changes including... |
- 13% increase in size - increase in TBG leads to woman being in a euthyroid state (due to estrogen_ - thyroid stimulating hormone does not cross the placenta |
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The adrenal glands change with... |
- two fold increase in serum cortisol - no change in anatomical size, but increase in glucocorticoid production |
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The pancreas changes include.. |
- hypertrophy and hyperplasia of cells - insulin resistance due to hPL. |
