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;
58 Cards in this Set
- Front
- Back
|
Cardiac output
|
Increases by 8 weeks gestation
|
|
|
Stroke volume
|
Increases early in pregnancy
|
|
|
Blood volume
|
Increases
|
|
|
Heart rate
|
Increases 10-15 bpm
|
|
|
SVR and BP
|
Decreases during first 24 weeks
Gradually increases back in third trimester |
|
|
Effect of vasopressors
|
Resistant by 8 weeks gestation
|
|
|
Physical cardiac signs
|
SEM, S3 gsllop, or split S2
No diastolic murmurs |
|
|
Heart silhouette
|
Enlarged due to diaphragmatic elevation
|
|
|
Plasma volume
|
Increases more than RBC mass
Physiologic anemia of pregnancy |
|
|
Iron
|
Higher requirements
|
|
|
Coagulation
|
Hypercoagulable
Increased risk of thrombosis |
|
|
Risk of thromboembolism
|
Increased
Highest risk post-partum |
|
|
Oxygen requirements
|
Increase
|
|
|
Tidal volume
|
Increases
|
|
|
Vital capacity
|
Increases
|
|
|
pCO2
|
Decreases
|
|
|
Serum bicarbonate
|
Decreases
|
|
|
Residual volume
|
Decreases
|
|
|
Expiratory reserve volume
|
Decreases
|
|
|
Total lung capacity
|
Decreases
|
|
|
Arterial pH
|
Maintained at same level
|
|
|
Renal pelvis and ureters
|
Dilated
|
|
|
GFR
|
Increases
|
|
|
Glucosuria
|
Present
|
|
|
Serum creatinine
|
Decreases
|
|
|
Serum uric acid
|
Decreases
|
|
|
Protein loss
|
Increased
Mild proteinuria |
|
|
Plasma sodium
|
Decreases
|
|
|
Plasma osmolality
|
Decreases
|
|
|
Skin changes
|
Chloasma
Mild hirsutism Striae gravidarum (stretch marks) Vascular spiders Palmer erythema Hyperpigmentation |
|
|
TG levels
|
Increase
|
|
|
Cholesterol levels
|
Increase
LDL especially increases |
|
|
FFA metabolism
|
Increases
More ketones |
|
|
Carbohydrate metabolism
|
Fasting hypoglycemia
Postprandial hyperglycemia |
|
|
Insulin levels
|
Increase post-prandially
|
|
|
Amino acid levels
|
Decrease
Less alanine for gluconeogenesis |
|
|
Total T4
|
Increases
|
|
|
TBG
|
Increases
|
|
|
Free T3 and T4
|
No change
|
|
|
TSH
|
Mild decrease early in pregnancy due to TSH-like effect of HCG
|
|
|
Dental changes
|
Gingival disease more common
Epulis gravidarum - gum line lesions that bleed easily |
|
|
GI changes
|
Nausea and vomiting - emesis gravidarum from 4-16 weeks, due to progesterone, hCG, and reduced smooth muscle function
Dietary cravings Pica - cravings for non-food items Ptyalism - excess saliva Gastric reflux Constipation |
|
|
Musculoskeletal
|
Lumbar lordosis
Change in body posture Bone turnover increases, but no bone loss |
|
|
Ophthalmic changes
|
Blurred vision due to fluid retention in cornea
Avoid changes in corrective lens prescriptions |
|
|
GU changes
|
Increased vaginal secretions
Vulvar varicosities and hemorrhoids Uterus increases in size Diastasis recti - physiologic separation of abdominal rectus muscles Hernia |
|
|
Fetal circulation in utero
|
Oxygenated blood from umbilical vein
Deoxygenated blood to umbilical artery Right to left shunts |
|
|
Fetal kidney function
|
400-1200mL of urine a day
Fetal urine is primary source of amniotic fluid in second half of pregnnacy |
|
|
Fetal thyroid function
|
Starts around 12 weeks gestation
Maternal TSH doesn't cross placenta |
|
|
hCG
|
Produced in highest levels in first trimester
|
|
|
Human placental lactogen
|
Highest levels in third trimester
Stimulates breast development |
|
|
Progesterone
|
Originates from corpus luteum until 8 weeks, when placenta takes over
Reduces smooth muscle tone in organs besides uterus Increases smooth muscle tone in uterus |
|
|
Placental structure
|
Chorionic plate and basal plate
Villous tree bathed in maternal blood Spiral arteries provide maternal blood |
|
|
Placental mosaicism
|
Small population of abnormal cells contribute to placenta
Can contribute to intrauterine growth restriction |
|
|
Placenta previa
|
Implantation of placenta near cervical os
Increases risk of life-threatening bleeding |
|
|
Abruptio placentae
|
Premature separation of the placenta
Increases risk of life-threatening bleeding |
|
|
Active transport
|
Amino acids
Calcium Iron |
|
|
Facilitated diffusion
|
Glucose
|
|
|
Transporters
|
Folate and B12
Folate reduces risk of neural tube defects |
