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9 Cards in this Set

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Describe the changes to the uterus during pregnancy.
hypertrophy and hyperplasia of uterine smooth muscle by estrogen
Braxton Hicks contractions
increased blood flow through uterine and ovarian arteries due to vasodilation of estrogen and progesterone
later in pregnancy, increase in uterine size is due to mechanical distention
Describe the changes to the cervix during pregnancy.
accumulated water and decreased collagen content cause cervix to soften and become cyanotic
increased vascularity of entire cervix
increased glandular activity leads to mucous plug
Describe the changes to the vagina during pregnancy.
tissue becomes more vascular, leading to purplish tinge (Chadwick's sign)
vaginal walls prepare for distention by increasing mucosa, musculature
vaginal secretions become thicker with a white color due to influence of progesterone
Describe the changes to the skin during pregnancy.
increased pigmentation due to MSH, estrogen, progesterone
high circulating estrogens cause vascular spiders and palmar erythema
Describe the changes to the breasts during pregnancy.
increased in size
may become painful
may express colostrum after several months of pregnancy
What is the ideal rate of weight gain during pregnancy?

What is the ideal weight gain for a pre-pregnancy BMI of <19? >26?
T1: 1.5 to 3 lbs total
T2, T3: 0.8 lbs/week

BMI <19: 28-40 lbs
BMI >26: no more than 20 pounds
How does water metabolism change in pregnancy?
water is retained and dependent pitting edema is seen:
1. increased venous pressure in lower extremities due to compression of vena cava and pelvic veins by gravid uterus
2. decreased interstitial colloid osmotic pressure
How does carbohydrate metabolism change during pregnancy?
first 20 weeks: increased insulin sensitivity
lower fasting glucose leads to glycogen synthesis and fat deposition

after 20 weeks:
insulin resistance develops and plasma insulin levels rise
higher levels of both insulin and glucose stimulate utilization of glucose
What is the proposed mechanism by which gestational diabetes develops?
increasing production of human placental lactogen causes insulin resistance