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9 Cards in this Set
- Front
- Back
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What hormones are produced by the fetoplacental unit? |
Estrogen, progesterone, human chorionic gonadotrophin (hGC), human placental lactogen(hPL)-proportional to placenta, prolactin (increases during pregnancy) |
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What are the functions of hCG? |
1. Promote steroidogenesis in the placental unit 2. Maintain the corpus luteum in the early weeks of pregnancy 3. Postive pregnancy test |
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What are the changes to the mother's weight? |
Average weight gain: 12.5kg Fetus (3.5kg), Uterus (1kg), Fat (4kg), Amniotic fluid(1kg), plasma, cells and fluid retention (2kg) |
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What are the changes to maternal blood volume and composition? |
Total Blood Volume: Increase by 30% Plasma Volume: Increase by 45% Red Cell Mass: Increase by 18-30% Haematocrit: Falls from 40% to 31% (dilutional anaemia) *Good because during pregnancy, cardiac output increases so reducing viscosity makes blood easier to pump. Haemoglobin concentration: Falls because increase in plasma> increase in RBC Total Oxygen Carrying Capacity: Increases beyond oxygen consumption White cell count: Rises, mainly neutrophils Plasma Protein Concentration: Falls though total plasma protein count increases due to bigger water volume Blood coagulation: Improved due to increased clotting factors, fibrinogen, platelet turnover |
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What are the changes to maternal cardiovascular system? |
Cardiac Output (SV*HR): Increases Stroke Volume: Increases Heart Rate: Increases BP= TPR*CO TPR: Falls due to Vasodilation caused by E, P, prostaglandins BP: Falls Venous Pressure: Increased due to mechanical compression of IVC by uterus and haemodynamic effect due to increased uterine blood flow. Supine hypotension: Low BP lying on back, fixed by lying on left (increase CO by 20%) or right (10%) Blood flow distribution:Increases to breast, uterus (50mL/min to 700mL/min), placenta, vagina and skin(to dissipate heat) and kidneys (30% to excrete fetus' waste). |
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What are the changes to maternal renal function? |
Kidney function- Blood to glomerulus to glomerulus membrane where secretion and reabsorption occurs Renal blood and plasma flow: Rises Glomerular filtration rate: rises due to increased RPF and fall in colloid osmotic pressure Plasma creatinine and urea levels: Fall. Low maternal waste products level so fetal creatine and urea can pass placenta via diffusion. Glyrosuria: occurs if filtered glucose load exceeds reabsorptive capacity. Sodium: retained to increase blood volume DESPITE sodium loss promoted by rise in GFR, expanded plasma volume and activation of the renin angiotensin system. Water: Retained Renal Pelvis and Ureters: Dilated due to more fluid and vasodilation due to progesterone Bladder symptoms: Increased frequency of micturition |
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What are the changes to maternal respiratory function? |
Minute ventilation: Rises up to 50% Tidal Volume: Rises Respiratory Rate: Unaltered PaCO2: Falls to 30mmHg at term due to progesterone-> mild respiratory alkalosis Thoracic Cage: Expands due to thoracic ligaments softening Diaphragm: Elevated due to relaxant effect of progesterone Functional residual capacity: Falls, each tidal volume less diluted-more effective each breath Forced Vital Capacity & Peak Expiratory Flow: Increase, % higher in parous women |
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What are the changes to maternal gastrointestinal function? |
Maternal appetite: Stimulated due to orexigenic effect of progesterone. Leptin( produced by fat and inhibits appetite) resistance increases during pregnancy. Cravings: Extreme to the extent of pica. Can experience morning sickness. Gastric motility: Decreases, longer transit time and increased water reabsorption-> Constipation Lower esophageal sphincter tone: Reduced -> Heart burn and reflux Gallbladder: Impaired contraction, increased stone fomation Saliva: Increased secretions Mineral Absorption: Increase in iron and calcium Liver: Size unaltered, plasma alkaline phosphatase(from placenta) elevated SI, LI: Shifted position |
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What are the changes to maternal metabolic rates? |
Metabolic rate: Increases due to fetus Carbohydrate Metabolism: Increased insulin secretion, low blood glucose in 1st trimester. Late pregnancy- insulin resistance develops due to human placental lactogen which reduces peripheral insulin sensitivity->mobilises free fatty acids from fat stores, free fatty acids converted to glucose and transported to fetus. May develop gestational diabetes. Protein metabolism: 500g retained by term High protein diet necessary, plasma amino acid levels fall. Fat metabolism: Fat= main maternal energy store. Plasma free fatty acids +cholesterol rise, low glycogen stores. Ketosis-> accelerated starvation response (Fatty acids in blood) |
