Physiological pregnancy symptoms& pre-conceptual care Flashcards Preview

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Flashcards in Physiological pregnancy symptoms& pre-conceptual care Deck (18)
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1

What is alpha-foetoprotein?

-A foetal hormone involved in pregnancy
-Produced in the liver of a developing fetus
-Elevated levels could indicate other cancers

2

What neurological physiological changes occur due to pregnancy?

-Increase in CSF
-Engorgement of epidural veins
-Decreased MAC
-Decreased LA volumes required

3

What cardiac physiological changes occur due to pregnancy?

-Increased CO
-Increased SV
-Increased HR
-Left ventricular hypertrophy
-Regurgitant murmurs
-Decreased systemic vascular resistance

4

What GI physiological changes occur due to pregnancy?

-Lower oesophageal sphincter tone
-Reflux
-Increased risk of aspiration
-decreased conc. of liver enzymes
-Increased ALP

5

What renal physiological changes occur due to pregnancy?

-Increased renal blood flow
-Increased GFR
-Decreased plasma urine and creatinine
-Increased urinary protein and glucose
-Increased risk of UTI

6

What endocrine physiological changes occur due to pregnancy?

-Increased progesterone& oestrogen
-Placenta secretes relaxin, human placental lactogen and human chorionic gonadotrophin
-Thyroid hyperplasia
-Transient hyperthyroidism
-Insulin resistance
-Increased cortisol secretion by adrenal glands

7

What musculoskeletal physiological changes occur due to pregnancy?

-Increased ligamentous laxity
-Increased risk of dislocation
-Increased lumbar lordosis

8

What respiratory physiological changes occur due to pregnancy?

-Increased mechanical ventilation (increased total volume & RR)
-Decreased PaCo2
-Increased Pao2
-Decreased function residual capacity

9

Is there a change in bicarbonate(mmol/l) during pregnancy?

-Slight decrease

10

Is there a change in base excess during pregnancy

-No change

11

How can we treat a PE in pregnancy

-Low molecular weight heparin
-Thrombolysis

12

What GI tract changes occur in pregnancy?

-Gastric pH increasing & intestinal motility reduced
-This may lead to delayed absorption

13

What renal changes occur in pregnancy?

-Kidney size increases by 1cm
-Increase in kidney volume by up to 30%
-Dilatation of the renal,calyces, pelvis & ureters
-GFR increase by 40-65%
-Serum creatinine conc. fall 35-55 micromol/L

14

What is a MEOWS chart& what is it used for?

Modified early obstetric warning system
-Used to track early physiological parameters and aid early recognition of acutely unwell women

15

What are the folic acid requirements for pregnant women

-400mcg of folic acid before conception ( at least 3 months before)
-5mg Folic acid for those at higher risk of neural tube defects

16

What makes a woman at higher risk of having a baby with neural tube defects?

-Maternal or Paternal neural tube defect
-Previous pregnancy affected by a neural tube defect
-Family history of neural tube defects
-Pre-existing diabetes mellitus
-Anti-epileptic diabetes mellitus
-BMI>30kg/ m^2

17

What is different in pregnancy ABCDEF approach?

-After 20 weeks we need to be aware of compression of the abdominal aorta & inferior vena cava by the gravid uterus when a pregnant woman lies in the supine position
-So we'd have to give an emergency c-section if the mother is injured/dead/fainted
-You can't lie a pregnant woman flat when she faints; need to lie her to the side or sit her up so she's more comfortable

18

What are the effects of folic acid deficiency?

-Mutations of 5,10-methylenetetrahydrofolate reductase enzyme ( this enzyme is essential for catalyzing the transfer of a methyl group to homocysteine to form methionine)
-Differential methylation of insulin-like growth factor 2 (IGF-2) gene
-hyperhomocysteinaemia
-direct effect on neural epithelium in the embryo