| Correct Answers
Cardiovascular adaptations to pregnancy
BP--
Decreases slightly in 2nd trimester and then gradually returns in 3rd trimester May
decrease in left lateral position
Hematology adaptations in pregnancy
Hct drop 28-40%
Coagulability --
Hyper coagulable during pregnancy due to increased clotting factors and decrease
fibrinolysis
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Renal changes in pregnancy
GFR, renal plasma flow, Cr Cl increases
Some normal glycosuria and proteinuria may occur Ureters, urethra, and bladder
dilate
Decreased bladder capacity and increase urine production Increase risk of UTI due
to urinary stasis
GI changes in pregnancy
Lower esophageal sphincter tone can cause reflux Nausea and vomiting
Constipation
Metabolic adaptations in pregnancy
,Increased fat deposits Increased blood lipids Increase salt accumulation Increased
water retention Increased body weight
Respiratory adaptations in pregnancy
Increased VO2
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Impaired ventilation (rise in diaphragm)
Musculoskeletal adaptations
Increased joint laxity
Increased risk of strains and sprains Gradual increase in lordosis
Separation of rectus abdominis due to pressure from an enlarged uterus
Integumentary changes in pregnancy
Striae gravidum -- stretch marks
Mask of chloasma -- irregular brown blotches and pigmentation on the cheeks or
forehead
Endocrine adaptations in pregnancy
Increased HCG
Increased human placental lactogen Increases estrogen
Increased progesterone
Emotional adaptations in pregnancy
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Increased emotional lability Increased instability
,Estrogen during pregnancy
Promotes growth of the uterus and glandular breast tissue Increase uterine blood
flow
Increased insulin like growth factors Stimulates growth of uterine muscle mass
Enhances myometrial contractility Increased sensitivity to oxytocin
Progesterone in pregnancy
Inhibits production of prostaglandins in uterus prevents myometrial contractions
Withdrawal of progestin at term leads to uterine contractions and onset of labor
Placenta
-Metabolizes and synthesizes agents necessary for sustaining pregnancy
-Provides immunologic barrier between maternal and fetal systems
-Functions as major endocrine gland
Hormones produced by placenta --
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HCG (human chorionic gonadotropin) HPL (human placental lactogen) Estrogen
Progesterone
HCG fHuman fchorionic fgonadotropin
Major frole fis fsustain fthe fcorpus fluteum fand fits fproduction fof fprogesterone fand
festrogen
Secreted ffor f8-10 fweeks fat fwhich ftime fthe fplacenta ffunction fis fadequate fand
fbecomes fthe fmajor fproducer fof fprogestin fand festrogen
Levels fnormally fdouble fevery f48-72 fhours fand fdoes funtil fit fpeaks
, Stabilizes fat f20,000
Nausea fand fvomiting f-- fnatural frise fand ffall fof fHCG flevels fcorrespond fto fnausea
fand fvomiting fof fpregnancy fduring ffirst ftrimester falthough fno fdirect fcause
Urine fpregnancy ftest f-- fmay fbe fpositive f2 fweeks fafter fconception for f5 fweeks
fafter fLMP
HPL fHuman fplacental flactogen
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Increases fmaternal ffatty facids fand ftriglycerides
Increases fmaternal finsulin fresistance fto freserve fglucose ffor fthe ffetus
Fetus fbegins fto fproduce finsulin fjust fbefore fbirth
Relaxin
Prepares fthe fendometrium fdecidual ftissue fto fensure fmaintenance fof fearly
fpregnancy
Inhibits futerine factivity fduring fpregnancy fand ftogether fwith fprogesterone, fsoftens
fligaments fresulting fin fminor finstability fof fpelvis fto fwiden fand ffacilitate fbirth
Presumptive fsigns fof fpregnancy
Amenorrhea fnausea, fvomiting ffatigue
urinary ffrequency fskin fchanges fchloasma
linea fnegra fstriae
breast fchanges