Physiological pregnancy symptoms& pre-conceptual care Flashcards

1
Q

What is alpha-foetoprotein?

A
  • A foetal hormone involved in pregnancy
  • Produced in the liver of a developing fetus
  • Elevated levels could indicate other cancers
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2
Q

What neurological physiological changes occur due to pregnancy?

A
  • Increase in CSF
  • Engorgement of epidural veins
  • Decreased MAC
  • Decreased LA volumes required
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3
Q

What cardiac physiological changes occur due to pregnancy?

A
  • Increased CO
  • Increased SV
  • Increased HR
  • Left ventricular hypertrophy
  • Regurgitant murmurs
  • Decreased systemic vascular resistance
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4
Q

What GI physiological changes occur due to pregnancy?

A
  • Lower oesophageal sphincter tone
  • Reflux
  • Increased risk of aspiration
  • decreased conc. of liver enzymes
  • Increased ALP
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5
Q

What renal physiological changes occur due to pregnancy?

A
  • Increased renal blood flow
  • Increased GFR
  • Decreased plasma urine and creatinine
  • Increased urinary protein and glucose
  • Increased risk of UTI
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6
Q

What endocrine physiological changes occur due to pregnancy?

A
  • 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
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7
Q

What musculoskeletal physiological changes occur due to pregnancy?

A
  • Increased ligamentous laxity
  • Increased risk of dislocation
  • Increased lumbar lordosis
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8
Q

What respiratory physiological changes occur due to pregnancy?

A
  • Increased mechanical ventilation (increased total volume & RR)
  • Decreased PaCo2
  • Increased Pao2
  • Decreased function residual capacity
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9
Q

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

A

-Slight decrease

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10
Q

Is there a change in base excess during pregnancy

A

-No change

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11
Q

How can we treat a PE in pregnancy

A
  • Low molecular weight heparin

- Thrombolysis

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12
Q

What GI tract changes occur in pregnancy?

A
  • Gastric pH increasing & intestinal motility reduced

- This may lead to delayed absorption

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13
Q

What renal changes occur in pregnancy?

A
  • 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
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14
Q

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

A

Modified early obstetric warning system

-Used to track early physiological parameters and aid early recognition of acutely unwell women

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15
Q

What are the folic acid requirements for pregnant women

A
  • 400mcg of folic acid before conception ( at least 3 months before)
  • 5mg Folic acid for those at higher risk of neural tube defects
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16
Q

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

A
  • 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
Q

What is different in pregnancy ABCDEF approach?

A
  • 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
Q

What are the effects of folic acid deficiency?

A
  • 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