Week 1 Maternal & Fetal 1 of 4 Flashcards Preview

SUM'20 - Advanced Principles > Week 1 Maternal & Fetal 1 of 4 > Flashcards

Flashcards in Week 1 Maternal & Fetal 1 of 4 Deck (57)
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1

MAC progressively does what during pregnancy?

Decreases

2

Why do MAC requirements decrease during pregnancy?

1. Hormonal (Progesterone) Changes 2. LARGE increases in Beta-endorpin level

3

Name the 3 major changes to the Maternal CNS:

1. Progressive decrease in MAC 2. Increase LA sensitivity 3. Obstruction of IVC by gravid uterus

4

Because of increased LA sensitivity, how much of a reduction in dose should be made?

up to 30%

5

Name 4 things the obstruction of IVC by the growing uterus causes:

1. Distension of epidural venous plexus

2. Increased epidural blood volume

3. The cephalad spread of LA during spinal / epidural anesthesia (as a result of decreased CSF and potential epidural space volumes)

4. Increased Risk of unintentional intravenous injection

6

Increased epidural blood volume (b/c of IVC obstruction) does what 3 things (to volumes and pressures):

1. Decreases Spinal CSF Vol

2. Decreases potential vol of epidural space

3. Increases epidural pressure

7

What are two anatomical changes seen in pregnancy: *regards to diagram of CXR /black and blue lines

- Heart appears enlarged b/c of upward pressure - lungs have less room to expand

8

Maternal Cardiovascular Changes: Blood volume

increases (25-40%)

9

Maternal Cardiovascular Changes: Plasma volume

Increases (55%) ---> leads to dilutional anemia

10

Maternal Cardiovascular Changes: Cardiac Output

Increases (40%)

11

Maternal Cardiovascular Changes: Stroke volume / EF

Increases

12

Maternal Cardiovascular Changes: Heart Rate

Increases

13

Maternal Cardiovascular Changes: Blood Pressure - Supine

Increases

14

Maternal Cardiovascular Changes: Blood Pressure - Lateral

Decreases

15

Maternal Cardiovascular Changes: Peripheral Resistance (SVR)

Decreases (-20%)

16

Name the two cardiovascular changes that DECREASE in pregnancy:

-Lateral position BP - SVR ~ 20%

17

What is this image showing: 


 

Maternal changes in CO -supine, side, sitting

18

What is this image showing: Insert Image

Maternal changes in HR -supine, side, sitting

19

What is this image showing: 

Maternal changes in SV -supine, side, sitting

20

Maternal CO returns to normal how long PP?

within 2 weeks

21

Maternal Blood volume increases around what % in 2nd and 3rd trimesters?

2nd- ~25-30% 3rd - 30-45% *mostly plasma volume

22

Maternal Cardiovascular changes: 40% increase in:

Cardiac Output

23

Maternal Cardiovascular changes: 17% increase in:

weight gain

24

Maternal Cardiovascular changes: increased first ___

Heart Sound (S1)

25

Maternal Cardiovascular changes: What cardiac abnormality can be heard on some pregnant pts?

Systolic ejection murmur

26

What is the cause of a heard Systolic ejection murmur?

d/t the hyperdynamic state (increase blood volumes, etc)

27

Maternal Cardiovascular changes: what do S3 and S4 indicate?

hyperdynamic states (increased blood vol and pressures)

28

Maternal Cardiovascular Changes:

 

the PMI shifts which direction? Why? 

-Left

- D/T elevation of diaphragm (d/t enlarging uterus) 

29

Maternal Cardiovascular Changes:

ECG

changes can occur

30

Maternal Cardiovascular Changes:

Blood pressure

Increases: Supine

Decreases: Lateral