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What causes the thick and white vaginal discharge observed during pregnancy?
What causes the thick and white vaginal discharge observed during pregnancy?
How does maternal position affect blood pressure during the second trimester?
How does maternal position affect blood pressure during the second trimester?
What is one primary reason for the physiological changes that occur during pregnancy?
What is one primary reason for the physiological changes that occur during pregnancy?
What is the primary characteristic of hyperventilation syndrome in pregnant women?
What is the primary characteristic of hyperventilation syndrome in pregnant women?
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What is the term for the upward movement of the uterus into the abdominal cavity as pregnancy progresses?
What is the term for the upward movement of the uterus into the abdominal cavity as pregnancy progresses?
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Which hormone is primarily associated with the relaxation of muscles during pregnancy?
Which hormone is primarily associated with the relaxation of muscles during pregnancy?
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What structural change occurs in the cervix during labor?
What structural change occurs in the cervix during labor?
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Which physiological change occurs in the vagina during pregnancy?
Which physiological change occurs in the vagina during pregnancy?
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During pregnancy, oxygen consumption increases by what percentage?
During pregnancy, oxygen consumption increases by what percentage?
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Why does urinary frequency increase in the first and third trimesters of pregnancy?
Why does urinary frequency increase in the first and third trimesters of pregnancy?
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What is a potential cause of constipation during pregnancy?
What is a potential cause of constipation during pregnancy?
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What happens to the uterus's weight at 40 weeks of pregnancy?
What happens to the uterus's weight at 40 weeks of pregnancy?
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What is the role of relaxin hormone during pregnancy?
What is the role of relaxin hormone during pregnancy?
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What percentage of pregnant women are affected by supine hypotension syndrome?
What percentage of pregnant women are affected by supine hypotension syndrome?
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What is the purpose of the mucus plug formed in the cervix during pregnancy?
What is the purpose of the mucus plug formed in the cervix during pregnancy?
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How might hormonal changes during pregnancy affect the musculoskeletal system?
How might hormonal changes during pregnancy affect the musculoskeletal system?
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What occurs in the cervix as a result of estrogen and progesterone during pregnancy?
What occurs in the cervix as a result of estrogen and progesterone during pregnancy?
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Which method should NOT be used over the pregnant abdomen?
Which method should NOT be used over the pregnant abdomen?
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What is the primary reason for keeping objects close to the body when lifting?
What is the primary reason for keeping objects close to the body when lifting?
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What commonly occurs during the early months of pregnancy related to the gastrointestinal tract?
What commonly occurs during the early months of pregnancy related to the gastrointestinal tract?
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What physical change happens to the vagina during the second stage of labor?
What physical change happens to the vagina during the second stage of labor?
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During which stage of labor is it advised to utilize relaxation techniques to conserve energy?
During which stage of labor is it advised to utilize relaxation techniques to conserve energy?
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What is an important consideration when lifting an object from above shoulder height?
What is an important consideration when lifting an object from above shoulder height?
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Which condition is characterized by a dark line developing on the stomach during pregnancy?
Which condition is characterized by a dark line developing on the stomach during pregnancy?
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What change occurs to the kidneys during pregnancy?
What change occurs to the kidneys during pregnancy?
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What type of pigmentation is referred to as 'mask of pregnancy'?
What type of pigmentation is referred to as 'mask of pregnancy'?
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Which technique is recommended for relieving calf muscle cramps?
Which technique is recommended for relieving calf muscle cramps?
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What type of skin changes may occur due to overstretching during pregnancy?
What type of skin changes may occur due to overstretching during pregnancy?
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What is a safe way to manage low back pain during pregnancy?
What is a safe way to manage low back pain during pregnancy?
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What happens to the color of the areolas after breastfeeding?
What happens to the color of the areolas after breastfeeding?
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During the first visit of medical antenatal care, which of the following is not typically included?
During the first visit of medical antenatal care, which of the following is not typically included?
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What is a sign of diastasis of rectus abdominis in women?
What is a sign of diastasis of rectus abdominis in women?
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What postural changes can occur during pregnancy?
What postural changes can occur during pregnancy?
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Which statement best describes the effects of the relaxin hormone during pregnancy?
Which statement best describes the effects of the relaxin hormone during pregnancy?
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What is one of the main purposes of antenatal care?
What is one of the main purposes of antenatal care?
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What position is suggested during the first stage of labor to assist with contractions?
What position is suggested during the first stage of labor to assist with contractions?
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What change to balance occurs during pregnancy?
What change to balance occurs during pregnancy?
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What is a potential effect of shortened hip flexors in pregnant women?
What is a potential effect of shortened hip flexors in pregnant women?
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Which component is included in the multidisciplinary antenatal care team?
Which component is included in the multidisciplinary antenatal care team?
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What is a common symptom addressed during return visits in antenatal care?
What is a common symptom addressed during return visits in antenatal care?
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Study Notes
Physiological Changes During Pregnancy
- Increased Estrogen and Progesterone cause uterine enlargement, increased vascularity, hyperplasia, and hypertrophy.
- Uterine Enlargement: Length increases from 6.5 cm to 32 cm, width from 4 cm to 24 cm, and weight from 50 gm to 1000 gm at 40 weeks.
- Fundal Height: Increases with progressive enlargement of the uterus.
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Prodromal (Pre-Labor) Stage:
- Uterine Shelfing: Fundus falls forward, making the abdomen look like a shelf when standing due to fetal head engagement.
- Lightening: Relief of upper abdominal pressure symptoms (dyspnea and palpitation) due to descent of the uterus.
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Cervix:
- Mucus Gland: Enlarged and secretes mucus forming a plug (operculum) that is expelled during labor.
- Vascularity and Softening: Increases in response to estrogen and progesterone.
- Effacement and Dilation: Cervix shortens and opens to 10 cm during labor, allowing for fetal passage.
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Vagina:
- Muscle Thickening: Thickens and becomes more elastic for dilation during labor.
- Length Increase: Anterior wall lengthens.
- Vascularization and Softening: Increases due to estrogen and progesterone.
- Leukorrhea: Thick white vaginal discharge occurs due to hormonal changes.
- pH: Lower vaginal pH is acidic (4-6.5) compared to non-pregnant women (3.5-4.5).
Cardiovascular System
- Cardiac Output: Increases by 30-50%, peaking at 28-32 weeks.
- Blood Pressure: Slightly decreases in the second trimester.
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Supine Hypotension (Pregnancy Hypotensive Syndrome): Occurs in 3-11% of pregnant women.
- Cause: The uterus puts pressure on the inferior vena cava (IVC) when lying on the back, reducing blood flow to the heart and uterus.
- Symptoms: Dizziness, lightheadedness, shortness of breath.
- Prevention: Lying on the side relieves pressure on the IVC.
Respiratory System
- Chest Size: Increases.
- Diaphragm: Moves upward.
- Hyperventilation Syndrome: Pregnant women breathe faster and deeper than usual.
- Oxygen Consumption: Increases by 14-20%.
- Tidal Volume: Increases by 30-40% to meet increased oxygen demand.
Urinary System
- Kidney Length and Volume: Increase during pregnancy and decrease postpartum.
- Micturition Frequency: Increases, especially in the first and third trimesters, due to uterine pressure on the bladder.
- Urinary Tract Infections: More likely due to urinary stasis.
Gastrointestinal Tract
- Morning Sickness and Vomiting: Common in early pregnancy.
- Indigestion: A common discomfort.
- Constipation: Caused by pressure on the intestines, relaxation of smooth muscles by relaxin, and sedentary habits.
- Hemorrhoids: Can develop due to increased pressure in the pelvic region.
Nervous System
- Mood Liability: Sleepiness, depression or excitement and insomnia can occur.
- Neuropraxia: Nerve compression due to water retention, leading to conditions like carpal tunnel syndrome.
- Pregnancy Cravings: Commonly experience.
Cutaneous System
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Pigmentations: Develop due to hormonal changes:
- Linea Nigra: A dark line appearing between the umbilicus and symphysis pubis.
- Darkening Areolas: The primary areola becomes darker and secondary areola appear.
- Cloasma Gravidarum (Mask of Pregnancy): Butterfly-shaped pigmentation on the forehead, nose, upper lip, and cheeks.
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Striae Gravidarum (Stretch Marks): Red streaks appear due to skin stretching and rupture of elastic fibers.
- Striae Albicantes: Pale white streaks develop after labor due to fibrosis.
Metabolic and Endocrine Changes
- Relaxin: Hormone secreted by the corpus luteum in the ovary, important for joint relaxation and uterine growth.
- Estrogen, Progesterone, and Human Placental Lactogen: Have significant effects on the body during pregnancy.
Musculoskeletal System
- Abdominal Muscles: Stretched to their limit.
- Ligaments: Softening and increased mobility due to relaxin, leading to increased risk of joint injury.
- Pelvic Floor Muscles: Drop by 2.5 cm due to uterine weight.
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Postural Changes: Forward head, rounded shoulder, increased lumbar lordosis, hyperextended knees, and pronated feet.
- Impact: Changes in balance.
- Muscle Changes: Shortened hip flexors, lower back and pectoral muscles, and elongated abdominal, neck, and upper back muscles.
- Waddling Gait: Due to lax ligaments and pelvic joint instability.
Antenatal Period and Care
- Antenatal Period: The time during pregnancy.
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Antenatal Care: Systemic medical supervision during pregnancy to ensure a healthy pregnancy and labor.
- Components: Medical, psychological, and physical care.
Antenatal Care Team
- Obstetrician: Provides medical care.
- Dietitian: Provides nutritional guidance.
- Physiotherapist: Provides physical therapy and guidance for exercise.
- Psychologist: Provides emotional and mental support.
- Pediatrician: Provides care for the newborn.
Medical Antenatal Care
- First Visit: Includes taking medical history, physical examination, urine and blood tests.
- Return Visits: Include monitoring symptoms, weight, edema, blood pressure, and performing abdominal examinations and urine tests
Physical Antenatal Care
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Role of Physiotherapy:
- Educate: On safe exercise, posture, and body mechanics.
- Treat: Concerns such as low back pain, pelvic pain, and muscle cramps.
- Help: Women prepare for labor and delivery.
- Provide: Pain relief techniques.
- Teach: Positions to facilitate labor.
Physical Antenatal Care (Specific Interventions)
- Pelvic Support: To reduce pubic pain from diastasis of rectus abdominis.
- Lumbar Pain Relief: Soft tissue techniques and mobilization.
- Cramp Relief: Sustained stretching and foot exercises.
- Relaxation Techniques: Reduce stress, pain, and promote energy conservation during labor.
- Breathing Awareness: Promote relaxation and manage pain during labor.
General Role of Physiotherapists
- Electrotherapy should not be used over the pregnant abdomen.
Low Back Pain Treatment
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Ice Application (25 Minutes): Reduces swelling, nerve conduction velocity, and increases endorphins and enkephalins.
- Methods: Ice cube massage (directly on skin) and ice packs.
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Description
Explore the significant physiological changes that occur during pregnancy, including the effects of hormones like estrogen and progesterone. This quiz covers uterine enlargement, changes in the cervix, and developmental stages leading to labor. Test your understanding of these essential concepts in prenatal physiology.
