Physiological Changes During Pregnancy
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Physiological Changes During Pregnancy

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@StimulativeMarigold5381

Questions and Answers

What is the average weight gain during a singleton pregnancy for a healthy woman?

11 kg

What is the estimated amount of water retained during pregnancy at term?

6.5 liters

When does blood volume start to increase during pregnancy?

From the 6th week

What is the percentage increase in RBC mass during pregnancy?

<p>20-30%</p> Signup and view all the answers

What is the advantage of relative hemodilution during pregnancy?

<p>It ensures optimum gaseous exchange between maternal and fetal circulation</p> Signup and view all the answers

What is the effect of progesterone on the respiratory system during pregnancy?

<p>It reduces total pulmonary resistance</p> Signup and view all the answers

What is the state of blood coagulation during pregnancy?

<p>Hypercoagulable</p> Signup and view all the answers

What is the cause of neutrophilic leukocytosis during pregnancy?

<p>All of the above</p> Signup and view all the answers

What is the effect of pregnancy on the glomerular filtration rate (GFR)?

<p>It increases by 50%</p> Signup and view all the answers

What is the cause of heartburn and dyspepsia during pregnancy?

<p>Relaxation of the cardiac sphincter</p> Signup and view all the answers

What is the appearance of striae after delivery?

<p>Glistening white</p> Signup and view all the answers

What is the effect of pregnancy on calcium absorption from the intestine and kidneys?

<p>It doubles</p> Signup and view all the answers

What is the effect of pregnancy on the maternal skeleton?

<p>It protects the skeleton from osteoporosis</p> Signup and view all the answers

What is the cause of backache and waddling gait during pregnancy?

<p>Both increased lumbar lordosis and softening of the ligaments</p> Signup and view all the answers

What is the effect of elevated fibrinogen level on Erythrocyte Sedimentation Rate (ESR)?

<p>It increases the ESR value</p> Signup and view all the answers

What is the reason for gestational thrombocytopenia?

<p>Hemodilution and increased platelet consumption</p> Signup and view all the answers

What is the effect of pregnancy on cardiac output (CO)?

<p>It increases by 40-50%</p> Signup and view all the answers

What is the cause of systolic murmur in the apical or pulmonary area during pregnancy?

<p>Decreased blood viscosity and torsion of the great vessels</p> Signup and view all the answers

What is the effect of progesterone on systemic vascular resistance (SVR)?

<p>It decreases SVR</p> Signup and view all the answers

What is the cause of supine hypotension syndrome during late pregnancy?

<p>Compression effect on the inferior vena cava</p> Signup and view all the answers

What is the effect of pregnancy on total metabolism?

<p>It increases total metabolism</p> Signup and view all the answers

What is the effect of insulin secretion on carbohydrate metabolism during pregnancy?

<p>It increases glucose and amino acid levels</p> Signup and view all the answers

What is the main reason behind the physiological changes that occur in a woman's body during pregnancy?

<p>To adapt to the increasing demands of the growing fetus</p> Signup and view all the answers

What is the approximate weight of the uterus in a non-pregnant state?

<p>60 g</p> Signup and view all the answers

What change occurs in the vaginal walls during pregnancy?

<p>They become hypertrophied, edematous, and more vascular</p> Signup and view all the answers

What is responsible for the bluish coloration of the cervix during pregnancy?

<p>Increased vascularity</p> Signup and view all the answers

What is the arrangement of the muscle fibers in the uterus during pregnancy?

<p>Three distinct layers of muscle fibers</p> Signup and view all the answers

Why does ovulation cease during pregnancy?

<p>Due to high levels of oestrogen and progesterone</p> Signup and view all the answers

What is the effect of the apposition of two double curve muscle fibers in the uterus?

<p>They occlude the blood vessels</p> Signup and view all the answers

What is the maximum spiraling of the arteries in the uterus reached at?

<p>20 weeks</p> Signup and view all the answers

What is the main hormone responsible for the pigmentation changes during pregnancy?

<p>Melanocyte stimulating hormone</p> Signup and view all the answers

What is the shape of the uterus beyond 36 weeks of pregnancy?

<p>Spherical</p> Signup and view all the answers

What is the term for the brownish black pigmented area in the midline of the abdomen during pregnancy?

<p>Linea nigra</p> Signup and view all the answers

What is the term for the slightly depressed linear lesions found in the abdominal wall during pregnancy?

<p>Striae gravidarum</p> Signup and view all the answers

What is the effect of the enlarged uterus on the bladder during pregnancy?

<p>It renders the bladder incapable of filling</p> Signup and view all the answers

When does the corpus luteum start to degenerate during pregnancy?

<p>After the 10th week</p> Signup and view all the answers

What is the main reason for the increased size of the breasts during pregnancy?

<p>Marked hypertrophy and proliferation of the ducts</p> Signup and view all the answers

When can colostrum be squeezed out of the breast during pregnancy?

<p>At about 12th week</p> Signup and view all the answers

Study Notes

Physiological Changes During Pregnancy

Genital Organs

  • Vulva: becomes edematous and more vascular, with superficial varicosities appearing in multiparae
  • Vagina: walls become hypertrophied, edematous, and more vascular, with copious, thin, and curdy white secretion
  • Uterus: undergoes enormous growth, weighing 60g in non-pregnant state and 900-1000g at term, with changes in muscles, arrangement of muscle fibers, and increase in supporting fibrous and elastic tissues
  • Cervix: stroma shows hypertrophy and hyperplasia of elastic and connective tissues, with increased vascularity and marked softening
  • Ovary: becomes enlarged due to increased vascularity and edema, with corpus luteum secreting oestrogen, progesterone, and relaxin

Breasts

  • Increase in size, with marked hypertrophy and proliferation of ducts and alveoli
  • Increased vascularity, leading to appearance of bluish veins
  • Nipples become larger, erectile, and deeply pigmented, with hypertrophied Montgomery's tubercles

Cutaneous Changes

  • Pigmentation: selective distribution, with chloasma gravidarum (pregnancy mask) on the face, and linea nigra on the abdomen
  • Striae: slightly depressed linear marks on the abdominal wall, thighs, and breasts, initially pinkish but becoming glistening white after delivery

Weight Gain

  • Total weight gain averages 11kg (24lb) for a healthy woman, with 1kg in the first trimester and 5kg each in the second and third trimesters
  • Increased sodium retention due to estrogen, progesterone, and aldosterone, leading to water retention of 6.5 liters at term

Hematological Changes

  • Blood volume: increases from 6th week, expanding rapidly to 40-50% above non-pregnant level at 30-34 weeks, with a total increase of 1.25 liters
  • RBC mass: increases by 20-30%, with a rise in erythropoietin level and reticulocyte count
  • Hemodilution: due to disproportionate increase in plasma and RBC volume, leading to a fall in hematocrit
  • Neutrophilic leukocytosis: occurs to the extent of 8,000/mm3 and even to 20,000/mm3 in labor, possibly due to estrogen and cortisol levels

Blood Coagulation Factors

  • Pregnancy is a hypercoagulable state, with fibrinogen level raised by 50%
  • Erythrocyte sedimentation rate (ESR) gives a higher value due to rise in fibrinogen and globulin levels and decreased blood viscosity
  • Platelets count: may show a static or slight fall, possibly due to hemodilution and increased platelet consumption

Anatomical Changes

  • Heart: pushed upward and outward with slight rotation to left due to elevation of the diaphragm, with a slight increase in pulse rate and possibility of palpitation and systolic murmur
  • Cardiac output: increases by 40-50% at 30-34 weeks, further increasing during labor and immediately following delivery

General Metabolic Changes

  • Total metabolism: increased due to the needs of the growing fetus and the uterus
  • Pregnancy is an anabolic state, with increased insulin secretion and hyperplasia and hypertrophy of beta cells of the pancreas

Systemic Changes

  • Respiratory system: total lung capacity reduced by 5%, with hyperemia and edema of the nasopharynx, causing nasal stuffiness and epistaxis
  • Urinary system: kidney shows dilatation of the ureters, renal pelvis, and calyces, with increased renal plasma flow and glomerular filtration rate
  • Alimentary system: relaxed cardiac sphincter, causing regurgitation of acid gastric content into the esophagus, leading to chemical esophagitis and heartburn
  • Calcium metabolism and skeletal system: increased demand for calcium by the growing fetus, with increased calcium absorption from the intestine and kidneys, and increased mobility of the pelvic joints due to hormone-induced softening of the ligaments.

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Description

This quiz covers the physiological changes that occur in the genital organs during pregnancy, including changes in the vulva, vagina, uterus, and cervix.

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