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What is the average weight gain during a singleton pregnancy for a healthy woman?
What is the average weight gain during a singleton pregnancy for a healthy woman?
What is the estimated amount of water retained during pregnancy at term?
What is the estimated amount of water retained during pregnancy at term?
When does blood volume start to increase during pregnancy?
When does blood volume start to increase during pregnancy?
What is the percentage increase in RBC mass during pregnancy?
What is the percentage increase in RBC mass during pregnancy?
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What is the advantage of relative hemodilution during pregnancy?
What is the advantage of relative hemodilution during pregnancy?
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What is the effect of progesterone on the respiratory system during pregnancy?
What is the effect of progesterone on the respiratory system during pregnancy?
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What is the state of blood coagulation during pregnancy?
What is the state of blood coagulation during pregnancy?
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What is the cause of neutrophilic leukocytosis during pregnancy?
What is the cause of neutrophilic leukocytosis during pregnancy?
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What is the effect of pregnancy on the glomerular filtration rate (GFR)?
What is the effect of pregnancy on the glomerular filtration rate (GFR)?
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What is the cause of heartburn and dyspepsia during pregnancy?
What is the cause of heartburn and dyspepsia during pregnancy?
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What is the appearance of striae after delivery?
What is the appearance of striae after delivery?
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What is the effect of pregnancy on calcium absorption from the intestine and kidneys?
What is the effect of pregnancy on calcium absorption from the intestine and kidneys?
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What is the effect of pregnancy on the maternal skeleton?
What is the effect of pregnancy on the maternal skeleton?
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What is the cause of backache and waddling gait during pregnancy?
What is the cause of backache and waddling gait during pregnancy?
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What is the effect of elevated fibrinogen level on Erythrocyte Sedimentation Rate (ESR)?
What is the effect of elevated fibrinogen level on Erythrocyte Sedimentation Rate (ESR)?
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What is the reason for gestational thrombocytopenia?
What is the reason for gestational thrombocytopenia?
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What is the effect of pregnancy on cardiac output (CO)?
What is the effect of pregnancy on cardiac output (CO)?
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What is the cause of systolic murmur in the apical or pulmonary area during pregnancy?
What is the cause of systolic murmur in the apical or pulmonary area during pregnancy?
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What is the effect of progesterone on systemic vascular resistance (SVR)?
What is the effect of progesterone on systemic vascular resistance (SVR)?
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What is the cause of supine hypotension syndrome during late pregnancy?
What is the cause of supine hypotension syndrome during late pregnancy?
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What is the effect of pregnancy on total metabolism?
What is the effect of pregnancy on total metabolism?
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What is the effect of insulin secretion on carbohydrate metabolism during pregnancy?
What is the effect of insulin secretion on carbohydrate metabolism during pregnancy?
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What is the main reason behind the physiological changes that occur in a woman's body during pregnancy?
What is the main reason behind the physiological changes that occur in a woman's body during pregnancy?
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What is the approximate weight of the uterus in a non-pregnant state?
What is the approximate weight of the uterus in a non-pregnant state?
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What change occurs in the vaginal walls during pregnancy?
What change occurs in the vaginal walls during pregnancy?
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What is responsible for the bluish coloration of the cervix during pregnancy?
What is responsible for the bluish coloration of the cervix during pregnancy?
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What is the arrangement of the muscle fibers in the uterus during pregnancy?
What is the arrangement of the muscle fibers in the uterus during pregnancy?
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Why does ovulation cease during pregnancy?
Why does ovulation cease during pregnancy?
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What is the effect of the apposition of two double curve muscle fibers in the uterus?
What is the effect of the apposition of two double curve muscle fibers in the uterus?
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What is the maximum spiraling of the arteries in the uterus reached at?
What is the maximum spiraling of the arteries in the uterus reached at?
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What is the main hormone responsible for the pigmentation changes during pregnancy?
What is the main hormone responsible for the pigmentation changes during pregnancy?
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What is the shape of the uterus beyond 36 weeks of pregnancy?
What is the shape of the uterus beyond 36 weeks of pregnancy?
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What is the term for the brownish black pigmented area in the midline of the abdomen during pregnancy?
What is the term for the brownish black pigmented area in the midline of the abdomen during pregnancy?
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What is the term for the slightly depressed linear lesions found in the abdominal wall during pregnancy?
What is the term for the slightly depressed linear lesions found in the abdominal wall during pregnancy?
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What is the effect of the enlarged uterus on the bladder during pregnancy?
What is the effect of the enlarged uterus on the bladder during pregnancy?
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When does the corpus luteum start to degenerate during pregnancy?
When does the corpus luteum start to degenerate during pregnancy?
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What is the main reason for the increased size of the breasts during pregnancy?
What is the main reason for the increased size of the breasts during pregnancy?
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When can colostrum be squeezed out of the breast during pregnancy?
When can colostrum be squeezed out of the breast during pregnancy?
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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.
