Pregnancy Health and EDD Calculation

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Questions and Answers

What is the primary physiological change related to fluid balance during pregnancy?

Fluid retention is the primary physiological change, with total body water increasing by 6.5-8.5 L by the end of pregnancy.

How does the plasma oncotic pressure change during pregnancy, and what is its significance?

Plasma oncotic pressure decreases by 20% during pregnancy due to reduced albumin concentration, affecting fluid distribution in the body.

What contributes to the physiological anemia observed in pregnant women?

Physiological anemia results from a 50% increase in plasma volume, leading to hemodilution and decreases in hemoglobin and hematocrit levels.

During which trimester is the rate of weight gain highest, and what is the average gain per week?

In the second trimester, weight gain averages 0.45 kg per week. Signup and view all the answers

Identify one hematological change that occurs during pregnancy and its physiological implication.

An increase in white blood cell count occurs, which helps enhance immune response during pregnancy. Signup and view all the answers

What is the significance of sodium retention during pregnancy?

Sodium retention contributes to fluid retention, facilitating adequate blood volume expansion necessary for fetal development. Signup and view all the answers

Explain the impact of increased polymorphonuclear leucocytes in the third trimester.

The increase in polymorphonuclear leucocytes aids in the mother's defense against infections during the latter stages of pregnancy. Signup and view all the answers

How does the decrease in serum vitamin B12 affect pregnant women?

The decrease in serum vitamin B12, due to its active transport to the fetus, can impact maternal energy levels and fetal development. Signup and view all the answers

What are the potential cardiovascular effects experienced by patients with heart diseases during the postpartum period?

Patients may experience elevated stroke volume, heart rate, and cardiac output for the first 2 days postpartum. Signup and view all the answers

How does maternal position affect cardiac function during pregnancy?

In the supine position, the enlarged uterus can cause aorto-caval compression, reducing cardiac filling and potentially leading to hypotension. Signup and view all the answers

What are the common changes noted in the ECG of a pregnant woman?

Common findings include sinus tachycardia, premature atrial and ventricular ectopic beats, mild Q wave, ST-segment depression, and left-axis deviation. Signup and view all the answers

What gastrointestinal symptoms are common during pregnancy due to hormonal changes?

Common symptoms include nausea and vomiting, constipation, indigestion, heartburn, and food cravings. Signup and view all the answers

How do the respiratory changes during pregnancy affect lung function?

Pregnancy increases tidal volume by 40% and total pulmonary blood flow while decreasing total lung capacity. Signup and view all the answers

What hormonal changes occur during early pregnancy and what hormones are primarily involved?

There is a dramatic increase in hormones produced by the placenta, including HCG, estrogen, progesterone, and human placental lactogen (HPL). Signup and view all the answers

What renal changes occur during pregnancy, and how do they affect serum levels of substances like urea?

There is a 50% increase in GFR leading to decreased serum levels of substances like urea, creatinine, and uric acid. Signup and view all the answers

What complications related to urinary function can arise due to smooth muscle relaxation and pressure effects in late pregnancy?

Pregnant women may develop hydronephrosis, hydroureter, urine stasis, UTI, and pyelonephritis. Signup and view all the answers

What does the Naegele rule entail for determining a pregnancy's Expected Date of Delivery (EDD)?

The Naegele rule involves adding 280 days (or 40 weeks) to the first day of the last menstrual period. Signup and view all the answers

What skin changes typically occur during pregnancy due to hormonal fluctuations?

Skin changes include increased pigmentation in areas like the face and abdomen, spider naevi, palmar erythema, and the development of striae gravidarum. Signup and view all the answers

How do striae gravidarum develop during pregnancy?

Striae gravidarum develop due to rapid skin stretching and decreased collagen from hormonal changes, resulting in the rupture of subcutaneous fibrous tissue. Signup and view all the answers

What cardiovascular changes occur in a pregnant woman to accommodate the developing fetus?

Cardiovascular changes include increased blood volume, decreased systemic vascular resistance, and increased heart rate. Signup and view all the answers

What is the significance of palmar erythema during pregnancy and what might it indicate?

Palmar erythema is a physiological change associated with high estrogen levels and may signal normal pregnancy progression or underlying liver function changes. Signup and view all the answers

Which hormone's secretion increases due to adrenal cortical hyperplasia during pregnancy, and what effect does it have?

Total plasma cortisol increases due to adrenal cortical hyperplasia, contributing to metabolic changes during pregnancy. Signup and view all the answers

Explain the significance of hCG detection timing in serum versus urine during pregnancy.

hCG can be detected in serum 8-12 days after ovulation and in urine 14-18 days after, making serum tests more sensitive early in pregnancy. Signup and view all the answers

How does total plasma calcium concentration change during pregnancy, and what remains unchanged?

Total plasma calcium decreases during pregnancy, while ionized calcium levels remain unchanged. Signup and view all the answers

What hormonal change contributes to insulin resistance in mid-pregnancy?

Increased cortisol or hPL during mid-pregnancy can lead to insulin resistance. Signup and view all the answers

Describe the physiological effect of relaxin during pregnancy on the skeletal system.

Relaxin hormone causes ligamentous relaxation and softening of collagenous tissues, leading to increased joint laxity. Signup and view all the answers

What is the role of TBG during pregnancy, and how does its concentration change?

TBG concentrations double during pregnancy, affecting the transport of thyroid hormones. Signup and view all the answers

What physiological changes occur in the breasts during pregnancy, and when do they start to manifest?

Breasts increase in size due to gland proliferation and fat deposition, starting around the second month of pregnancy. Signup and view all the answers

How does alkaline phosphatase level change during pregnancy, and what is its source?

Alkaline phosphatase levels increase during pregnancy due to placental alkaline phosphatase. Signup and view all the answers

What are the reasons for the observed increase in platelet count during the first week postpartum?

The increase in platelet count postpartum may be attributed to the physiological changes that restore homeostasis after delivery. Signup and view all the answers

Describe the changes in plasma fibrinogen levels during pregnancy and its relevance.

Plasma fibrinogen levels increase by 50% during pregnancy, contributing to a hypercoagulable state, which helps prevent excessive bleeding during labor. Signup and view all the answers

What are Goodell's sign and Chadwick's sign, and how do they relate to changes during pregnancy?

Goodell's sign indicates softening of the cervix due to increased fluid, while Chadwick's sign refers to the bluish discoloration of the cervix and vagina due to increased vascularity. Signup and view all the answers

Why is the decrease in fibrinolytic activity significant during pregnancy?

The decrease in fibrinolytic activity reduces the risk of hemorrhage during pregnancy and protects the developing fetus by maintaining vascular integrity. Signup and view all the answers

Explain the impact of a growing uterus on the cardiovascular system during pregnancy.

The growing uterus elevates the diaphragm, resulting in breathlessness, and pushes the heart upwards and to the left, potentially causing left ventricle hypertrophy. Signup and view all the answers

What happens to cardiac output after delivery, and what is the physiological mechanism behind this change?

After delivery, cardiac output can increase by 10-20% due to autotransfusion from the empty uterus into the maternal circulation. Signup and view all the answers

How does the viscosity of cervical mucus change during pregnancy and why is this significant?

The cervical mucus becomes more viscous and forms a mucus plug that acts as a barrier against infections. Signup and view all the answers

Discuss the effects of pregnancy on heart sounds and their clinical significance.

Pregnancy is associated with increased loudness of the first and second heart sounds, and the third heart sound may be audible, reflecting hemodynamic changes. Signup and view all the answers

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Study Notes

Naegele's rule

Used to estimate a woman's expected date of delivery (EDD)
A common and useful method for estimating EDD
Add 7 days to the first day of the last menstrual period (LMP)
Subtract 3 months
Add 1 year if required

Nadia's EDD

Nadia's LMP was January 1, 2016,
Adding 7 days: January 8, 2016,
Subtracting 3 months: October 8, 2016
Nadia's estimated EDD is October 8, 2016

Cardiovascular Changes during Pregnancy

The heart rate increases, generally by about 10-15 beats/minute
Stroke volume (amount of blood pumped with each beat) increases
This increase in stroke volume and heart rate leads to a significant increase in cardiac output (total blood pumped by the heart per minute) by about 40%
Total blood volume also increases by about 40%
The growing uterus, particularly in the supine position, can compress the vena cava and aorta, leading to decreased blood flow to the heart and a drop in blood pressure (supine hypotension)
These changes reflect the body's effort to supply adequate blood flow to the growing fetus and placenta.
These cardiovascular changes generally return to normal after delivery, but can take several days.

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