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Pregnancy Physiology Quiz
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Pregnancy Physiology Quiz

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@HonorableXenon

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Questions and Answers

What is primarily responsible for the increase in cardiac output during pregnancy?

  • Increased heart rate and increased stroke volume (correct)
  • Increased stroke volume and decreased heart rate
  • Increased heart rate and decreased stroke volume
  • Decreased heart rate and decreased stroke volume

    • What condition is associated with approximately 5% of women at term during pregnancy?

  • Supine hypotension syndrome (correct)
  • Hepatic dysfunction
  • Hypercoagulable state
  • Gastroesophageal reflux disease

    • What happens to renal plasma flow and glomerular filtration rate during pregnancy?

  • Both remain unchanged
  • Both increase (correct)
  • Only renal plasma flow decreases
  • Both decrease significantly

    • Which of the following changes in the hepatic system is noted during pregnancy?

    <p>Decrease in serum pseudcholinesterase activity</p> Signup and view all the answers

    Which factor does NOT contribute to the hypercoagulable state associated with pregnancy?

    <p>Decrease in factor VIII concentrations</p> Signup and view all the answers

    What is the average increase in blood volume during pregnancy?

    <p>1000 – 1500 mL</p> Signup and view all the answers

    What happens to the minimum alveolar concentration (MAC) during pregnancy?

    <p>Decreases by as much as 40%</p> Signup and view all the answers

    Which physiological change occurs in the respiratory system during pregnancy?

    <p>Decrease in functional residual capacity</p> Signup and view all the answers

    Why does hyperventilation occur during pregnancy?

    <p>To slightly increase Pao2</p> Signup and view all the answers

    How does the body compensate for respiratory alkalosis during pregnancy?

    <p>Decrease in plasma bicarbonate concentration</p> Signup and view all the answers

    Which type of breathing is favored during pregnancy?

    <p>Thoracic breathing</p> Signup and view all the answers

    What is the average blood loss during a vaginal delivery?

    <p>400 – 500 mL</p> Signup and view all the answers

    What physiological change leads to dilutional anemia during pregnancy?

    <p>Increased plasma volume</p> Signup and view all the answers

    What is the term for the state of carrying and developing a fetus within the female body?

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

    The first trimester of pregnancy lasts for six months.

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

    During pregnancy, how much does the minimum alveolar concentration (MAC) decrease by at term?

    <p>40%</p> Signup and view all the answers

    At term, pregnant women experience an increase in blood volume by _____ mL.

    <p>1000 – 1500</p> Signup and view all the answers

    What happens to functional residual capacity (FRC) during pregnancy?

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

    Match the physiological changes with the corresponding systems:

    <p>Respiratory system = Increase in tidal volume and respiratory rate Cardiovascular system = Increase in blood volume CNS = Enhanced sensitivity to local anesthesia Diaphragm = Elevation during pregnancy</p> Signup and view all the answers

    Pregnant women experience a compensatory increase in plasma bicarbonate concentration to prevent respiratory alkalosis.

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

    What type of breathing is favored during pregnancy?

    <p>Thoracic breathing</p> Signup and view all the answers

    The average blood loss during a cesarean section is approximately _____ mL.

    <p>800 – 1000</p> Signup and view all the answers

    What physiological change is primarily responsible for dilutional anemia during pregnancy?

    <p>Increase in plasma volume</p> Signup and view all the answers

    What causes supine hypotension syndrome in pregnant women?

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

    Renal plasma flow and glomerular filtration rate decrease during pregnancy.

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

    What is the percentage increase in stroke volume during pregnancy?

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

    Pregnancy is associated with a __________ state, which means increased tendency for blood to clot.

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

    Match the physiological changes during pregnancy with their corresponding effects:

    <p>Increase in stroke volume = Increased cardiac output Decreased serum pseudcholinesterase = Altered drug metabolism Hypercoagulable state = Increased risk of thrombosis Decreased plasma osmolality = Body fluid adaptation</p> Signup and view all the answers

    Which of the following is NOT affected by pregnancy?

    <p>Hepatic blood flow</p> Signup and view all the answers

    Gastroesophageal reflux and esophagitis are uncommon during pregnancy.

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

    What is the percentage increase in heart rate during pregnancy?

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

    In pregnancy, concentrations of factors VII, VIII, IX, X, and XII __________.

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

    What is a common effect of opioid and anticholinergic drugs during pregnancy?

    <p>Reduce lower esophageal sphincter pressure</p> Signup and view all the answers

    What percentage of increase in stroke volume is noted at term during pregnancy?

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

    Supine hypotension syndrome affects around 10% of women at term during pregnancy.

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

    What causes renal plasma flow and glomerular filtration rate to increase during pregnancy?

    <p>Hormonal changes and increased blood volume</p> Signup and view all the answers

    During pregnancy, the plasma osmolality decreases by _____ mOsm/kg.

    <p>8-10</p> Signup and view all the answers

    Match the following systems with their physiological change during pregnancy:

    <p>Cardiovascular System = Increased heart rate Renal System = Increased glomerular filtration rate Gastrointestinal System = Increased gastroesophageal reflux Hematological System = Hypercoagulable state</p> Signup and view all the answers

    Which of the following substances increases during pregnancy, contributing to the hypercoagulable state?

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

    The overall hepatic function and blood flow significantly increase during pregnancy.

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

    The inferior vena cava can be compressed by the _____ during pregnancy, leading to supine hypotension syndrome.

    <p>gravid uterus</p> Signup and view all the answers

    What common condition related to the gastrointestinal system can occur during pregnancy?

    <p>Gastroesophageal reflux</p> Signup and view all the answers

    What decrease in serum pseudocolinesterase activity is noted at term?

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

    What is the primary reason for the increase in tidal volume during pregnancy?

    <p>Increased metabolic demand</p> Signup and view all the answers

    Functional residual capacity (FRC) increases during pregnancy.

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

    What physiological change helps prevent significant respiratory alkalosis during pregnancy?

    <p>Decreased plasma bicarbonate concentration</p> Signup and view all the answers

    During pregnancy, blood volume increases by approximately ______ mL.

    <p>1000-1500</p> Signup and view all the answers

    Match the physiological changes with their corresponding changes in the body:

    <p>Increased heart rate = Increased cardiac output Increased minute ventilation = Increased oxygen consumption Decreased FRC = Preferred thoracic breathing Dilutional anemia = Increased plasma volume</p> Signup and view all the answers

    During labor, which of the following is a common average blood loss for vaginal delivery?

    <p>400-500 mL</p> Signup and view all the answers

    Pregnant women have a decreased sensitivity to local anesthesia during regional analgesia.

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

    What term describes the increased tendency for blood to clot during pregnancy?

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

    During pregnancy, the minimum alveolar concentration (MAC) decreases by as much as ________%.

    <p>40</p> Signup and view all the answers

    What happens to the hemoglobin concentration in pregnant women?

    <p>It remains greater than 11 g/dL</p> Signup and view all the answers

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

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

    During pregnancy, there is a decrease in glomerular filtration rate.

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

    What percentage increase in stroke volume is noted during pregnancy?

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

    The __________ is often noted in echocardiography during pregnancy due to cardiac adaptations.

    <p>myocardial hypertrophy</p> Signup and view all the answers

    Match the following conditions with their related physiological changes:

    <p>Supine hypotension syndrome = Compression of inferior vena cava Gastroesophageal reflux = Lower esophageal sphincter pressure reduction Increased blood coagulability = Higher levels of fibrinogen Decreased serum pseudocolinesterase = 20-30% at term</p> Signup and view all the answers

    What is the effect of opioid and anticholinergic drugs on the gastrointestinal system during pregnancy?

    <p>Facilitate gastroesophageal reflux</p> Signup and view all the answers

    Plasma osmolality decreases by 5-8 mOsm/kg during pregnancy.

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

    What happens to the concentrations of factors VII, VIII, IX, X, and XII during pregnancy?

    <p>They increase.</p> Signup and view all the answers

    Approximately __________ of women at term develop the supine hypotension syndrome.

    <p>5%</p> Signup and view all the answers

    What change occurs in creatinine levels during pregnancy?

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

    Which physiological change occurs in the cardiovascular system during pregnancy?

    <p>Increased cardiac output</p> Signup and view all the answers

    Functional residual capacity (FRC) increases during pregnancy.

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

    What is the average increase in blood volume during pregnancy?

    <p>1000 - 1500 mL</p> Signup and view all the answers

    At term, pregnant women typically have a hemoglobin concentration greater than ______ g/dL.

    <p>11</p> Signup and view all the answers

    Match the following changes with their physiological systems:

    <p>Increased minute ventilation = Respiratory system Increased plasma volume = Cardiovascular system Decreased FRC = Respiratory system Decreased sensitivity to local anesthesia = Nervous system</p> Signup and view all the answers

    What happens to PaCO2 levels during pregnancy?

    <p>Decreases to 28 – 32 mmHg</p> Signup and view all the answers

    The average blood loss during a cesarean section is less than that during a vaginal delivery.

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

    What physiological adaptation helps prevent significant respiratory alkalosis during pregnancy?

    <p>Compensatory decrease in plasma bicarbonate concentration</p> Signup and view all the answers

    Pregnancy is divided into three trimesters, with each trimester lasting ______ months.

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

    What is the average blood volume in pregnant women at term?

    <p>90 ml/kg</p> Signup and view all the answers

    What is the percentage increase in heart rate during pregnancy?

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

    Supine hypotension syndrome affects around 5% of women at term.

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

    What is the primary reason for the increase in stroke volume during pregnancy?

    <p>Increased blood volume and enlarged cardiac chambers.</p> Signup and view all the answers

    Approximately _____ of women at term develop supine hypotension syndrome.

    <p>5%</p> Signup and view all the answers

    Match the changes in the cardiovascular system during pregnancy:

    <p>Heart Rate = 20% increase Stroke Volume = 30% increase Cardiac Output = 40% increase Myocardial Hypertrophy = Noted on echocardiography</p> Signup and view all the answers

    Which hormone is linked to the hypercoagulable state during pregnancy?

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

    Gastroesophageal reflux is uncommon during pregnancy.

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

    What happens to plasma osmolality during pregnancy?

    <p>Decreases by 8-10 mOsm/kg.</p> Signup and view all the answers

    Fibrinogen concentrations increase during pregnancy, contributing to a __________ state.

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

    Match the substances with their changes during pregnancy:

    <p>Renal Plasma Flow = Increases Glomerular Filtration Rate = Increases Blood Urea Nitrogen = Decreases Creatinine = Decreases</p> Signup and view all the answers

    What is the average increase in blood volume during pregnancy?

    <p>1000 – 1500 mL</p> Signup and view all the answers

    Functional residual capacity (FRC) decreases during pregnancy.

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

    What happens to tidal volume during pregnancy?

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

    At term, the minimum alveolar concentration (MAC) decreases by _____%.

    <p>40</p> Signup and view all the answers

    Match the physiological changes with the corresponding systems:

    <p>CNS = Decreased MAC Respiratory = Increased tidal volume Cardiovascular = Increased blood volume Gastrointestinal = Gastroesophageal reflux</p> Signup and view all the answers

    What compensatory mechanism prevents significant respiratory alkalosis during pregnancy?

    <p>Compensatory decrease in plasma bicarbonate concentration</p> Signup and view all the answers

    Cardiac output and blood volume do not change significantly during pregnancy.

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

    What is the average blood loss during a cesarean section?

    <p>800 – 1000 mL</p> Signup and view all the answers

    Oxygen consumption and minute ventilation _____ during pregnancy.

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

    Which of the following statements about hemoglobin concentration during pregnancy is correct?

    <p>It usually remains greater than 11 g/dL</p> Signup and view all the answers

    What is the percentage increase in heart rate during pregnancy?

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

    Supine hypotension syndrome occurs in approximately 5% of women at term during pregnancy.

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

    What physiological state is associated with an increased tendency for blood to clot during pregnancy?

    <p>hypercoagulable state</p> Signup and view all the answers

    The increase in cardiac output during pregnancy is primarily due to increases in heart rate and __________.

    <p>stroke volume</p> Signup and view all the answers

    Match the cardiovascular changes with their corresponding percentage increase during pregnancy:

    <p>Heart Rate = 20% Stroke Volume = 30% Cardiac Output = 40%</p> Signup and view all the answers

    What causes supine hypotension syndrome in pregnant women?

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

    Renal plasma flow and glomerular filtration rate decrease during pregnancy.

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

    What condition related to the gastrointestinal system is common during pregnancy?

    <p>Gastroesophageal reflux</p> Signup and view all the answers

    During pregnancy, concentrations of factors VII, VIII, IX, X, and XII __________.

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

    What physiological change is noted in the hepatic system during pregnancy?

    <p>Decrease in enzyme activity</p> Signup and view all the answers

    What physiological change occurs in the cardiovascular system during pregnancy?

    <p>Increased cardiac output and blood volume</p> Signup and view all the answers

    Functional residual capacity (FRC) increases during pregnancy.

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

    How much does the average blood volume increase during pregnancy?

    <p>1000 to 1500 mL</p> Signup and view all the answers

    During pregnancy, women may experience _____, a condition associated with decreased functional residual capacity.

    <p>rapid oxygen desaturation</p> Signup and view all the answers

    Match the following physiological changes with their corresponding outcomes during pregnancy:

    <p>Increased minute ventilation = Elevated tidal volume Decreased PaCO2 = Respiratory alkalosis prevention Increased plasma volume = Dilutional anemia Enhanced sensitivity to local anesthesia = Regional anesthesia effectiveness</p> Signup and view all the answers

    What is the average blood loss during a vaginal delivery?

    <p>400 - 500 mL</p> Signup and view all the answers

    At term, the minimum alveolar concentration (MAC) remains unchanged during pregnancy.

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

    What type of breathing is favored during pregnancy?

    <p>Thoracic breathing</p> Signup and view all the answers

    During pregnancy, the concentration of hemoglobin usually remains greater than _____ g/dL.

    <p>11</p> Signup and view all the answers

    Match the following physiological effects with their corresponding organ systems during pregnancy:

    <p>Cardiovascular = Increased blood volume Respiratory = Decreased functional residual capacity Endocrine = Hormonal changes Nervous = Enhanced sensitivity to anesthesia</p> Signup and view all the answers

    What is the approximate increase in heart rate at term during pregnancy?

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

    Supine hypotension syndrome affects approximately 5% of women at term during pregnancy.

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

    What happens to plasma osmolality during pregnancy?

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

    During pregnancy, a __________ state is associated with an increased tendency for blood to clot.

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

    Match the following systems with their physiological changes during pregnancy:

    <p>Cardiovascular System = Cardiac chambers enlarge Renal System = Increase in renal plasma flow Gastrointestinal System = Gastroesophageal reflux Hematological System = Increase in fibrinogen levels</p> Signup and view all the answers

    Which factor is likely to decrease during pregnancy?

    <p>Creatinine levels</p> Signup and view all the answers

    Serum pseudocolinesterase activity increases at term during pregnancy.

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

    What is a common gastrointestinal issue experienced during pregnancy?

    <p>gastroesophageal reflux</p> Signup and view all the answers

    Factors VII, VIII, IX, X, and XII __________ during pregnancy.

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

    What is the percentage increase in stroke volume noted at term during pregnancy?

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

    What is the range of decrease in minimum alveolar concentration (MAC) by term during pregnancy?

    <p>30% - 40%</p> Signup and view all the answers

    Functional residual capacity (FRC) increases during pregnancy.

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

    What compensatory mechanism prevents significant respiratory alkalosis during pregnancy?

    <p>A decrease in plasma bicarbonate concentration</p> Signup and view all the answers

    During pregnancy, the average blood volume increases by ______ mL.

    <p>1000 – 1500</p> Signup and view all the answers

    Match the physiological changes with their corresponding effects during pregnancy:

    <p>Increase in tidal volume = Enhances oxygen delivery Decrease in FRC = Promotes rapid oxygen desaturation Increase in blood volume = May lead to dilutional anemia Elevated diaphragm = Compensated by chest expansion</p> Signup and view all the answers

    Which of the following is a common average blood loss during vaginal delivery?

    <p>400 – 500 mL</p> Signup and view all the answers

    Oxygen consumption and minute ventilation decrease during pregnancy.

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

    What is the average hemoglobin concentration during pregnancy that usually remains greater than?

    <p>11 g/dL</p> Signup and view all the answers

    Pregnant women's sensitivity to local anesthesia during regional anesthesia is _______ compared to non-pregnant women.

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

    What happens to inspiratory reserve volume during pregnancy?

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

    Pregnancy is divided into two trimesters.

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

    Functional residual capacity (FRC) decreases up to 20% at term during pregnancy.

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

    Cardiac output and blood volume decrease during pregnancy to meet metabolic demands.

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

    Isolation of the diaphragm is compensated by a decrease in the anteroposterior diameter of the chest.

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

    Plasma bicarbonate concentration increases to prevent respiratory alkalosis during pregnancy.

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

    Hemoglobin concentration in pregnant women usually remains below 11 g/dL.

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

    Pregnant women experience enhanced sensitivity to local anesthesia during regional anesthesia.

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

    The average blood loss during vaginal delivery is greater than that of a cesarean section.

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

    Tidal volume increases during pregnancy.

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

    The term for the state of carrying a developing fetus is gestation.

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

    Cardiac output increases by 40% during pregnancy primarily due to increases in heart rate and stroke volume.

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

    Approximately 5% of women experience supine hypotension syndrome at term.

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

    Renal plasma flow and glomerular filtration rate decrease during pregnancy.

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

    Fibrinogen concentrations decrease during pregnancy, increasing the risk of bleeding.

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

    Gastroesophageal reflux and esophagitis are commonly experienced by many pregnant women.

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

    There is a significant increase in serum pseudocolinesterase activity at term during pregnancy.

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

    Plasma osmolality decreases by 8-10 mOsm/kg during pregnancy.

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

    Pregnancy is associated with a hypo-coagulable state, reducing the risk of thrombosis.

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

    Opioid and anticholinergic drugs may delay gastric emptying during pregnancy.

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

    Stroke volume increases by 40% at term during pregnancy.

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

    Cardiac output increases by approximately 40% at term due to a 20% increase in heart rate and a 30% increase in stroke volume.

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

    Supine hypotension syndrome affects approximately 10% of women at term during pregnancy.

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

    During pregnancy, renal plasma flow and glomerular filtration rate both decrease.

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

    Factors VII, VIII, IX, X, and XII decrease during pregnancy, contributing to a hypercoagulable state.

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

    Pregnant women may experience gastroesophageal reflux and esophagitis as common conditions.

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

    The overall hepatic function and blood flow significantly increase during pregnancy.

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

    Plasma osmolality decreases by 8 - 10 mOsm/kg during pregnancy.

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

    Creatinine levels tend to increase during pregnancy.

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

    Myocardial hypertrophy is frequently observed in pregnant women through echocardiography.

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

    Opioid and anticholinergic drugs have no effect on the lower esophageal sphincter pressure.

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

    Pregnancy is divided into four trimesters.

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

    During pregnancy, the minimum alveolar concentration (MAC) decreases by up to 40% at term.

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

    Blood volume during pregnancy typically increases by more than 2000 mL.

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

    Thoracic breathing is less favored than abdominal breathing during pregnancy.

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

    Functional residual capacity (FRC) decreases by up to 20% at term during pregnancy.

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

    Hemoglobin concentration typically remains below 11 g/dL during pregnancy.

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

    Pregnancy causes a significant increase in plasma bicarbonate concentration.

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

    The average blood loss during cesarean delivery is around 400-500 mL.

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

    Oxygen consumption and minute ventilation both decrease during pregnancy.

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

    Pregnant women experience decreased sensitivity to local anesthesia during regional anesthesia.

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

    What is the effect of pregnancy on oxygen consumption and minute ventilation?

    <p>Both oxygen consumption and minute ventilation increase during pregnancy.</p> Signup and view all the answers

    How does plasma volume change during pregnancy and what effect does it have?

    <p>Plasma volume increases by about 55%, leading to dilutional anemia.</p> Signup and view all the answers

    What happens to the functional residual capacity (FRC) in pregnant women?

    <p>Functional residual capacity decreases by up to 20% at term.</p> Signup and view all the answers

    Why is there an increased sensitivity to local anesthesia during pregnancy?

    <p>Pregnant patients exhibit enhanced sensitivity due to physiological changes.</p> Signup and view all the answers

    How does the respiratory system adapt to prevent respiratory alkalosis during pregnancy?

    <p>A compensatory decrease in plasma bicarbonate concentration occurs.</p> Signup and view all the answers

    What physiological change is responsible for the average blood loss during vaginal delivery?

    <p>The average blood loss of 400-500 mL is due to increased blood volume and vascular changes.</p> Signup and view all the answers

    Explain the role of increased cardiac output during pregnancy.

    <p>Increased cardiac output meets the metabolic demands of the mother and fetus.</p> Signup and view all the answers

    What happens to the diaphragm during pregnancy, and how is this compensated?

    <p>The diaphragm is elevated, compensated by an increase in the anteroposterior diameter of the chest.</p> Signup and view all the answers

    How does pregnancy affect the minute ventilation in terms of its components?

    <p>Minute ventilation increases due to rises in tidal volume and respiratory rate.</p> Signup and view all the answers

    How does myocardial hypertrophy affect cardiac function during pregnancy?

    <p>Myocardial hypertrophy leads to increased cardiac efficiency, helping to accommodate the higher blood volume and output required during pregnancy.</p> Signup and view all the answers

    What physiological factor contributes to the increase in stroke volume during pregnancy?

    <p>Increased blood volume and improved myocardial contractility contribute to the enhanced stroke volume during pregnancy.</p> Signup and view all the answers

    Explain how supine hypotension syndrome develops in pregnant women.

    <p>Supine hypotension syndrome occurs when the gravid uterus compresses the inferior vena cava, reducing venous return and causing a drop in blood pressure.</p> Signup and view all the answers

    What changes occur in the renal system during pregnancy?

    <p>During pregnancy, there is an increase in renal plasma flow and glomerular filtration rate, leading to lower levels of creatinine and blood urea nitrogen.</p> Signup and view all the answers

    Describe the impact of pregnancy on the lower esophageal sphincter pressure.

    <p>Pregnancy decreases the lower esophageal sphincter pressure, often leading to gastroesophageal reflux and esophagitis.</p> Signup and view all the answers

    How does the activity of serum pseudocolinesterase change at term during pregnancy?

    <p>Serum pseudocolinesterase activity decreases by 20-30% at term during pregnancy.</p> Signup and view all the answers

    What hematological changes are associated with pregnancy?

    <p>Pregnancy is associated with a hypercoagulable state, characterized by increased levels of fibrinogen and coagulation factors VII, VIII, IX, X, and XII.</p> Signup and view all the answers

    Why might plasma osmolality decrease during pregnancy?

    <p>Plasma osmolality decreases by 8-10 mOsm/kg due to increased plasma volume and hemodilution.</p> Signup and view all the answers

    What cardiac changes are typically observed at term in a pregnant woman?

    <p>At term, a pregnant woman typically exhibits an increase in both heart rate and stroke volume, enhancing overall cardiac output.</p> Signup and view all the answers

    How does pregnancy impact hepatic function?

    <p>Overall hepatic function and blood flow remain unchanged during pregnancy, although there is a notable decrease in serum pseudocolinesterase activity.</p> Signup and view all the answers

    Study Notes

    Pregnancy Trimesters

    • Pregnancy is divided into three trimesters, each lasting three months.

    Physiological Changes During Pregnancy

    • Pregnancy impacts most organ systems in the body.
    • Changes are primarily adaptive and beneficial for the mother in managing the stresses of pregnancy, labor, and delivery.

    Central Nervous System

    • The minimum alveolar concentration (MAC) for anesthetics decreases during pregnancy, reaching up to a 40% reduction at term.
    • Pregnant patients show heightened sensitivity to local anesthetics during regional anesthesia and analgesia.

    Respiratory System

    • Oxygen consumption and minute ventilation increase throughout pregnancy.
    • Tidal volume, respiratory rate, and inspiratory reserve volume also increase.
    • Partial pressure of carbon dioxide (PaCO2) decreases to 28-32 mmHg.
    • Thoracic breathing becomes more prevalent than abdominal breathing.
    • Functional residual capacity (FRC) decreases up to 20% at term.
    • The combination of decreased FRC and increased oxygen consumption leads to rapid oxygen desaturation during periods of apnea.
    • Significant respiratory alkalosis is prevented by a compensatory decrease in plasma bicarbonate concentration.
    • Hyperventilation might slightly increase partial pressure of oxygen (PaO2).
    • Elevation of the diaphragm is compensated by an increase in the anteroposterior diameter of the chest.

    Cardiovascular System

    • Cardiac output and blood volume increase to meet the metabolic demands of both the mother and fetus.
    • Plasma volume increases by 55%, exceeding the 45% increase in red cell mass, resulting in dilutional anemia and reduced blood viscosity.
    • Hemoglobin concentration usually remains above 11 g/dL.
    • At term, blood volume increases by 1,000 to 1,500 mL in most women, reaching a total body volume of 90 mL/kg.
    • Average blood loss during vaginal delivery is 400 to 500 mL compared to 800 to 1,000 mL for a cesarean section.
    • Blood volume does not return to normal until 1 to 2 weeks after delivery.
    • The increase in cardiac output (40% at term) is attributed to increases in heart rate (20%) and stroke volume (30%).
    • Cardiac chambers enlarge, and myocardial hypertrophy is often observed on echocardiography.
    • Approximately 5% of women at term develop supine hypotension syndrome, caused by complete or near-complete compression of the inferior vena cava by the gravid uterus.

    Renal & Gastrointestinal System

    • Renal plasma flow and glomerular filtration rate increase during pregnancy.
    • Creatinine and blood urea nitrogen levels may decrease.
    • Plasma osmolality decreases by 8 to 10 mOsm/kg.
    • Gastroesophageal reflux and esophagitis are common during pregnancy.
    • Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, potentially facilitating gastroesophageal reflux and delaying gastric emptying.

    Hepatic System

    • Overall hepatic function and blood flow remain unchanged.
    • There is a 20 to 30% decrease in serum pseudocholinesterase activity at term.

    Hematological System

    • Pregnancy is associated with a hypercoagulable state.
    • Fibrinogen and concentrations of factors VII, VIII, IX, X, and XII all increase.

    Pregnancy

    • State of carrying and developing a fetus within the female body
    • Divided into three trimesters
      • First trimester: first three months
      • Second trimester: second three months
      • Third trimester: last three months
    • Impacts most organ systems, many changes are adaptive and beneficial for the mother

    CNS

    • Minimum alveolar concentration (MAC) decreases during pregnancy
      • Decreases by as much as 40% at term
    • Pregnant patients experience enhanced sensitivity to local anesthesia during regional anesthesia and analgesia

    Respiratory System

    • Oxygen consumption and minute ventilation increase during pregnancy
    • Tidal volume, respiratory rate, and inspiratory reserve volume also increase
    • PaCO2 decreases to 28 - 32 mmHg
    • Thoracic breathing is favored over abdominal breathing
    • Functional residual capacity (FRC) decreases up to 20% at term
      • The combination of decreased FRC and increased O2 consumption leads to rapid oxygen desaturation during periods of apnea
    • Significant respiratory alkalosis is prevented by a compensatory decrease in plasma bicarbonate concentration
    • Hyperventilation may slightly increase PaO2
    • Elevation of the diaphragm is compensated by an increase in the anteroposterior diameter of the chest

    Cardiovascular System

    • Cardiac output and blood volume increase to meet maternal and fetal metabolic demands
    • An increase in plasma volume (55%) exceeds the increase in red cell mass (45%)
      • Produces dilutional anemia and reduced blood viscosity
    • Hemoglobin concentration typically remains greater than 11 g/dL
    • At term:
      • Blood volume increases by 1,000 - 1,500 mL in most women
      • Total body volume reaches 90 mL/kg
    • Average blood loss during vaginal delivery is 400 - 500 mL compared to 800 - 1,000 mL for a cesarean section
    • Blood volume does not return to normal until 1 - 2 weeks after delivery
    • The increase in cardiac output (40% at term) is due to increases in heart rate (20%) and stroke volume (30%)
    • Cardiac chambers enlarge and myocardial hypertrophy is often observed on echocardiography
    • Approximately 5% of women at term develop the supine hypotension syndrome
      • The cause of this syndrome appears to be complete or near-complete occlusion of the inferior vena cava by the gravid uterus

    Renal & Gastrointestinal System

    • Renal plasma flow and glomerular filtration rate increase during pregnancy
    • Creatinine and blood urea nitrogen may decrease
    • Plasma osmolality decreases by 8 - 10 mOsm/kg
    • Gastroesophageal reflux and esophagitis are common during pregnancy
    • Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, may facilitate gastroesophageal reflux and delay gastric emptying

    Hepatic System

    • Overall hepatic function and blood flow remain unchanged
    • A 20 - 30% decrease in serum pseudocholinesterase activity at term

    Hematological System

    • Pregnancy is associated with a hypercoagulable state
    • Fibrinogen and concentrations of factors VII, VIII, IX, X, and XII all increase

    Pregnancy

    • The state of carrying and developing a fetus within the female body.
    • Divided into three trimesters:
      • First trimester: The first three months of pregnancy.
      • Second trimester: The second three months of pregnancy.
      • Third trimester: The last three months of pregnancy.
    • Affects most organ systems.
    • Many physiological changes are adaptive and helpful for the mother to tolerate the stresses of pregnancy, labor, and delivery.

    CNS

    • Minimum alveolar concentration (MAC) decreases during pregnancy, by as much as 40% at term.
    • Pregnant patients have enhanced sensitivity to local anesthesia during regional anesthesia and analgesia.

    Respiratory System

    • Oxygen consumption and minute ventilation increase during pregnancy.
    • Tidal volume, respiratory rate, and inspiratory reserve volume also increase.
    • PaCO2 decreases to 28 – 32 mmHg.
    • Thoracic breathing is favored over abdominal breathing.
    • Functional residual capacity (FRC) decreases up to 20% at term.
    • The combination of decreased FRC and increased oxygen consumption promotes rapid oxygen desaturation during periods of apnea.
    • Significant respiratory alkalosis is prevented by a compensatory decrease in plasma bicarbonate concentration.
    • Hyperventilation may slightly increase PaO2.
    • Elevation of the diaphragm is compensated by an increase in the anteroposterior diameter of the chest.

    Cardiovascular System

    • Cardiac output and blood volume increase to meet maternal and fetal metabolic demands.
    • An increase (55%) in plasma volume in excess of increased red cell mass (45%) produces dilutional anemia and reduces blood viscosity.
    • Hemoglobin concentration usually remains greater than 11 g/dL.
    • At term:
      • Blood volume has increased by 1000 – 1500 mL in most women.
      • Total body volume reaches 90 mL/kg.
    • Average blood loss during vaginal delivery is 400 – 500 mL, compared with 800 – 1000 mL for a Cesarean section.
    • Blood volume does not usually return to normal until 1 – 2 weeks after delivery.
    • The increase in cardiac output (40% at term) is due to increases in heart rate (20%) and stroke volume (30%).
    • Cardiac chambers enlarge, and myocardial hypertrophy is often noted on echocardiography.
    • Approximately 5% of women at term develop the supine hypotension syndrome.
    • The cause of this syndrome appears to be complete or near-complete occlusion of the inferior vena cava by the gravid uterus.

    Renal & Gastrointestinal System

    • Renal plasma flow and glomerular filtration rate increase during pregnancy.
    • Creatinine and blood urea nitrogen may decrease.
    • Plasma osmolality decreases by 8 – 10 mOsm/kg.
    • Gastroesophageal reflux and esophagitis are common during pregnancy.
    • Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, which may facilitate gastroesophageal reflux and delay gastric emptying.

    Hepatic System

    • Overall hepatic function and blood flow are unchanged.
    • A 20 – 30% decrease in serum pseudocholinesterase activity at term.

    Hematological System

    • Pregnancy is associated with a hypercoagulable state.
    • Fibrinogen and concentrations of factors VII, VIII, IX, X, and XII all increase.

    Pregnancy

    • The state of carrying a developing fetus within the female body
    • Divided into three trimesters: first, second, and third trimester
    • The duration of each trimester is three months
    • Pregnancy greatly affects most organ systems, with many changes appearing to be adaptive to pregnancy, labor, and delivery

    Central Nervous System (CNS)

    • The minimum alveolar concentration (MAC) decreases during pregnancy by as much as 40% at term
    • Pregnant patients are more sensitive to local anesthesia during regional anesthesia and analgesia

    Respiratory System

    • Oxygen consumption and minute ventilation increase during pregnancy
    • Tidal volume, respiratory rate, and inspiratory reserve volume also increase
    • PaCO2 decreases to 28 – 32 mmHg
    • Thoracic breathing is favored over abdominal breathing during pregnancy
    • Functional residual capacity (FRC) decreases up to 20% at term
    • Increased oxygen consumption combined with decrease in FRC promotes rapid oxygen desaturation during apnea
    • Significant respiratory alkalosis is prevented by a compensatory decrease in plasma bicarbonate concentration
    • Hyperventilation may increase PaO2 slightly
    • Elevation of the diaphragm is compensated by an increase in the anteroposterior diameter of the chest

    Cardiovascular System

    • Cardiac output and blood volume increase to meet maternal and fetal metabolism demands
    • Plasma volume increases by 55% while the increase in red cell mass is 45%. This results in dilutional anemia and reduced blood viscosity
    • Despite the reduced blood viscosity, Hb concentration usually remains greater than 11g/dL
    • At term:
      • Blood volume increases by 1000 - 1500 mL in most women
      • Total body volume reaches 90 ml/kg
      • Average blood loss during vaginal delivery is 400 - 500 mL while Cesarean section is 800-1000 mL
      • Blood volume does not return to normal until 1-2 weeks after delivery
    • The increase in cardiac output (40% at term) is due to increases in heart rate (20%) and stroke volume (30%)
    • Cardiac chambers enlarge and myocardial hypertrophy are often noted on echocardiogram
    • Approximately 5% of women at term develop the supine hypotension syndrome caused by complete or near-complete compression of the inferior vena cava by the gravid uterus

    Renal & Gastrointestinal System

    • Renal plasma flow and glomerular filtration rate increase during pregnancy
    • Creatinine and blood urea nitrogen may decrease
    • Plasma osmolality decreases by 8-10 mOsm/kg
    • Gastroesophageal reflux and esophagitis are common during pregnancy
    • Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure which may facilitate gastroesophageal reflux and delay gastric emptying

    Hepatic System

    • Overall hepatic function and blood flow are unchanged
    • A 20-30% decrease in serum pseudocholinesterase activity at term

    Hematological System

    • Pregnancy is associated with a hypercoagulable state
    • Fibrinogen and concentrations of factors VII, VIII, IX, X, XII all increase

    Pregnancy

    • Pregnancy is the state of carrying and developing a fetus within the female body.
    • Pregnancy is divided into three trimesters:
      • First Trimester: The first three months.
      • Second Trimester: The second three months of pregnancy.
      • Third Trimester: The last three months.
    • Pregnancy affects most organ systems.

    CNS

    • The Minimum Alveolar Concentration (MAC) decreases during pregnancy, by as much as 40% at term.
    • Pregnant patients have enhanced sensitivity to local anesthesia during regional anesthesia and analgesia.

    Respiratory System

    • Oxygen consumption and minute ventilation increase during pregnancy.
    • Tidal volume, respiratory rate, and inspiratory reserve volume also increase.
    • PaCO2 decreases to 28-32 mmHg.
    • Thoracic breathing is favored over abdominal breathing.
    • Functional Residual Capacity (FRC) decreases up to 20% at term.
    • The combination of decreased FRC and increased O2 consumption promotes rapid oxygen desaturation during periods of apnea.
    • Significant respiratory alkalosis is prevented by a compensatory decrease in plasma bicarbonate concentration.
    • Hyperventilation may slightly increase PaO2.
    • Elevation of the diaphragm is compensated by an increase in the anteroposterior diameter of the chest.

    Cardiovascular System

    • Cardiac output and blood volume increase to meet maternal and fetal metabolic demand.
    • There is an increase (55%) in plasma volume in excess of increased red cell mass (45%), producing dilutional anemia and reducing blood viscosity.
    • Hemoglobin concentration usually remains greater than 11 g/dL.
    • At term:
      • Blood volume has increased by 1000–1500 mL in most women.
      • Total body volume reaches 90 ml/kg.
    • Average blood loss during vaginal delivery is 400–500 mL compared to 800–1000 mL for a Cesarean section.
    • Blood volume does not return to normal until 1–2 weeks after delivery.
    • The increase in cardiac output (40% at term) is due to increases in heart rate (20%) and stroke volume (30%).
    • Cardiac chambers enlarge, and myocardial hypertrophy is often noted in echocardiography.
    • Approximately 5% of women at term develop the supine hypotension syndrome.
    • The cause of the syndrome appears to be the complete or near-complete occlusion of the inferior vena cava by the gravid uterus.

    Renal & Gastrointestinal System

    • Renal plasma flow and glomerular filtration rate increase during pregnancy.
    • Creatinine and blood urea nitrogen may decrease.
    • Plasma osmolality decreases by 8–10 mOsm/kg.
    • Gastroesophageal reflux and esophagitis are common during pregnancy.
    • Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, which may facilitate gastroesophageal reflux and delay gastric emptying.

    Hepatic System

    • Overall hepatic function and blood flow are unchanged.
    • There is a 20–30% decrease in serum pseudocholinesterase activity at term.

    Hematological System

    • Pregnancy is associated with a hypercoagulable state.
    • Fibrinogen and concentrations of factors VII, VIII, IX, X, and XII all increase.

    Pregnancy

    • Carrying and developing a fetus within the female body
    • Divided into three trimesters: first, second, and third trimesters, each lasting three months
    • Affects most organ systems with changes being adaptive to tolerate the stresses of pregnancy, labor, and delivery

    CNS

    • Decreased Minimum Alveolar Concentration (MAC) during pregnancy, up to 40% at term
    • Increased sensitivity to Local Anesthesia during regional anesthesia and analgesia

    Respiratory System

    • Increased oxygen consumption and minute ventilation
    • Increased tidal volume, respiratory rate, and inspiratory reserve volume
    • Decreased PaCo2 to 28-32 mmHg
    • Thoracic breathing favored over abdominal breathing
    • Decreased Functional Residual Capacity (FRC) by up to 20% at term contributing to rapid oxygen desaturation during apnea
    • Significant respiratory alkalosis is prevented by decreased plasma bicarbonate concentration
    • Hyperventilation slightly increases Pao2
    • Diaphragm elevation is compensated by increased anteroposterior diameter of the chest

    Cardiovascular System

    • Increased cardiac output and blood volume to meet maternal and fetal metabolic demand
    • Plasma volume increases by 55% exceeding the 45% increase in red cell mass, causing dilutional anemia and reduced blood viscosity
    • Hemoglobin concentration remains greater than 11 g/dL
    • At term, blood volume increases by 1000-1500 mL and total body volume reaches 90 mL/kg
    • Average blood loss during vaginal delivery is 400-500 mL, compared to 800-1000 mL for a cesarean section
    • Blood volume doesn’t return to normal until 1-2 weeks after delivery
    • Increased Cardiac Output (40% at term) due to increased heart rate (20%) and stroke volume (30%)
    • Cardiac chambers enlarge and myocardial hypertrophy is often noted during echocardiography
    • Approximately 5% of women at term develop supine hypotension syndrome caused by compression of the inferior vena cava by the gravid uterus

    Renal & Gastrointestinal System

    • Increased renal plasma flow and glomerular filtration rate
    • Decreased Creatinine and blood urea nitrogen
    • Decreased Plasma Osmolality by 8-10 mOsm/kg
    • Gastroesophageal reflex and esophagitis are common
    • Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, facilitating gastroesophageal reflex and delaying gastric emptying

    Hepatic System

    • Overall hepatic function and blood flow remain unchanged
    • 20-30% decrease in serum pseudocholinesterase activity at term

    Hematological System

    • Pregnancy associated with hypercoagulable state
    • Increased Fibrinogen and concentrations of factors VII, VIII, IX, X, XII

    Pregnancy & Trimesters

    • Pregnancy involves the development of a fetus within the female body.
    • It's divided into three trimesters, each lasting three months.

    Central Nervous System (CNS)

    • Minimum alveolar concentration (MAC) decreases during pregnancy, reaching up to a 40% reduction by term.
    • Pregnant patients exhibit enhanced sensitivity to local anesthesia during regional anesthesia and analgesia.

    Respiratory System

    • Oxygen consumption and minute ventilation increase during pregnancy.
    • Tidal volume, respiratory rate, and inspiratory reserve volume also increase.
    • PaCO2 decreases to 28-32 mmHg.
    • Thoracic breathing is favored over abdominal breathing.
    • Functional residual capacity (FRC) decreases up to 20% at term.
    • The combined effect of decreased FRC and increased oxygen consumption promotes rapid oxygen desaturation during periods of apnea.
    • Significant respiratory alkalosis is prevented by a compensatory decrease in plasma bicarbonate concentration.
    • Hyperventilation may slightly increase PaO2.
    • Elevation of the diaphragm is compensated by an increase in the anteroposterior diameter of the chest.

    Cardiovascular System

    • Cardiac output and blood volume increase to meet maternal and fetal metabolic demands.
    • Plasma volume increases by 55%, exceeding the 45% increase in red cell mass, resulting in dilutional anemia and reduced blood viscosity.
    • Hemoglobin concentration typically remains above 11 g/dL.
    • At term, blood volume has increased by 1000-1500 mL in most women.
    • Total body volume reaches 90 mL/kg.
    • Average blood loss during vaginal delivery is 400-500 mL, compared to 800-1000 mL for a Cesarean section.
    • Blood volume does not return to normal until 1-2 weeks after delivery.
    • The increase in cardiac output (40% at term) is attributed to increases in heart rate (20%) and stroke volume (30%).
    • Cardiac chambers enlarge and myocardial hypertrophy is often observed on echocardiography.
    • Approximately 5% of women at term develop supine hypotension syndrome, potentially caused by compression of the inferior vena cava by the gravid uterus.

    Renal & Gastrointestinal System

    • Renal plasma flow and glomerular filtration rate increase during pregnancy.
    • Creatinine and blood urea nitrogen levels may decrease.
    • Plasma osmolality decreases by 8-10 mOsm/kg
    • Gastroesophageal reflux and esophagitis are common during pregnancy.
    • Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, potentially contributing to gastroesophageal reflux and delayed gastric emptying.

    Hepatic System

    • Overall hepatic function and blood flow remain unchanged.
    • A 20-30% decrease in serum pseudocholinesterase activity occurs at term.

    Hematological System

    • Pregnancy is associated with a hypercoagulable state.
    • Fibrinogen and concentrations of factors VII, VIII, IX, X, and XII all increase.

    Pregnancy Physiology Changes

    • Pregnancy is the state of carrying and developing a fetus within the female body.
    • Three trimesters:
      • First trimester: First three months
      • Second trimester: Second three months
      • Third trimester: Last three months
    • Pregnancy affects most organ systems, with many changes being adaptive and beneficial for the mother.

    Central Nervous System (CNS)

    • Minimum alveolar concentration (MAC): Decreases during pregnancy, up to 40% at term.
    • Sensitivity to local anesthesia: Increased sensitivity during regional anesthesia and analgesia.

    Respiratory System

    • Oxygen consumption & minute ventilation: Increase during pregnancy.
    • Tidal volume, respiratory rate, and inspiratory reserve volume: Also increase.
    • PaCO2: Decreases to 28 – 32 mmHg.
    • Thoracic breathing: Favored over abdominal breathing.
    • Functional residual capacity (FRC): Decreases up to 20% at term. This, combined with increased oxygen consumption, leads to rapid oxygen desaturation during apnea.
    • Respiratory alkalosis: Prevented by a compensatory decrease in plasma bicarbonate concentration.
    • Hyperventilation: May slightly increase PaO2.
    • Diaphragm elevation: Compensated by an increase in the anteroposterior diameter of the chest.

    Cardiovascular System

    • Cardiac output and blood volume: Increase to meet maternal and fetal metabolic demand.
    • Plasma volume: Increases by 55%, exceeding the increase in red cell mass (45%), resulting in dilutional anemia and reduced blood viscosity.
    • Hemoglobin concentration: Usually remains above 11 g/dL.
    • Blood volume at term: Increases by 1000-1500 mL in most women, reaching 90 mL/kg.
    • Blood loss during delivery: 400-500 mL for vaginal delivery and 800-1000 mL for cesarean section.
    • Blood volume return to normal: Occurs 1-2 weeks after delivery.
    • Cardiac output increase: At term, increases by 40%, due to increases in heart rate (20%) and stroke volume (30%).
    • Cardiac chamber enlargement & myocardial hypertrophy: Often observed on echocardiography.
    • Supine hypotension syndrome: Affects approximately 5% of women at term. This syndrome is caused by compression of the inferior vena cava by the gravid uterus.

    Renal & Gastrointestinal System

    • Renal plasma flow and glomerular filtration rate: Increase during pregnancy.
    • Creatinine and blood urea nitrogen: May decrease.
    • Plasma osmolality: Decreases by 8-10 mOsm/kg.
    • Gastroesophageal reflux and esophagitis: Common during pregnancy.
    • Opioids and anticholinergic drugs: Reduce lower esophageal sphincter pressure, facilitating gastroesophageal reflux and delaying gastric emptying.

    Hepatic System

    • Overall hepatic function and blood flow: Remain unchanged.
    • Serum pseudocholinesterase activity: Decreases by 20-30% at term.

    Hematological System

    • Hypercoagulable state: Associated with pregnancy.
    • Fibrinogen and concentrations of factors VII, VIII, IX, X, XII: All increase.

    Pregnancy

    • Pregnancy is the state of carrying and developing a fetus within the female body.
    • Pregnancy is divided into three trimesters: first, second, and third.
    • The first trimester is the first three months of pregnancy.
    • The second trimester is the second three months of pregnancy.
    • The third trimester is the last three months of pregnancy.

    Central Nervous System (CNS)

    • Minimum alveolar concentration (MAC) decreases during pregnancy, by as much as 40% at term.
    • Pregnant patients have enhanced sensitivity to local anesthesia during regional anesthesia and analgesia.

    Respiratory System

    • Oxygen consumption and minute ventilation increase during pregnancy.
    • Tidal volume, respiratory rate, and inspiratory reserve volume increase.
    • PaCO2 decreases to 28-32 mmHg.
    • Thoracic breathing is favored over abdominal breathing.
    • Functional residual capacity (FRC) decreases up to 20% at term.
    • The combination of decreased FRC and increased O2 consumption promotes rapid oxygen desaturation during periods of apnea.
    • Significant respiratory alkalosis is prevented by a compensatory decrease in plasma bicarbonate concentration.
    • Hyperventilation may slightly increase PaO2.
    • Elevation of the diaphragm is compensated by an increase in the anteroposterior diameter of the chest.

    Cardiovascular System

    • Cardiac output and blood volume increase to meet maternal and fetal metabolic demands.
    • An increase (55%) in plasma volume in excess of red cell mass increase (45%) produces dilutional anemia and reduces blood viscosity.
    • Hemoglobin concentration usually remains greater than 11g/dL.
    • At term, blood volume increases by 1000-1500 mL in most women.
    • Total body volume reaches 90 ml/kg.
    • Average blood loss during vaginal delivery is 400-500 mL, compared with 800-1000 mL for a cesarean section.
    • Blood volume does not return to normal until 1-2 weeks after delivery.
    • The increase in cardiac output (40% at term) is due to increases in heart rate (20%) and stroke volume (30%).
    • Cardiac chambers enlarge and myocardial hypertrophy is often noted on echocardiography.
    • Approximately 5% of women at term develop the supine hypotension syndrome.
    • The cause of this syndrome appears to be complete or near-complete occlusion of the inferior vena cava by the gravid uterus.

    Renal and Gastrointestinal System

    • Renal plasma flow and glomerular filtration rate increase during pregnancy.
    • Creatinine and blood urea nitrogen may decrease.
    • Plasma osmolality decreases by 8-10 mOsm/kg.
    • Gastroesophageal reflux and esophagitis are common during pregnancy.
    • Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, which may facilitate gastroesophageal reflux and delay gastric emptying.

    Hepatic System

    • Overall hepatic function and blood flow remain unchanged.
    • There is a 20-30% decrease in serum pseudocholinesterase activity at term.

    Hematological System

    • Pregnancy is associated with a hypercoagulable state.
    • Fibrinogen and concentrations of factors VII, VIII, IX, X, and XII all increase.

    Pregnancy and the CNS

    • Minimum alveolar concentration (MAC) decreases during pregnancy, by as much as 40% at term
    • Pregnant patients have a higher sensitivity to local anesthetics during regional anesthesia and analgesia

    Pregnancy and the Respiratory System

    • Oxygen consumption and minute ventilation increase during pregnancy
    • Tidal volume, respiratory rate, and inspiratory reserve volume increase
    • PaCO2 decreases to 28-32 mmHg
    • Thoracic breathing is favored over abdominal breathing
    • Functional residual capacity (FRC) decreases up to 20% at term
    • Decreased FRC and increased oxygen consumption lead to rapid oxygen desaturation during apnea
    • Significant respiratory alkalosis is prevented by a decrease in plasma bicarbonate concentration
    • Hyperventilation slightly increases PaO2
    • The diaphragm is elevated and compensated by an increase in the anteroposterior diameter of the chest

    Pregnancy and the Cardiovascular System

    • Cardiac output and blood volume increase to meet maternal and fetal metabolic demand
    • Plasma volume increases by 55% while red cell mass increases by 45%, producing dilutional anemia and reducing blood viscosity
    • Hemoglobin concentration usually remains greater than 11 g/dL
    • At term, blood volume has increased by 1000-1500 mL in most women
    • Total body volume reaches 90 ml/kg
    • Average blood loss during vaginal delivery is 400-500 mL, compared to 800-1000 mL for a cesarean section
    • Blood volume does not return to normal until 1-2 weeks after delivery
    • Cardiac output increases by 40% at term due to increased heart rate (20%) and stroke volume (30%)
    • Cardiac chambers enlarge, and myocardial hypertrophy is often noted on echocardiography
    • Approximately 5% of women at term develop the supine hypotension syndrome
    • The cause of this syndrome is compression of the inferior vena cava by the gravid uterus

    Pregnancy and the Renal and Gastrointestinal System

    • Renal plasma flow and glomerular filtration rate increase during pregnancy
    • Creatinine and blood urea nitrogen may decrease
    • Plasma osmolality decreases by 8-10 mOsm/kg
    • Gastroesophageal reflux and esophagitis are common during pregnancy
    • Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, facilitating gastroesophageal reflux and delaying gastric emptying

    Pregnancy and the Hepatic System

    • Overall hepatic function and blood flow are unchanged
    • A 20-30% decrease in serum pseudocholinesterase activity at term

    Pregnancy and the Hematologic System

    • Pregnancy is associated with a hypercoagulable state
    • Fibrinogen and concentrations of factors VII, VIII, IX, X, XII increase

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    Physiological Changes During Pregnancy PDF

    Description

    Test your knowledge on the physiological changes that occur during pregnancy. This quiz covers trimesters, central nervous system adaptations, and respiratory changes. Learn how these changes benefit both the mother and the developing baby.

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