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Questions and Answers
What is primarily responsible for the increase in cardiac output during pregnancy?
What is primarily responsible for the increase in cardiac output during pregnancy?
What condition is associated with approximately 5% of women at term during pregnancy?
What condition is associated with approximately 5% of women at term during pregnancy?
What happens to renal plasma flow and glomerular filtration rate during pregnancy?
What happens to renal plasma flow and glomerular filtration rate during pregnancy?
Which of the following changes in the hepatic system is noted during pregnancy?
Which of the following changes in the hepatic system is noted during pregnancy?
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Which factor does NOT contribute to the hypercoagulable state associated with pregnancy?
Which factor does NOT contribute to the hypercoagulable state associated with pregnancy?
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What is the average increase in blood volume during pregnancy?
What is the average increase in blood volume during pregnancy?
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What happens to the minimum alveolar concentration (MAC) during pregnancy?
What happens to the minimum alveolar concentration (MAC) during pregnancy?
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Which physiological change occurs in the respiratory system during pregnancy?
Which physiological change occurs in the respiratory system during pregnancy?
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Why does hyperventilation occur during pregnancy?
Why does hyperventilation occur during pregnancy?
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How does the body compensate for respiratory alkalosis during pregnancy?
How does the body compensate for respiratory alkalosis during pregnancy?
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Which type of breathing is favored during pregnancy?
Which type of breathing is favored during pregnancy?
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What is the average blood loss during a vaginal delivery?
What is the average blood loss during a vaginal delivery?
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What physiological change leads to dilutional anemia during pregnancy?
What physiological change leads to dilutional anemia during pregnancy?
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What is the term for the state of carrying and developing a fetus within the female body?
What is the term for the state of carrying and developing a fetus within the female body?
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The first trimester of pregnancy lasts for six months.
The first trimester of pregnancy lasts for six months.
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During pregnancy, how much does the minimum alveolar concentration (MAC) decrease by at term?
During pregnancy, how much does the minimum alveolar concentration (MAC) decrease by at term?
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At term, pregnant women experience an increase in blood volume by _____ mL.
At term, pregnant women experience an increase in blood volume by _____ mL.
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What happens to functional residual capacity (FRC) during pregnancy?
What happens to functional residual capacity (FRC) during pregnancy?
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Match the physiological changes with the corresponding systems:
Match the physiological changes with the corresponding systems:
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Pregnant women experience a compensatory increase in plasma bicarbonate concentration to prevent respiratory alkalosis.
Pregnant women experience a compensatory increase in plasma bicarbonate concentration to prevent respiratory alkalosis.
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What type of breathing is favored during pregnancy?
What type of breathing is favored during pregnancy?
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The average blood loss during a cesarean section is approximately _____ mL.
The average blood loss during a cesarean section is approximately _____ mL.
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What physiological change is primarily responsible for dilutional anemia during pregnancy?
What physiological change is primarily responsible for dilutional anemia during pregnancy?
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What causes supine hypotension syndrome in pregnant women?
What causes supine hypotension syndrome in pregnant women?
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Renal plasma flow and glomerular filtration rate decrease during pregnancy.
Renal plasma flow and glomerular filtration rate decrease during pregnancy.
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What is the percentage increase in stroke volume during pregnancy?
What is the percentage increase in stroke volume during pregnancy?
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Pregnancy is associated with a __________ state, which means increased tendency for blood to clot.
Pregnancy is associated with a __________ state, which means increased tendency for blood to clot.
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Match the physiological changes during pregnancy with their corresponding effects:
Match the physiological changes during pregnancy with their corresponding effects:
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Which of the following is NOT affected by pregnancy?
Which of the following is NOT affected by pregnancy?
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Gastroesophageal reflux and esophagitis are uncommon during pregnancy.
Gastroesophageal reflux and esophagitis are uncommon during pregnancy.
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What is the percentage increase in heart rate during pregnancy?
What is the percentage increase in heart rate during pregnancy?
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In pregnancy, concentrations of factors VII, VIII, IX, X, and XII __________.
In pregnancy, concentrations of factors VII, VIII, IX, X, and XII __________.
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What is a common effect of opioid and anticholinergic drugs during pregnancy?
What is a common effect of opioid and anticholinergic drugs during pregnancy?
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What percentage of increase in stroke volume is noted at term during pregnancy?
What percentage of increase in stroke volume is noted at term during pregnancy?
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Supine hypotension syndrome affects around 10% of women at term during pregnancy.
Supine hypotension syndrome affects around 10% of women at term during pregnancy.
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What causes renal plasma flow and glomerular filtration rate to increase during pregnancy?
What causes renal plasma flow and glomerular filtration rate to increase during pregnancy?
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During pregnancy, the plasma osmolality decreases by _____ mOsm/kg.
During pregnancy, the plasma osmolality decreases by _____ mOsm/kg.
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Match the following systems with their physiological change during pregnancy:
Match the following systems with their physiological change during pregnancy:
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Which of the following substances increases during pregnancy, contributing to the hypercoagulable state?
Which of the following substances increases during pregnancy, contributing to the hypercoagulable state?
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The overall hepatic function and blood flow significantly increase during pregnancy.
The overall hepatic function and blood flow significantly increase during pregnancy.
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The inferior vena cava can be compressed by the _____ during pregnancy, leading to supine hypotension syndrome.
The inferior vena cava can be compressed by the _____ during pregnancy, leading to supine hypotension syndrome.
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What common condition related to the gastrointestinal system can occur during pregnancy?
What common condition related to the gastrointestinal system can occur during pregnancy?
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What decrease in serum pseudocolinesterase activity is noted at term?
What decrease in serum pseudocolinesterase activity is noted at term?
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What is the primary reason for the increase in tidal volume during pregnancy?
What is the primary reason for the increase in tidal volume during pregnancy?
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Functional residual capacity (FRC) increases during pregnancy.
Functional residual capacity (FRC) increases during pregnancy.
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What physiological change helps prevent significant respiratory alkalosis during pregnancy?
What physiological change helps prevent significant respiratory alkalosis during pregnancy?
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During pregnancy, blood volume increases by approximately ______ mL.
During pregnancy, blood volume increases by approximately ______ mL.
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Match the physiological changes with their corresponding changes in the body:
Match the physiological changes with their corresponding changes in the body:
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During labor, which of the following is a common average blood loss for vaginal delivery?
During labor, which of the following is a common average blood loss for vaginal delivery?
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Pregnant women have a decreased sensitivity to local anesthesia during regional analgesia.
Pregnant women have a decreased sensitivity to local anesthesia during regional analgesia.
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What term describes the increased tendency for blood to clot during pregnancy?
What term describes the increased tendency for blood to clot during pregnancy?
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During pregnancy, the minimum alveolar concentration (MAC) decreases by as much as ________%.
During pregnancy, the minimum alveolar concentration (MAC) decreases by as much as ________%.
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What happens to the hemoglobin concentration in pregnant women?
What happens to the hemoglobin concentration in pregnant women?
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What is the primary cause of supine hypotension syndrome during pregnancy?
What is the primary cause of supine hypotension syndrome during pregnancy?
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During pregnancy, there is a decrease in glomerular filtration rate.
During pregnancy, there is a decrease in glomerular filtration rate.
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What percentage increase in stroke volume is noted during pregnancy?
What percentage increase in stroke volume is noted during pregnancy?
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The __________ is often noted in echocardiography during pregnancy due to cardiac adaptations.
The __________ is often noted in echocardiography during pregnancy due to cardiac adaptations.
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Match the following conditions with their related physiological changes:
Match the following conditions with their related physiological changes:
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What is the effect of opioid and anticholinergic drugs on the gastrointestinal system during pregnancy?
What is the effect of opioid and anticholinergic drugs on the gastrointestinal system during pregnancy?
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Plasma osmolality decreases by 5-8 mOsm/kg during pregnancy.
Plasma osmolality decreases by 5-8 mOsm/kg during pregnancy.
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What happens to the concentrations of factors VII, VIII, IX, X, and XII during pregnancy?
What happens to the concentrations of factors VII, VIII, IX, X, and XII during pregnancy?
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Approximately __________ of women at term develop the supine hypotension syndrome.
Approximately __________ of women at term develop the supine hypotension syndrome.
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What change occurs in creatinine levels during pregnancy?
What change occurs in creatinine levels during pregnancy?
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Which physiological change occurs in the cardiovascular system during pregnancy?
Which physiological change occurs in the cardiovascular system during pregnancy?
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Functional residual capacity (FRC) increases during pregnancy.
Functional residual capacity (FRC) increases during pregnancy.
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What is the average increase in blood volume during pregnancy?
What is the average increase in blood volume during pregnancy?
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At term, pregnant women typically have a hemoglobin concentration greater than ______ g/dL.
At term, pregnant women typically have a hemoglobin concentration greater than ______ g/dL.
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Match the following changes with their physiological systems:
Match the following changes with their physiological systems:
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What happens to PaCO2 levels during pregnancy?
What happens to PaCO2 levels during pregnancy?
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The average blood loss during a cesarean section is less than that during a vaginal delivery.
The average blood loss during a cesarean section is less than that during a vaginal delivery.
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What physiological adaptation helps prevent significant respiratory alkalosis during pregnancy?
What physiological adaptation helps prevent significant respiratory alkalosis during pregnancy?
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Pregnancy is divided into three trimesters, with each trimester lasting ______ months.
Pregnancy is divided into three trimesters, with each trimester lasting ______ months.
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What is the average blood volume in pregnant women at term?
What is the average blood volume in pregnant women at term?
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What is the percentage increase in heart rate during pregnancy?
What is the percentage increase in heart rate during pregnancy?
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Supine hypotension syndrome affects around 5% of women at term.
Supine hypotension syndrome affects around 5% of women at term.
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What is the primary reason for the increase in stroke volume during pregnancy?
What is the primary reason for the increase in stroke volume during pregnancy?
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Approximately _____ of women at term develop supine hypotension syndrome.
Approximately _____ of women at term develop supine hypotension syndrome.
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Match the changes in the cardiovascular system during pregnancy:
Match the changes in the cardiovascular system during pregnancy:
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Which hormone is linked to the hypercoagulable state during pregnancy?
Which hormone is linked to the hypercoagulable state during pregnancy?
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Gastroesophageal reflux is uncommon during pregnancy.
Gastroesophageal reflux is uncommon during pregnancy.
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What happens to plasma osmolality during pregnancy?
What happens to plasma osmolality during pregnancy?
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Fibrinogen concentrations increase during pregnancy, contributing to a __________ state.
Fibrinogen concentrations increase during pregnancy, contributing to a __________ state.
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Match the substances with their changes during pregnancy:
Match the substances with their changes during pregnancy:
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What is the average increase in blood volume during pregnancy?
What is the average increase in blood volume during pregnancy?
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Functional residual capacity (FRC) decreases during pregnancy.
Functional residual capacity (FRC) decreases during pregnancy.
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What happens to tidal volume during pregnancy?
What happens to tidal volume during pregnancy?
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At term, the minimum alveolar concentration (MAC) decreases by _____%.
At term, the minimum alveolar concentration (MAC) decreases by _____%.
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Match the physiological changes with the corresponding systems:
Match the physiological changes with the corresponding systems:
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What compensatory mechanism prevents significant respiratory alkalosis during pregnancy?
What compensatory mechanism prevents significant respiratory alkalosis during pregnancy?
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Cardiac output and blood volume do not change significantly during pregnancy.
Cardiac output and blood volume do not change significantly during pregnancy.
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What is the average blood loss during a cesarean section?
What is the average blood loss during a cesarean section?
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Oxygen consumption and minute ventilation _____ during pregnancy.
Oxygen consumption and minute ventilation _____ during pregnancy.
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Which of the following statements about hemoglobin concentration during pregnancy is correct?
Which of the following statements about hemoglobin concentration during pregnancy is correct?
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What is the percentage increase in heart rate during pregnancy?
What is the percentage increase in heart rate during pregnancy?
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Supine hypotension syndrome occurs in approximately 5% of women at term during pregnancy.
Supine hypotension syndrome occurs in approximately 5% of women at term during pregnancy.
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What physiological state is associated with an increased tendency for blood to clot during pregnancy?
What physiological state is associated with an increased tendency for blood to clot during pregnancy?
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The increase in cardiac output during pregnancy is primarily due to increases in heart rate and __________.
The increase in cardiac output during pregnancy is primarily due to increases in heart rate and __________.
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Match the cardiovascular changes with their corresponding percentage increase during pregnancy:
Match the cardiovascular changes with their corresponding percentage increase during pregnancy:
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What causes supine hypotension syndrome in pregnant women?
What causes supine hypotension syndrome in pregnant women?
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Renal plasma flow and glomerular filtration rate decrease during pregnancy.
Renal plasma flow and glomerular filtration rate decrease during pregnancy.
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What condition related to the gastrointestinal system is common during pregnancy?
What condition related to the gastrointestinal system is common during pregnancy?
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During pregnancy, concentrations of factors VII, VIII, IX, X, and XII __________.
During pregnancy, concentrations of factors VII, VIII, IX, X, and XII __________.
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What physiological change is noted in the hepatic system during pregnancy?
What physiological change is noted in the hepatic system during pregnancy?
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What physiological change occurs in the cardiovascular system during pregnancy?
What physiological change occurs in the cardiovascular system during pregnancy?
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Functional residual capacity (FRC) increases during pregnancy.
Functional residual capacity (FRC) increases during pregnancy.
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How much does the average blood volume increase during pregnancy?
How much does the average blood volume increase during pregnancy?
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During pregnancy, women may experience _____, a condition associated with decreased functional residual capacity.
During pregnancy, women may experience _____, a condition associated with decreased functional residual capacity.
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Match the following physiological changes with their corresponding outcomes during pregnancy:
Match the following physiological changes with their corresponding outcomes during pregnancy:
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What is the average blood loss during a vaginal delivery?
What is the average blood loss during a vaginal delivery?
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At term, the minimum alveolar concentration (MAC) remains unchanged during pregnancy.
At term, the minimum alveolar concentration (MAC) remains unchanged during pregnancy.
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What type of breathing is favored during pregnancy?
What type of breathing is favored during pregnancy?
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During pregnancy, the concentration of hemoglobin usually remains greater than _____ g/dL.
During pregnancy, the concentration of hemoglobin usually remains greater than _____ g/dL.
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Match the following physiological effects with their corresponding organ systems during pregnancy:
Match the following physiological effects with their corresponding organ systems during pregnancy:
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What is the approximate increase in heart rate at term during pregnancy?
What is the approximate increase in heart rate at term during pregnancy?
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Supine hypotension syndrome affects approximately 5% of women at term during pregnancy.
Supine hypotension syndrome affects approximately 5% of women at term during pregnancy.
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What happens to plasma osmolality during pregnancy?
What happens to plasma osmolality during pregnancy?
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During pregnancy, a __________ state is associated with an increased tendency for blood to clot.
During pregnancy, a __________ state is associated with an increased tendency for blood to clot.
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Match the following systems with their physiological changes during pregnancy:
Match the following systems with their physiological changes during pregnancy:
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Which factor is likely to decrease during pregnancy?
Which factor is likely to decrease during pregnancy?
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Serum pseudocolinesterase activity increases at term during pregnancy.
Serum pseudocolinesterase activity increases at term during pregnancy.
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What is a common gastrointestinal issue experienced during pregnancy?
What is a common gastrointestinal issue experienced during pregnancy?
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Factors VII, VIII, IX, X, and XII __________ during pregnancy.
Factors VII, VIII, IX, X, and XII __________ during pregnancy.
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What is the percentage increase in stroke volume noted at term during pregnancy?
What is the percentage increase in stroke volume noted at term during pregnancy?
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What is the range of decrease in minimum alveolar concentration (MAC) by term during pregnancy?
What is the range of decrease in minimum alveolar concentration (MAC) by term during pregnancy?
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Functional residual capacity (FRC) increases during pregnancy.
Functional residual capacity (FRC) increases during pregnancy.
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What compensatory mechanism prevents significant respiratory alkalosis during pregnancy?
What compensatory mechanism prevents significant respiratory alkalosis during pregnancy?
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During pregnancy, the average blood volume increases by ______ mL.
During pregnancy, the average blood volume increases by ______ mL.
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Match the physiological changes with their corresponding effects during pregnancy:
Match the physiological changes with their corresponding effects during pregnancy:
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Which of the following is a common average blood loss during vaginal delivery?
Which of the following is a common average blood loss during vaginal delivery?
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Oxygen consumption and minute ventilation decrease during pregnancy.
Oxygen consumption and minute ventilation decrease during pregnancy.
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What is the average hemoglobin concentration during pregnancy that usually remains greater than?
What is the average hemoglobin concentration during pregnancy that usually remains greater than?
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Pregnant women's sensitivity to local anesthesia during regional anesthesia is _______ compared to non-pregnant women.
Pregnant women's sensitivity to local anesthesia during regional anesthesia is _______ compared to non-pregnant women.
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What happens to inspiratory reserve volume during pregnancy?
What happens to inspiratory reserve volume during pregnancy?
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Pregnancy is divided into two trimesters.
Pregnancy is divided into two trimesters.
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Functional residual capacity (FRC) decreases up to 20% at term during pregnancy.
Functional residual capacity (FRC) decreases up to 20% at term during pregnancy.
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Cardiac output and blood volume decrease during pregnancy to meet metabolic demands.
Cardiac output and blood volume decrease during pregnancy to meet metabolic demands.
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Isolation of the diaphragm is compensated by a decrease in the anteroposterior diameter of the chest.
Isolation of the diaphragm is compensated by a decrease in the anteroposterior diameter of the chest.
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Plasma bicarbonate concentration increases to prevent respiratory alkalosis during pregnancy.
Plasma bicarbonate concentration increases to prevent respiratory alkalosis during pregnancy.
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Hemoglobin concentration in pregnant women usually remains below 11 g/dL.
Hemoglobin concentration in pregnant women usually remains below 11 g/dL.
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Pregnant women experience enhanced sensitivity to local anesthesia during regional anesthesia.
Pregnant women experience enhanced sensitivity to local anesthesia during regional anesthesia.
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The average blood loss during vaginal delivery is greater than that of a cesarean section.
The average blood loss during vaginal delivery is greater than that of a cesarean section.
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Tidal volume increases during pregnancy.
Tidal volume increases during pregnancy.
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The term for the state of carrying a developing fetus is gestation.
The term for the state of carrying a developing fetus is gestation.
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Cardiac output increases by 40% during pregnancy primarily due to increases in heart rate and stroke volume.
Cardiac output increases by 40% during pregnancy primarily due to increases in heart rate and stroke volume.
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Approximately 5% of women experience supine hypotension syndrome at term.
Approximately 5% of women experience supine hypotension syndrome at term.
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Renal plasma flow and glomerular filtration rate decrease during pregnancy.
Renal plasma flow and glomerular filtration rate decrease during pregnancy.
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Fibrinogen concentrations decrease during pregnancy, increasing the risk of bleeding.
Fibrinogen concentrations decrease during pregnancy, increasing the risk of bleeding.
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Gastroesophageal reflux and esophagitis are commonly experienced by many pregnant women.
Gastroesophageal reflux and esophagitis are commonly experienced by many pregnant women.
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There is a significant increase in serum pseudocolinesterase activity at term during pregnancy.
There is a significant increase in serum pseudocolinesterase activity at term during pregnancy.
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Plasma osmolality decreases by 8-10 mOsm/kg during pregnancy.
Plasma osmolality decreases by 8-10 mOsm/kg during pregnancy.
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Pregnancy is associated with a hypo-coagulable state, reducing the risk of thrombosis.
Pregnancy is associated with a hypo-coagulable state, reducing the risk of thrombosis.
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Opioid and anticholinergic drugs may delay gastric emptying during pregnancy.
Opioid and anticholinergic drugs may delay gastric emptying during pregnancy.
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Stroke volume increases by 40% at term during pregnancy.
Stroke volume increases by 40% at term during pregnancy.
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Cardiac output increases by approximately 40% at term due to a 20% increase in heart rate and a 30% increase in stroke volume.
Cardiac output increases by approximately 40% at term due to a 20% increase in heart rate and a 30% increase in stroke volume.
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Supine hypotension syndrome affects approximately 10% of women at term during pregnancy.
Supine hypotension syndrome affects approximately 10% of women at term during pregnancy.
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During pregnancy, renal plasma flow and glomerular filtration rate both decrease.
During pregnancy, renal plasma flow and glomerular filtration rate both decrease.
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Factors VII, VIII, IX, X, and XII decrease during pregnancy, contributing to a hypercoagulable state.
Factors VII, VIII, IX, X, and XII decrease during pregnancy, contributing to a hypercoagulable state.
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Pregnant women may experience gastroesophageal reflux and esophagitis as common conditions.
Pregnant women may experience gastroesophageal reflux and esophagitis as common conditions.
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The overall hepatic function and blood flow significantly increase during pregnancy.
The overall hepatic function and blood flow significantly increase during pregnancy.
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Plasma osmolality decreases by 8 - 10 mOsm/kg during pregnancy.
Plasma osmolality decreases by 8 - 10 mOsm/kg during pregnancy.
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Creatinine levels tend to increase during pregnancy.
Creatinine levels tend to increase during pregnancy.
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Myocardial hypertrophy is frequently observed in pregnant women through echocardiography.
Myocardial hypertrophy is frequently observed in pregnant women through echocardiography.
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Opioid and anticholinergic drugs have no effect on the lower esophageal sphincter pressure.
Opioid and anticholinergic drugs have no effect on the lower esophageal sphincter pressure.
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Pregnancy is divided into four trimesters.
Pregnancy is divided into four trimesters.
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During pregnancy, the minimum alveolar concentration (MAC) decreases by up to 40% at term.
During pregnancy, the minimum alveolar concentration (MAC) decreases by up to 40% at term.
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Blood volume during pregnancy typically increases by more than 2000 mL.
Blood volume during pregnancy typically increases by more than 2000 mL.
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Thoracic breathing is less favored than abdominal breathing during pregnancy.
Thoracic breathing is less favored than abdominal breathing during pregnancy.
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Functional residual capacity (FRC) decreases by up to 20% at term during pregnancy.
Functional residual capacity (FRC) decreases by up to 20% at term during pregnancy.
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Hemoglobin concentration typically remains below 11 g/dL during pregnancy.
Hemoglobin concentration typically remains below 11 g/dL during pregnancy.
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Pregnancy causes a significant increase in plasma bicarbonate concentration.
Pregnancy causes a significant increase in plasma bicarbonate concentration.
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The average blood loss during cesarean delivery is around 400-500 mL.
The average blood loss during cesarean delivery is around 400-500 mL.
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Oxygen consumption and minute ventilation both decrease during pregnancy.
Oxygen consumption and minute ventilation both decrease during pregnancy.
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Pregnant women experience decreased sensitivity to local anesthesia during regional anesthesia.
Pregnant women experience decreased sensitivity to local anesthesia during regional anesthesia.
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What is the effect of pregnancy on oxygen consumption and minute ventilation?
What is the effect of pregnancy on oxygen consumption and minute ventilation?
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How does plasma volume change during pregnancy and what effect does it have?
How does plasma volume change during pregnancy and what effect does it have?
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What happens to the functional residual capacity (FRC) in pregnant women?
What happens to the functional residual capacity (FRC) in pregnant women?
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Why is there an increased sensitivity to local anesthesia during pregnancy?
Why is there an increased sensitivity to local anesthesia during pregnancy?
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How does the respiratory system adapt to prevent respiratory alkalosis during pregnancy?
How does the respiratory system adapt to prevent respiratory alkalosis during pregnancy?
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What physiological change is responsible for the average blood loss during vaginal delivery?
What physiological change is responsible for the average blood loss during vaginal delivery?
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Explain the role of increased cardiac output during pregnancy.
Explain the role of increased cardiac output during pregnancy.
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What happens to the diaphragm during pregnancy, and how is this compensated?
What happens to the diaphragm during pregnancy, and how is this compensated?
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How does pregnancy affect the minute ventilation in terms of its components?
How does pregnancy affect the minute ventilation in terms of its components?
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How does myocardial hypertrophy affect cardiac function during pregnancy?
How does myocardial hypertrophy affect cardiac function during pregnancy?
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What physiological factor contributes to the increase in stroke volume during pregnancy?
What physiological factor contributes to the increase in stroke volume during pregnancy?
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Explain how supine hypotension syndrome develops in pregnant women.
Explain how supine hypotension syndrome develops in pregnant women.
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What changes occur in the renal system during pregnancy?
What changes occur in the renal system during pregnancy?
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Describe the impact of pregnancy on the lower esophageal sphincter pressure.
Describe the impact of pregnancy on the lower esophageal sphincter pressure.
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How does the activity of serum pseudocolinesterase change at term during pregnancy?
How does the activity of serum pseudocolinesterase change at term during pregnancy?
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What hematological changes are associated with pregnancy?
What hematological changes are associated with pregnancy?
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Why might plasma osmolality decrease during pregnancy?
Why might plasma osmolality decrease during pregnancy?
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What cardiac changes are typically observed at term in a pregnant woman?
What cardiac changes are typically observed at term in a pregnant woman?
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How does pregnancy impact hepatic function?
How does pregnancy impact hepatic function?
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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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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.