OB Study Guide PDF

OB Study Guide 1. What changes does the uterus undergo? The uterus enlarges significantly during pregnancy, increasing in size to 20 times that of its pre-pregnant state The capacity increases from 10 mL to 5000 mL to accommodate the developing fetus and placenta (80% of th...

OB Study Guide 1. What changes does the uterus undergo? The uterus enlarges significantly during pregnancy, increasing in size to 20 times that of its pre-pregnant state The capacity increases from 10 mL to 5000 mL to accommodate the developing fetus and placenta (80% of that is uteroplacental) Weight of the Uterus increases from 70g to 1,100g Expanded Circulatory Volume Leads to Vascular Congestion (Blood Flow of Uterus is 500-600ml/min at Term) 2. What is the impact of hormones on smooth muscle? Progesterone relaxes smooth muscles, leading to slower gastrointestinal transit (causing bloating and constipation) and relaxation of the bladder, which increases the risk of urinary stasis Estrogen & progesterone relax smooth muscle in cervix & pelvic floor ligament Respiratory estrogen, progesterone & prostaglandins Dyspnea Nasal & sinus congestion Epistaxis (nosebleed) Renal increased progesterone Increased urine output Incontinence Increased risk for UTI Gastrointestinal increased progesterone Slow stomach emptying & relax the esophageal sphincter → _reflux of gastric contents (heartburn) Slow digestive process & movement of stool → _bloating, flatulence, constipation Decrease muscle tone of gallbladder → _increased risk of gallstone formation & cholestasis 3. What causes edema in the lower extremities? How can this be relieved? Increased venous pressure and decreased blood flow to the extremities, due to compression of the iliac veins and inferior vena cava, cause edema. (s/b they also cause varicosities in the legs and vulva and hemorrhoids) Relief: Elevating the legs, avoiding prolonged standing, and wearing compression stockings can help relieve it. Do Not Lay on your back 4. What causes nasal and sinus congestion?  Estrogen, progesterone, and prostaglandins cause vascular engorgement and smooth muscle relaxation, leading to nasal and sinus congestion, dyspnea and epistaxis. 5. What changes in lab values might occur as a result of adaptations of the cardiovascular system? Increase in RBC by 30% Increase in RBC volume by 18-33% Increase in Plasma Volume by 50% Increase in WBC Count up to 16,000 in the absence of infection Iron deficiency anemia Hemoglobin