OB Midterm Exam Study Guide PDF

OB Midterm Exam Study Guide Physiologic Adaptations to Pregnancy What changes does the uterus undergo? Hypertrophy of the uterine wall Softening of the vaginal muscle & connective tissue in preparation for expansion of tissue to accommodate passage of fetus through the birth cana...

OB Midterm Exam Study Guide Physiologic Adaptations to Pregnancy What changes does the uterus undergo? Hypertrophy of the uterine wall Softening of the vaginal muscle & connective tissue in preparation for expansion of tissue to accommodate passage of fetus through the birth canal Hypertrophy of cervical glands leads to formation of mucus plug, which serves as a protective barrier between uterus/fetus & vagina Increased vascularity & hypertrophy of vaginal & cervical glands leads to increase in leukorrhea Cessation of menstrual cycle (amenorrhea) & ovulation Enlargement & stretching of uterus, increasing in size up to 20 times that of its pre-pregnant state Expanded circulatory volume leads to increased vascular congestion (blood flow of uterus is 500-600 mL/min at term) Weight of the uterus increases from 70g to 1100g What is the impact of hormones on smooth muscle? Respiratory: estrogen, progesterone & prostaglandins o Dyspnea o Nasal & sinus congestion o Epistaxis (nosebleed) Renal: increased progesterone o Increased urine output o Incontinence o Increased risk for UTI Gastrointestinal: increased progesterone o Slow stomach emptying & relax the esophageal sphincter → reflux of gastric contents (heartburn) o Slow digestive process & movement of stool → bloating, flatulence, constipation o Decrease muscle tone of gallbladder → increased risk of gallstone formation & cholestasis Estrogen & progesterone relax smooth muscle in cervix & pelvic floor ligaments What causes edema in the lower extremities? How can this be relieved? Causes o Increased venous pressure o Decreased blood flow to extremities due to compression of iliac veins & inferior vena cava ▪ Do NOT lay on back o Decreased renal flow in the 3rd trimester Relief o Sleeping on the left side o Elevation o Hydration o Exercise o Compression socks o Standing or walking What causes nasal and sinus congestion? Estrogen, progesterone & prostaglandins cause vascular engorgement & smooth muscle relaxation, leading to nasal & sinus congestion What changes in lab values might occur as a result of adaptations of the cardiovascular system? Increase in: o RBC count by 30% o RBC volume by 18-33% o Plasma volume by 50% o WBC up to 16,000 mm3 in the absence of infection o Heart rate o Stroke volume o Heart size  o Hypercoagulability ▪ Plasma fibrin by 40% ▪ Fibrinogen by 50% Decrease in: o Hemoglobin