MATERNAL PHYSIOLOGY
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Maternal Physiology: A Comprehensive Overview of Physiological Changes During Pregnancy, Lecture notes of Medical Sciences
A detailed overview of maternal physiology during pregnancy, covering key changes in various organ systems. It explores hormonal production by the placenta, mechanisms of placental transfer, alterations in uterine blood flow, cardiovascular changes, pulmonary function alterations, hematologic changes, coagulation changes, gastrointestinal alterations, and renal function changes. The document also highlights the increased risk of certain conditions during pregnancy, such as anemia, dvt, pe, gerd, gall bladder disease, constipation, ascending uti, and nephrolithiasis. It is a valuable resource for students and healthcare professionals seeking to understand the physiological adaptations that occur during pregnancy.
Typology: Lecture notes
2022/2023
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MATERNAL PHYSIOLOGY
Placenta
Hormone production
Mechanisms of placental transfer
Changes in uterus
Cardiopulmonary changes
Hematologic changes
Alterations in GI function
Renal function changes
MATERNAL PHYSIOLOGY OVERVIEW
HORMONE FUNCTION Human placental lactogen (HPL) Antagonizes insulin spares glucose for use by fetus Enhances lipolysis provides alternate fuel source for mother Human chorionic gonadotropin (hCG) Stimulates corpus luteum to secrete estradiol and progesterone HORMONE PRODUCTION BY THE PLACENTA
MECHANISM EXAMPLES
Simple diffusion Water, oxygen, carbon dioxide Facilitated diffusion Glucose Active transport Amino acids, iron Pinocytosis Drugs, immunoglobulins
MECHANISMS OF
PLACENTAL TRANSFER
DISTRIBUTION OF UTERINE BLOOD FLOW DURING PREGNANCY Myomet Endomet Placenta
CARDIAC
FUNCTION
PERCENT
INCREASE IN
PREGNANCY
Heart rate 5-15% Stroke volume 25-30% Cardiac output 35-50% CARDIOVASCULAR CHANGES DURING PREGNANCY
DANGEROUS CARDIAC DISEASES IN PREGNANCY
Stenotic valve
lesions
Ischemic heart
disease
Marfan syndrome
Eisenmenger’s
syndrome
Primary pulmonary
hypertension
PULMONARY FUNCTION ALTERATIONS IN PREGNANCY
PULMONARY CAPACITY CHANGE Inspiratory capacity (IRV
- TV) Increased Vital capacity (IRV + TV + ERV) Unchanged Functional residual capacity (ERV + RV) Decreased Total lung capacity (IRV+TV+ERV+RV) Decreased PULMONARY FUNCTION ALTERATIONS IN PREGNANCY
ALTERATIONS IN ARTERIAL BLOOD GASES (^) Increased pH (^) Decreased pCO (^) Decreased HCO (^) PARTIALLY COMPENSATED RESPIRATORY ALKALOSIS
ETIOLOGY KEY DIAGNOSTIC TEST(S) Iron deficiency RBC indices, serum ferritin Hemodilution RBC indices Folate deficiency RBC indices, serum folate B 12 deficiency RBC indices, serum folate Hemoglobinopathy Hgb electrophoresis PRINCIPAL CAUSES OF ANEMIA IN PREGNANCY
PERIPHERAL BLOOD
SMEARS
Enhanced hepatic synthesis of I, II, VII, VIII, IX, and X Placenta III (tissue thromboplastin) Platelets aggregate more readily COAGULATION CHANGES IN PREGNANCY
VIRCHOW’S TRIAD THROMBOSIS Venous stasis Alteration in venous wall Hyper- coagulable state