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PREGNANCY (Physiological changes (Cardio
increased CO (HR x SV)
…
PREGNANCY
Physiological changes
Cardio
- increased CO (HR x SV)
- decreased BP (especially diastolic, lowest at 24 weeks)
Resp
- increased tidal volume and minute ventilation
- decreased TLC
- increased total body O2 consumption
- hyperventilation
GIT
- Reflux esophagitis, haemorrhoids, cholestasis
Renal
- increased GFR 50%
- decreased BUN and creatinine
- urine stasis, UTI (asymptomatic)
Haem
- decreased hematocrit
- increased plasma volume (due to incr in plasma > RBC)
- hypercoagulable state, increased clotting factors, increased venous stasis and endothelial damage
Endo
- incr HCG, human placental lactogen, progesterone, estrogen, TBG, T3, T4, prolactin
Derma
- incr estrogen --> spider angiomata, palmar erythema
- incr melanocyte stimulating hormone --> linea nigra, nipples, face (melasma)
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Complications of:
-
VBAC
Uterine rupture 1:200
- discuss major harm to mother (c-sec, rupture, bleeding, bladder damage) and baby (hypoxic ischemic encephalopathy 1:1000)
- discuss the benefits of VBAC
- discuss safeguards against the risks of VBAC (monitor, staff)