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Pregnancy Physiology - Coggle Diagram
Pregnancy Physiology
Common symptoms during pregnancy
Respiratory
Dyspnea
Unclear mechanism
May be due to progesterone induced hyperventilation
Cardiovascular
Ejection systolic murmur
Gestational HTN
Gestational pre-eclampsia
Haematological
Anaemia
Venous thromboembolism
Due to pro-coagulatory state
Risk factors: prolonged bed rest
Thrombocytopenia (8-10%)
Endocrine
Transient hyperthyroidism
Renal
Glycosuria
Physiological hydronephrosis + hydroureter
GI
Gastro-esophageal reflux
Treatment
Antacids
Elevating head of bed
Nausea, vomiting
Always in 1st trimester, until 12 weeks of gestation
Severe form: hyperemesis gravidarum
Primarily thought to be associated with rising hCG
Treatment
Light snacks instead of large meals
Avoid triggers
Avoid iron supplements
Anti-emetics
Dimenhydrinate (H1 receptor antagonist)
Promethazine (dopamine antagonist)
Metoclopramide (UGI motility stimulant)
Constipation
Due to decreased gut motility from progesterone
Increased water absorption from gut
Oral iron supplements
Also leads to haemorrhoids
Fainting and dizziness
Insufficient blood and O2 to the brain
Progesterone causing vasodilation
Standing for a long time
Supine hypotension
Backache
Increased lumbar lordosis
Strain on back muscles
Ligamentous laxity
Due to progesterone and relaxin
Physiological changes during pregnancy
Respiratory system
Increased O2 consumption by 20%
Supports extra cardiac, renal, respiratory work
Supports uterine and breast development
Supports metabolism of the feto-placental unit
Increased ventilation by 40%
Increased tidal volume by 40%
Decreased maternal PCO2
Allows for more placental transfer of CO2 from fetus
Cardiovascular system
Decreased SVR
Decreased afterload
Increased plasma volume
Increased preload
Increased HR by 10-20bpm
Increased stroke volume
Increased cardiac output by 30-50%
Decreased BP
Greatest reduction during 2nd trimester
Haematological system
Increased plasma volume
Starting at 6-8 weeks
Increased RBC mass by 20%
Increased erythropoiesis
Decreased Hb, haematocrit, and RBC count
Increased WBC and neutrophils
Decreased platelets
Due to haemodilution
Physiologically increased fibrinolysis within uteroplacental circulation to maintain blood flow
Endocrine system
Increased thyroxine binding globulin and total T3+4 (by 50%)
hCG increases
Decreased TSH
Increased free T3+4
hCG has mild thyroid stimulating ability
Renal system
Increased kidney size
Increased renal plasma flow by 60-80%
Increased GFR by 50%
Decreased serum creatinine and urea
Decreased glucose reabsorption
Increased glucose excretion by 10x
GI system
Increased intragastric pressure
Decreased LES pressure
Decreased gastric peristalsis
Increased small and large bowel transit time to increase water absorption from gut
Hepatobiliary system
Increased liver metabolism
Increased ALP
Decreased GGT, albumin, bilirubin
Anatomical changes during pregnancy
Respiratory system, due to:
Enlarging uterus
Hormonal changes
Increased laxity of thoracic ligaments
Lifting of ribcage
Upward flaring of ribs
Elevation of diaphragm