Hoe does oestrogen levels change during pregnancy?
Oestrogen levels continuously rise during pregnancy. (drops right at the end to allow for labour)
How do progesterone levels change during pregnancy?
Progesterone levels rise continuously during pregnancy. Orignially produced by corpus luteum but then placenta takes over the role. (drops right at the end to allow for labour)
How does oestrogeon prepare the maternal body for delivery?
It does this by increasing the number of oxytocin receptors in the uterus.
What. is progesterones role in pregnancy?
- maintain uterine lining
- smooth muscle relaxant
how does breathing change for the mother during pregnancy and why?
- More diaphragmatic breathing
- increased tidal volume
- relative hyperventillation
- > because there is an increase in intra abdominal pressure due to the enlargment of the uterus.
What cardiovascular changes are there for the mother in pregnancy?
- increased cardiac output ( cardiac output= heart rate x stroke volume)
- decreased systemic vascular resistance (causes increased stroke volume)
- drop in blood pressure
What haematological changes are there for the mother during pregnancy?
- increase in plasma volume -> 40%
- increase in red blood cell volume -> 25%
(plasma volume increases more than red blood cell volume so a net lower volume of RBCs making anaemia common in pregnancy)
-increase in clotting factors (pregnancy is a hyper-coagulable state)
what musculoskeletal effects does the mother experience during pregnancy? (due to uterine enlargment)
- increased BMI
- stretch marks
- lower back pain
- lordosis
- sciatica
- calf cramp
what dermatological changes are there for the mother in pregnancy?
- increased skin pigmentation
- distention and proliferation of blood vessels
what are some of the physical effects of increased progesterone and oestrogeon in the body?
- breast enlargment
-areolar pigmentation
-uterine hypotrophy and stretching
cervical gland hypotrophy -> increase in mucus secretion at the cervix forming mucus plug - increase of lactic acid in vagina
What are the changes to the mothers breasts during pregnancy? (by oestrogen and progesterone)
oestrogen:
- increase in adipose tissue
- lactiferous duct system gets ready for breast feeding
progesterone:
-enlargment of breast lobules
What are the urological changes to the mother during pregnancy?
- increase in renal blood flow (40%) –> more frequent urination
- increased kidney size
- ureter dialation (due to smooth muscle relaxing effects of progesterone)
main changes to gastro-inteastinal system for the mother during pregnancy?
- increased intra abdominal pressure
effects of increased progesterone:
-oesophageal relaxation (reflux) - reduced bowel motility
How is a constant supply of thyroxin to the foetus ensured early in pregnancy and why is this important?
- increase in oestrogeon levels means an increase in thyroid-binding globulin (TBG).
- meaning more free T3 andT4 to bing to TBG which will increase the amount of thyroxin secreted by the anterior pituatry gland
- (levels of free T3 and T4 stays the same but overall levels rise)
- thyroxin is important for neuralation
How does the endocrine system help ensure there is a continuous supply of glucose to the foetus?
- during pregnancy (mainly second trimester) there is an increase in anti- insullin hormones (human placental lactogen, prolactin and cortisol)
- this increases insullin resistance in the mother and reduces peripheral uptake
During pregnancy the mother switches to a different energy source through lipolysis to provide substrate for maternal metabolism, what risk does this cause?
- increased lipolysis means an increase in fatty acids in the blood plasma
- breakdown of lipids can cause ketogenesis, meaning the mother is at a higher risk of ketoacidosis.
what causes an increase in total blood volume during pregnancy?
Pregnancy results in the activation of the renin-angiotensin-aldosterone system, leading to an increase in sodium levels and water retention.
what are the effects of an increase metabollic rate on the mother during pregnancy?
- increased demand for oxygen causes :
- increased tidal volume
- increased minute ventillation rate
describe the latent phase of the first stage of labour
- stretching of cervix sends nerve impulses to the hypothalmus and posterior pituatry gland to release oxytocin
- oxytocin stimulates uterus contractions
- placenta produces prostaglandins which also stimulates uterine contractions
- these contractions cause the cervix to stretch even more so the cycle continues (positive feedback loop)
when does the active phase of the first stage start and what does it consist of?
- once the cervix dilated to 3/4 cm active phase begins
- cervix continues to dilate
- contractions are regular and more painful
- crowning at 10cm dilated
What happens in the 2nd stage of labour?
- cervix is fully dilated
- from crowning to when the baby is born
what happens in the third stage of labour?
- placental delivery
- placenta is slowly detaching
- uterus is still contracting
- risk of haemorrhage
what criteria means labour has begun?
- regular painful contractions
- cervix effacment
what does cervix effacement mean?
- thinning and shortening
