Physiological changes during pregnancy

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physiology changes during pregnancy, knowledge for primary FRCA

Created Dec 20, 2010
by 007wendy

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	Side A	Side B
1	cardiac output	increase by 50%
2	stroke volume	increase by 30%
3	heart rate	increase by 25%
4	ejection fraction	increase by 20%
5	left ventricle mass	increase by 50%
6	Left ventricular end-diastolic volume	increase by 10%
7	systemic vascular resistance	decrease by 20%
8	pulmonary vascular resistance	decrease by 34%
9	systolic blood pressure	decrease by 8%
10	diastolic blood pressure	decrease by 20-25%
11	ECG changes in pregnancy	sinus tachcardia, ST depression, T wave flattening, left axis deviation
12	heart valve sizes	12-14% increase
13	Heart sounds in pregnancy	loud split S1, S3, S4 (16%), tricuspid regurge: mid-systolic murmur L sternal edge
14	CVP	normal except when supine in late pregnancy
15	pulmonary artery pressure, pulmonary capillary wedge pressure	unchanged
16	Total blood volume	increase by 45%
17	plasma volume	increase by 50%
18	RBC volume	increase by 30%
19	WCC	increased
20	haemtocrit (packed cell volume)	decreased by 15%
21	haemoglobin	decrease by 15%
22	Total plama protein	decrease by 18%
23	albumin	decrease by 14%
24	Globulin	can increase or decrease
25	Plasma cholinesterase	decrease by 25%
26	colloid osmotic pressure	decrease by 18%
27	platelets	same or decrease by 5%
28	prothrombin time	decrease by 20%
29	bleeding time	decrease by 10%
30	APTT partial thromboplastin time	decrease by 20%
31	antithrombin III	decrease by 10%
32	fibrin degradation products	increase by 100%
33	plasminogen, fibrinolysis	increase
34	clotting factors	all increase except 11 and 13 which decrease by 50%
35	lung compliance	unchanged
36	FEV1, FEV1/FVC	unchanged
37	tidal volume	increases steadily to 45% at term
38	FRC	decreased to 30% at term (25% reduction expiratory reserve volume, 15% reduced residual volume)
39	Inspiratory capacity	increase by 15% at term
40	upper airway	dilated
41	closing capacity	no change
42	inspiratory reserve volume	increase by 5%
43	expiratory reserve volume	decrease by 25%
44	minute ventilation	increase by 50%
45	alveolar ventilation	increase by 70%
46	respiratory rate	increase by 0-15%
47	dead space	increase by 45%
48	total pulmonary vascular resistance	decrease by 50%
49	PaCO2	decrease to 3.7-4.2kPa
50	PaO2	increase to 13.3-14.6kPa
51	pH	increase to 7.44
52	HCO3-	decrease to 18-21 mmol/l
53	oxygen consumption	increase by 30-60%
54	lower oesophageal pressure	increased to 15.7cmH20 from 15.2cmH20
55	gastric acid secretion	decreased
56	gastric pressure (supine)	11.1cmH20 (from 5.7 nonpregnant)
57	Barrier pressure	Barrier pressure = LOS pressure - gastric pressure = 4.6cmH20, REDUCED from 9.5cmH20
58	gastric emptying	no change or decreased slightly during labour
59	MAC	decreased by 40%
60	epidural space volume	decreased
61	epidural space pressure	increased (from negative values in nonpregnancy to positive)
62	CSF pressure	increased
63	CSF volume	decreased
64	CSF composition	unchanged
65	CSF pH	more alkaline, increased pH
66	local anaesthetics	increased sensitivity, decreased dose requirements
67	renal plasma flow	increased
68	GFR	increased to 150ml/min (125ml/min nonpregnant)
69	urine volume	increased
70	renal tubular reabsorption	decreased
71	glycosuria, proteinuria	increased
72	creatinine clearance	increased
73	plasma urea and creatinine concentration	decreased
74	hormone responsible for milk production	prolactin
75	hormone responsible for milk ejection	oxytocin