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summarise pregnancy hormones
placental prolactin
placental lactogens
corticotropin releasing hormone
aldosterone
erythropoietin
summarise anatomical changes during pregnancy
uterine enlargement
hypertrophy of uterine musculature
diaphragm displace cranially by gravid uterus
apex of heart moved to anterior and to left
left ventricular hypertrophy
changes in calcium conc
weight gain
how does pregnancy affect blood volume
increased blood volume→ 40 % by full term
how does pregnancy affect red cell mass
increases linearly→ 30%
how does pregnancy affect haematocrit and haemoglobin? what’s an advantage of this
decrease in both
→ plasma volume increases more than cell mass
decreased viscosity leads to reduced resistance in flow= better placental perfusion
mechanism of hormonal stimulation in pregnancy in CVS
stimulation of RAAS
aldosterone= sodium ion and water retention= increased plasma volume
increased renal erythropoietin = increases red cell mass
what supplement will restore Hb levels in pregnancy
iron and folic acid
how is peripheral vascular resistance affected in pregnancy
reduced by 40% in mid-pregnancy→ increases after to full term
how does pregnancy affect cardiac output
increased blood volume- more blood enters heart
decreased peripheral resistance= reduced afterload
increases stroke volume= increased maternal heart rate= increased cardiac output (CO= SV x HR)
describe aortocaval compression during pregnancy
enlarged uterus= IVC and abdominal aorta compressed
compression of IVC= decreased venous return to heart= decreased BP
compression of aorta= reduced uteroplacental and renal blood flow