Physiological changes in pregnancy :
Uterus never comes back to its pregnancy weight. Will be slighty5higher with each pregnancy
How to counsel for round ligament pain.. Avoid sharp movement.. Heat compresses and local stuff.. Its. Normal
How to counsel for supine hypotension syndrome: tell to get up slowly.. Not all of a sudden.
Why left lateral but not right lateral: because aorta sparing
Uterine souffle can be in non pregnant states like fibroids
Must not confuse with fhs. Fhs will be faster and wont coincide with maternal pulse
Dont confuse show with waters after rupture of membranes
Cervical ectropion is Physiological
Chloasma is pigmentation of the face
Importance of hypercoagulability in pregnancy
Why hypercogulability?
Heemodilution importance?
This pregancy-induced oedema is usually relieved by rest.. So in the morning less... And increases with term.
But odema which is so generalised and extensive, spreading to the knee any demand which is extensive, and non pitting they must think of preeclampsia
Before 20 weeks it reduces because of low Vascular Resistance after 20.weeks increases because of increased blood volume preclamsia is mainly after 20 days
Before 20.weeks.suspect chronic hypertension
two reasons why iron is onl in second trimester number one is because the patient has nausea vomiting so wanted on the nausea vomiting side effects and because iron demands more in second trimester onwards
platelet count is normally above 1 lakh per if it is below 100000 think of preeclampsia
Hypothyroidism In Pregnancy diagnosis
HCG stimulaes t4. Levels increase
threshold reduces because normally that is the case in pregancy that thyroid levels fall
ventricular remodeeling of the heart to compensate so thats why the stats are the way it is
severe anemia can also trigger heart failure
cant operate in left lateral
Pregnancy sis a state of compensated respiratory alkalosis.
Hyperventilation doesnt refer to the rate. Its both the rate and tidal volume!
Hyperventilation = increase in rate and/or tidal volume much more than what is required to get rid of co2
why polyuria = 1. increased water intake 2 increased renal blood flow and gfr 3 pressure of uterus on the bladder
Proteinuria because increased gfr
How to collect a 24 hr urine sample ? According to pathology, and on top of that obs and gyn.
the uterus is dextrorotated in normal pregnancy. so occupies the right side more...becase of sigmoid colon and everything. so compresses the right side more.left lateral is to reduce this compression....especially on the veins. And also reduce posterioir squeeze onto the aorta.
why increased chance of uti? statis of urine because of hydroureter and also urinary retention because of pressure.
urine dipstick test should be done on every visit to check for protein and sugar and nitrite positive for bacteria.
Failure to excerete conc urine can also happen because of bladder congestion
Progesterone causes smooth muscle relaxation everywhere. That is why feeling hot as peripheral cutaneous vessels dilated and akso hydroureters and also acid reflux....ut spider naeve and palmar erytheme is oestrogen!
Heart burn how to counsel ⇒ avoid spicy meals. Choclolate or any food that triggers it. Avoid reclining after meals. Take small frequent meals. Take gaviscon when it strikes.
multiparous women are more at risk of developing galle stones because with each pregancy it has become relaxed leading to sludge formation.
Laxative that is recommended to be used in pregnancy ?
on clear fluids because 1. gastric emptying time is reduced 2 what if needed ceasrian section and anesthesia
Tb is known to flare up in the post partum period
TLC increased without clinical signs and symptoms of infection is okay. could be explained as a shift from peripheries to the blood. like what happens after exercise and during stress etc - so not actual increase or increase in production but just distribution.
why cell mediated immunity decreases? To protect the fetus from rejection?
heart sounds can be sometimes felt after only 10 weeks and thats okay
Sometimes the question might ask whats the next step. Not whats the management - not obvious steps but the next step.
The only organism that excists in acidic ph in the vagina is candida. But still bacterial vaginosis can be there. same risk factors as in non pregnant women.