Physiology of Pregnancy

TERMS TO KNOW

Aldosterone: Enhances Na+ reabsorption at the collecting duct of the kidney

Aneuploidies: Abnormal numbers of chromosomes that may occur as a consequence of abnormal meiotic division of chromosomes in gamete formation

Antidiuretic hormone (arginine vasopressin): Acts to conserve water by increasing the permeability of the collecting duct of the kidney Blastocyst: At the 8- to 16-cell stage, the blastomere develops a central cavity and becomes a blastocyst. The cells on the outer layer differentiate to become trophoblasts.

Blastogenic period: The first 4 weeks of human development Blastomere/morula: In 2 to 4 days after fertilization, a fertilized oocyte undergoes a series of cellular divisions and becomes a blastomere or morula

BMI: A calculation that relates patient's height to weight: Weight(kg)/height(m2) Obese = > 30 Overweight = 25 to 29.9 Norm = 18.5 to 24.9

Does not consider lean body mass or percentage of body fat Conception: The fertilization of an ovum by sperm

Decidua: The name given to the endometrium or lining of the uterus during pregnancy and the tissue around the ectopically located fertilized ovum

Embryonic period: Begins with the folding of the embryonic disk (which is formed from the inner cell mass) in week 2 of development Erythrocyte sedimentation rate (ESR): A nonspecific laboratory indicator of infectious disease and inflammatory states. An anticoagulant is added to a tube of blood, and the distance the red blood cells fall in 1 hour is the rate.

Fetus: The term given to the conceptus after 8 weeks of life; it has a crown-rump length of 30 mm and a gestational age of 10 weeks. The fetal period continues until birth.

Gestational age: The time calculated from the last menstrual period and by convention exceeds the developmental age by 2 weeks

Joint changes (i.e., pubic symphysis) + postural changes secondary to change in center of gravity results in backaches and other aches that are common in pregnancy.

Oocyte: The primitive ovum before it has completely developed Primary: The oocyte at the end of the growth period of oogonium and before the first maturation division has occurred

Secondary: The larger of two oocytes resulting from the first maturation division

Oogenesis: Formation and development of the ovum Oogonium: The primordial cell from which an oocyte originates Organogenesis: Occurs between 4 and 8 weeks after conception Polar body: The small cell produced in oogenesis resulting from the divisions of the primary and secondary oocytes Preembryonic period: The first 2 weeks after fertilization Pregenesis: The time period between the formation of germ cells and the union of sperm and egg

Puerperium: The period of up to 6 weeks after childbirth, during which the size of the uterus decreases to normal

Residual volume (RV): The volume of gas contained in the lungs after a maximal expiration

Tidal volume (TV): The volume of air that is inhaled and exhaled during normal quiet breathing

Total lung capacity (TLC): The volume of gas contained in the lungs after a maximal inspiration

Vital capacity (VC): The volume of gas that is exhaled from the lungs in going from TLC to RV

Zona pellucida: Inner, solid, thick membranous envelope of the ovum (vitelline membrane, zona radiata)

GENERAL EFFECTS OF PREGNANCY ON THE MOTHER

Table 4-1 summarizes maternal physiologic changes during pregnancy.

If normal prepregnancy weight: Patient should gain 25 to 35 lbs. during pregnancy. There should be little weight. gain in T1 and most of weight gain in T2 and T3.

Ideal weight gain: T1: 1.5 to 3 lbs. gained T2 and T3: 0.8 lbs./wk

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