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Increased during pregnancy

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Increased during pregnancy

Post by mandible on Wed Feb 24, 2010 3:03 pm

increased during prgnancy :.....
*renal excretion of HCO3
*plasma volume 2600_____ 3800ml.(until 32wks.) it is related to the size of the fetus .
*Red cell mass(1400ml _____1650-1800) until term .
*COP (4.5l___6.1 l/min) = 40% early and reach plateau at 24 __ 30wks
*HR (80 ___ 90/min) = 10 %
* O2 consumption (250 __ 300ml ) increased by 30 __ 50 ml at term .
*stroke volume increased by 64 __ 71 ml ... this inc in cardiac out put 1500 ml ( skin 500--- uterus 400 at term 700..... kidney 300 others (git , breast 300).
*Renin inc in pregnancy and estrogen containing pills but the action of angiotensinogen 2 is blocked so decreased PR
*Fluid transfer across the endothelium so Oedema.
*EDHF (endothelial derived hyperpolarizing factor )
* Throboxane ( 3-5 times) until term
*EDrwF
*Endothelin .
*clotting factors 1,5, 8 .
* Increased PAI (plasminogen activating inhibitor===> decreased fibrinolysis)
*Increased PTA (tissue plasmin activator)==> inc fibrinolysis
*Generalised inflamatory response
*erythropoiten (3times )
*Ventliation due to progesterone(40% more in the first trimester).
* The inc in O2 is 50ml ( 20 fetus , 18 metabolic activity ,6 COP , 6 inc inrenal work.
*ADH.
*the sensitivity of the respiratoratory to Co2( like does hypoxia )
*Diaphragm 4cm ( transverse diameter of the chest 2cm , subcostal angle 38 - 103 degree )
* Pulmonary blood flow 40%
* pulmonary arterial pressure (12--19%)
*Tidal volume 200ml
*Alveular ventilation 30%
*Vital capacity (MAY).
*Minute volume (3L)
*Kidney length (1cm ) due to inc cell size.
*Ureter dilated due to ( proges cause smooth muscle reaxation+obstruction by the uterus and collectig system)
*Renal blood flow 1.2L/min___1.5L/min early and decreased in the 3rd trimest )
*GFR(120 ml/min.
*filtered load of glucose ====> glucosuria.
*Renal excretion of sugars, water and soluble vitamins ,proteins(albumin)
and transferin , amino acids.
*Aldosterone and deoxycorticosterone , cortisol ( total and free ) max in 3rd trimest.
*Inc filtered load of sodium (balanced by reabsorption)
*Apettite and thirst .
*Motilia and somatostatin
*Gums.swell and bled easily , caries.
*Gastric emptying time (50 to 100 min )
*Inc osteolytic activity=====> inc alkaline phosphatase
*Serum bile acids ===>cholyglycin
*Fatty acids
*Enhanced insulin response to glucose early in the 2nd trimest so inc in 2hr plasma glucose
*Binding proteins , transferin binding capacity
*B globin
* SHBG.
* IgM , IgD.
*lipids (TG , cholesterol ,phospho lipids , FFAs , lipoproteins ,.
*Pro vit A ,E ,D .
Parathrmone
*copper (2--3 times ) due to inc ceruplasmin.
*susceptability to infection (polio , infuensa , malaria ).
*Erythropoiesis due to ( erythroid hyperplasia and inc transferin )
*TWBC (neutrophils)
*MCV
*ESR
*Red cell fragility (RC)
*red cell size .
*Fibrinogen. FAP
*Factor 7,8,9,10,12 from the third trimest
*Fetal arrterial presure through out prgnanacy.
*Water reabsorption in large itestine .
Iron absorbtion
*Size of the thyroid gland .
*Protein bound iodine .
*total T3
*Androstenadione , Testerone.
*The proportion of B to T cells AND WE HAVE DECREASED DURING PREGNANCY SOON ( URS nagm)
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mandible
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