Mnemonics: Maternal physiology
Hormones That Increase in Pregnancy
What needs to be memorized: Nine hormones that increase during pregnancy: hCG, hPL, Estrogen, Progesterone, Prolactin, Thyroid hormones, Cortisol, Aldosterone, and Relaxin
Mnemonic: "Pregnancy Test Happy hai, EPP check karo, Thyroid aur CAR ready"
🔗 The Breakdown:
- Happy → HCG and HPL (the two hormones detected in pregnancy tests)
- E → Estrogen
- P → Progesterone
- P → Prolactin
- Thyroid → Thyroid hormones (T3, T4)
- C → Cortisol
- A → Aldosterone
- R → Relaxin
Components of Maternal Weight Gain
What needs to be memorized: Eight components of ~12.5 kg total weight gain and their approximate weights
Mnemonic: "FM radio 3.5, BE careful 1.5, AU gold 1, BP half"
💡 The Pattern: Everything comes in pairs with the same weight!
🔗 The Breakdown:
- FM (3.5 kg each) → Fetus (3.5 kg) + Maternal fat stores (3.5 kg)
- BE (1.5 kg each) → Blood volume (1.5 kg) + Extracellular fluid (1.5 kg)
- AU (1 kg each) → Amniotic fluid (1 kg) + Uterus enlargement (1 kg)
- BP (0.5 kg each) → Breasts (0.5 kg) + Placenta (0.6 kg)
Total: 3.5×2 + 1.5×2 + 1×2 + 0.5×2 = 12.5 kg
Physiological Anemia of Pregnancy
What needs to be memorized: Why hemoglobin concentration decreases despite increased total hemoglobin - Plasma volume increases more than RBC mass
Mnemonic: "Plasma (45%) race mein aage, RBC (25%) peeche - GAP = Anemia"
🔗 The Breakdown:
- Plasma volume increases by 45% (आगे - ahead in the race)
- RBC mass increases by only 20-30% (पीछे - behind in the race)
- The GAP between them = Dilutional/Physiological Anemia
- Hemoglobin concentration decreases, but total hemoglobin increases
Respiratory Changes - What Increases in Pregnancy
What needs to be memorized: Three main respiratory parameters that increase: Tidal Volume, Minute Ventilation, and Oxygen Consumption
Mnemonic: "TV-MV dekhne se Oxygen zyada lagta hai"
🔗 The Breakdown:
- TV → Tidal Volume increases (by 30-40%)
- MV → Minute Ventilation increases (by 50%)
- Oxygen → Oxygen consumption increases (by 20%)
Think: Watching TV and music videos (MV) requires more oxygen - just like pregnancy!
Renal Changes in Pregnancy
What needs to be memorized: GFR increases by 50% while serum creatinine decreases
Mnemonic: "GFR ko 50% Gift mila, Creatinine ko Kick"
🔗 The Breakdown:
- Gift → GFR increases by 50% (also RPF increases by 50-80%)
- Kick → Serum Creatinine DECREASES (common exam trap!)
- Also remember: BUN also decreases
- Physiological Glycosuria and Proteinuria may occur (GP = "Good Pregnancy")
Supine Hypotensive Syndrome
What needs to be memorized: Occurs after 20 weeks due to IVC compression; relieved by left lateral position
Mnemonic: "Supine mein IVC dabta, Left lateral mein aaram"
🔗 The Breakdown:
- Supine position → Gravid uterus compresses IVC
- Dabta (compressed) → Decreased venous return → Hypotension
- Left lateral → Best position for relief (shifts uterus off IVC)
- Occurs after 20 weeks gestation
Remember: LEFT is RIGHT! (Left lateral is the right position)
Hypercoagulable State in Pregnancy
What needs to be memorized: Five factors that increase creating a hypercoagulable state: Blood volume, WBC, ESR, Fibrinogen, Clotting factors
Mnemonic: "Pregnancy mein BWEFC up - clotting ka setup"
🔗 The Breakdown:
- B → Blood volume increases
- W → WBC increases (leucocytosis up to 15,000)
- E → ESR increases (markedly elevated)
- F → Fibrinogen increases
- C → Clotting factors increase (II, VII, VIII, IX, X, XII)
Clinical correlation: Increased risk of DVT and PE in pregnancy
What decreases slightly: Hemoglobin concentration (dilutional), Platelet count (mild)
Cardiac Output Changes
What needs to be memorized: Cardiac output increases by 30-50% and peaks at 28-32 weeks
Mnemonic: "CO maximum at THIRTY weeks - think 30-30 cricket match"
🔗 The Breakdown:
- 30-50% → Cardiac output increases by this much
- 30 weeks → Peak cardiac output at 28-32 weeks (30 is middle)
- Heart rate increases by 10-15 bpm
- Stroke volume also increases
- Returns to normal by 2 weeks postpartum
Think: Like a cricket match - maximum action at 30-30 overs (middle of pregnancy)!
Gastrointestinal Changes
What needs to be memorized: GI motility decreases, gastric emptying slows, LES tone decreases
Mnemonic: "Pregnancy mein GI system SLOW ho jata"
🔗 The Breakdown:
- S → Stomach emptying delayed (increased aspiration risk in anesthesia)
- L → LES (Lower Esophageal Sphincter) tone decreased → GERD/reflux
- O → Intestinal mOtility decreased → Constipation
- W → Wait time for digestion increased
Clinical tip: NPO guidelines stricter in pregnancy due to slow gastric emptying
