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LLAMAS, April Danica E.

BSN-III-C

Why is there an increase blood flow in the kidney during


pregnancy?

During pregnancy , each kidney increases in length by 1-1,5cm,


with a concomitant increase in weight. The renal pelvis is dilated. The
ureters are dilated above the brim of the bony pelvis. The ureters also
elongate, widen, and become more curved. Thus there is an increase
in urinary stasis, this may lead to infection and may make tests of
renal function difficult to interpret. The absolute cause of
hydonephrosis and hydroureter in pregnancy is unknown, there may
be several contributing factors: 1-Elevated progesterone levels may
contribute to hypotonia of the smooth muscle in the ureter. 2-The
ovarian vein complex in the suspensory ligament of the ovary may
enlarge enough to compress the ureter at the brim of the bony pelvis,
thus causing dilatation above that level. 3-Dextorotation of the uterus
during pregnancy, may explain why the right ureter is usually more
dilated than the left. 4-Hyperplasia of smooth muscle in distal one-third
of the ureter may cause reduction in the luminal size.

Why does the blood supply of the mother increases during


pregnancy?

During pregnancy, the woman's heart must work harder because


as the fetus grows, the heart must pump more blood to the uterus. By
the end of pregnancy, the uterus is receiving one fifth of the woman's
prepregnancy blood supply. During pregnancy, the amount of blood
pumped by the heart (cardiac output) increases by 30 to 50%. As
cardiac output increases, the heart rate at rest speeds up from a
normal prepregnancy rate of about 70 beats per minute to 80 or 90
beats per minute. During exercise, cardiac output and heart rate
increase more when a woman is pregnant than when she is not. During
labor, cardiac output increases by an additional 10%. After delivery,
cardiac output decreases rapidly at first, then more slowly. It returns to
the prepregnancy level about 6 weeks after delivery.

Certain heart murmurs and irregularities in heart rhythm may


appear because the heart is working harder. Sometimes a pregnant
woman may feel these irregularities. Such changes are normal during
pregnancy. However, other abnormal heart sounds and rhythms (for
example, diastolic murmurs and tachyarrythmias), which occur more
often in pregnant women, may require treatment.

Blood pressure usually decreases during the 2nd trimester but


may return to a normal prepregnancy level in the 3rd trimester.

The volume of blood increases by 50% during pregnancy. The


amount of fluid in the blood increases more than the number of red
blood cells (which carry oxygen). Thus, even though there are more
red blood cells, blood tests indicate mild anemia, which is normal. For
reasons not clearly understood, the number of white blood cells (which
fight infection) increases slightly during pregnancy and markedly
during labor and the first few days after delivery.

The enlarging uterus interferes with the return of blood from the
legs and the pelvic area to the heart. As a result, swelling (edema) is
common, especially in the legs. Varicose veins commonly develop in
the legs and in the area around the vaginal opening (vulva). They
sometimes cause discomfort. Clothing that is loose around the waist
and legs is more comfortable and does not restrict blood flow. Some
measures not only ease the discomfort but may also reduce leg
swelling and make varicose veins more likely to disappear after
delivery by wearing elastic support hose, resting frequently with the
legs elevated and lying on the left side.

Witch Hazel
Is an astringent produced from the leaves and bark of the North
American Witch Hazel shrub (Hamamelis virginiana), which grows
naturally from Nova Scotia west to Ontario, Canada, and south
toFlorida and Texas in the United States. This plant was widely used for
medicinal purposes by American Indians.

The essential oil of witch hazel is not sold separately as a


consumer product. The plant does not produce enough essential oil to
make production viable. However, there are various distillates of witch
hazel (called hydrosols or hydrolats) that are gentler than the "drug
store" witch hazel and contain alcohol.
The bark and leaves are astringent; the extract, also referred to
as witch hazel, is used medicinally. Extracts from its bark and leaves
are used in aftershave lotions and lotions for treating bruises and
insect bites. Witch-hazel helps to shrink and contract blood vessels
back to normal size, hence its use as the active ingredient in
many hemorrhoid medications. It is also a common treatment
for postnatal tearing of the perineum. The seeds contain a quantity of
oil and are edible. It is also used in treating acne.

Dextrose

Better known today as glucose, this sugar is the chief source of


energy in the body. Glucose is chemically considered a simple sugar. It
is the main sugar that the body manufactures. The body makes
glucose from all three elements of food, protein, fat and
carbohydrates, but in largest part from carbohydrates. Glucose serves
as the major source of energy for living cells. It is carried to each cell
through the bloodstream. The cells cannot, however, use the glucose
without the help of insulin. When sampled in blood, glucose is tested in
transit.

Epsom Salt

Also known as Magnesium sulfate (or magnesium sulphate) is


a chemical compound containing magnesium, sulfur and oxygen, with
the formula MgSO4. It is often encountered as the
heptahydrate epsomite (MgSO4·7H2O). Another hydrate form
is kieserite.

Anhydrous magnesium sulfate is used as a drying agent. Since


the anhydrous form is hygroscopic (readily absorbs water from the air)
and is therefore difficult to weigh accurately, the hydrate is often
preferred when preparing solutions, for example in medical
preparations. Epsom salt has been traditionally used as a component
of bath salts.

Medical uses:
Oral magnesium sulfate is commonly used as a saline laxative. Epsom
salt is also available in a gel form for topical application in treating
aches and pains.

Indications for its internal use are:

 Replacement therapy for hypomagnesemia.


 Magnesium sulfate is the first-line antiarrhythmic agent
for torsades de pointes in cardiac arrest under the 2005 ECC
guidelines and for managing quinidine-induced arrhythmias.
 As a bronchodilator after beta-agonist and anticholinergic agents
have been tried, e.g. in severe exacerbations of asthma.] Recent
studies have revealed that magnesium sulfate can be nebulized to
reduce the symptoms of acute asthma. It is commonly administered
via the intravenous route for the management of severe
asthma attacks.
 A 2004 research study showed that both magnesium and sulfate
are absorbed through the skin when bathing in 1% w/v solution.
 Magnesium sulfate can be used to treat eclampsia in pregnant
women.
 Magnesium sulfate can also delay labor in the case of premature
labor, to delay preterm birth.[11][12]
 Intravenous magnesium sulfate may be able to prevent cerebral
palsy in preterm babies.
 Solutions of sulfate salts such as Epsom salt may be given as
first aid for barium chloride poisoning.

Indications for topical use are:

 Magnesium sulfate paste has been used as an agent for


dehydrating (drawing) boils, carbuncles, and abscesses.
 Magnesium sulfate solution has also been shown to be an
effective aid in the fight against blemishes and acne when applied
directly to problematic areas, usually in poultice form. If combined
with water and made into a cream, it can be applied to the face to
remove blackheads.
 Magnesium sulfate, when used through soaking, can soothe
muscle pains and help improve rough patches in the skin.
 Soaking in a warm bath containing Epsom salt (magnesium
sulfate) can be beneficial to soothe, relax,and relieve herpes
outbreak symptoms, such as itching and lesions relating to genital
herpes and shingles.

Cortisol

Is an important hormone in the body, secreted by the adrenal


glands and involved in the following functions such as proper glucose
metabolism, regulation of blood pressure, insulin release for blood
sugar maintenance, immune function, inflammatory response.

Normally, it’s present in the body at higher levels in the morning,


and at its lowest at night. Although stress isn’t the only reason that
cortisol is secreted into the bloodstream, it has been termed “the
stress hormone” because it’s also secreted in higher levels during the
body’s ‘fight or flight’ response to stress, and is responsible for several
stress-related changes in the body. Small increases of cortisol have
some positive effects such as a quick burst of energy for survival
reasons, heightened memory functions, a burst of increased immunity,
lower sensitivity to pain, helps maintain homeostasis in the body.

While cortisol is an important and helpful part of the body’s


response to stress, it’s important that the body’s relaxation
response to be activated so the body’s functions can return to normal
following a stressful event. Unfortunately, in our current high-stress
culture, the body’s stress response is activated so often that the body
doesn’t always have a chance to return to normal, resulting in a state
of chronic stress.

Higher and more prolonged levels of cortisol in the bloodstream


(like those associated with chronic stress) have been shown to have
negative effects, such as impaired cognitive performance, suppressed
thyroid function, blood sugar imbalances such as hyperglycemia,
decreased bone density, decrease in muscle tissue, higher blood
pressure, lowered immunity and inflammatory responses in the body,
slowed wound healing, and other health consequences, increased
abdominal fat, which is associated with a greater amount of health
problems than fat deposited in other areas of the body. Some of the
health problems associated with increased stomach fat are heart
attacks, strokes, the development of metabolic syndrome, higher
levels of “bad” cholesterol (LDL) and lower levels of “good” cholesterol
(HDL), which can lead to other health problems.

Aldosterone hormone

A hormone made by the outer portion (cortex) of the adrenal


gland that regulates the balance of salt and water in the body.
Aldosterone is secreted in response to low salt levels.
Aldosterone then activates the MR (for mineralocorticoid receptor)
gene. (Aldosterone is classified as a mineralocorticoid hormone.) The
product of the MR gene, in turn, stimulates the kidney to reabsorb and
retain salt, thereby retaining water.
An MR gene mutation leads to salt retention and high blood
pressure early in life which becomes much worse with pregnancy.

Anti-diuretic Hormone
A relatively small (peptide) molecule that is released by the
pituitary gland at the base of the brain after being made nearby (in the
hypothalamus). ADH has an antidiuretic action that prevents the
production of dilute urine (and so is antidiuretic).
A syndrome of inappropriate secretion of ADH results in the
inability to put out dilute urine, perturbs fluid (and electrolyte) balance,
and causes nausea, vomiting, muscle cramps, confusion and
convulsions. This syndrome may occur in association with oat-cell lung
cancer, pancreatic cancer, prostate cancer, and Hodgkin's disease as
well as a number of other disorders.
ADH also can stimulate contraction of arteries and capillaries.
ADH is also known as vasopressin.

Location of the kidney


Located at the rear of the abdominal cavity in the
retroperitoneum, the kidneys receive blood from the paired renal
arteries, and drain into the paired renal veins. Each kidney excretes
urine into a ureter, itself a paired structure that empties into the
urinary bladder.

References:
http://www.medstudents.com.br/ginob/ginob5.html

http://www.merck.com/mmhe/sec22/ch257/ch257d.html

http://en.wikipedia.org/wiki/Witch_hazel_(astringent)

http://en.wikipedia.org/wiki/Witch-hazel.html

http://en.wikipedia.org/wiki/Magnesium_sulfate

http://stress.about.com/od/stresshealth/a/cortisol.htm

http://www.medterms.com/script/main/art.asp?articlekey=3784