A 38-year-old woman, gravida 1 para 0, at 34 weeks gestation comes to the office due to increasing swelling in her hands and legs. The patient first noticed the swelling a few weeks ago but now cannot stand for more than an hour without needing to elevate her legs. She has no orthopnea, dyspnea, or chest pain. The patient has no chronic medical conditions and takes no daily medications. Vital signs are normal. Cardiac examination is within normal limits. Lungs are clear to auscultation. Bilateral lower extremities have 2+ pitting edema to the midshin. Urine dipstick shows no protein. Compared to a healthy nonpregnant woman, which of the following parameters is most likely to be decreased in this patient?

Question

A 38-year-old woman, gravida 1 para 0, at 34 weeks gestation comes to the office due to increasing swelling in her hands and legs.  The patient first noticed the swelling a few weeks ago but now cannot stand for more than an hour without needing to elevate her legs.  She has no orthopnea, dyspnea, or chest pain.  The patient has no chronic medical conditions and takes no daily medications.  Vital signs are normal.  Cardiac examination is within normal limits.  Lungs are clear to auscultation.  Bilateral lower extremities have 2+ pitting edema to the midshin.  Urine dipstick shows no protein.  Compared to a healthy nonpregnant woman, which of the following parameters is most likely to be decreased in this patient?

Quizplus · Accepted Answer

Eductional Objective: During pregnancy, systemic vascular resistance decreases and plasma blood volume increases. Venous capacitance and a decrease in pulmonary vascular resistance allow for accommodation of increased blood volume without affecting central venous pressure (CVP). Despite a normal CVP, peripheral edema is common in pregnancy due to decreased capillary oncotic pressure that encourages leakage of fluid into dependent peripheral tissues (eg, lower extremities).

A 38-Year-Old Woman, Gravida 1 Para 0, at 34 Weeks