Thu11November0627PM 9

Are the following true or false during a normal pregnancy?

True / False

Plasma albumin concentration falls by 25% Correct

Erythrocyte sedimentation rate (ESR) is unchanged Correct

The mean white cell count is 12 ×109/L at term Incorrect answer selected

The platelet count is reduced by 20% Correct

Total blood volume increases by 50% Correct

Explanation

At term, the total blood volume (red cell volume + plasma volume) is 48% greater than pre-pregnancy levels.1

The ESR (and CRP) increases during pregnancy as a result of a rise in circulating fibrinogen.2

Whilst platelet turnover increases during pregnancy, an increase in production typically leads to only a small fall in platelet count (<5%).3

Albumin production fails to keep up with the expansion in plasma volume and leads to a reduction in colloid osmotic pressure and the formation of oedema. A typical serum albumin value in the non-pregnant state ranges from 33-41 g/L compared with 24-31 g/L during the third timester of pregnancy.

Reference:

Pritchard JA. Changes in the blood volume during pregnancy and delivery. Anesthesiology. 1965;26:393-399.

Ozanne P, et al. Erythrocyte aggregation during normal pregnancy. Am J Obstet Gynecol. 1983;147:576-83.

Tygart SG, McRoyan DK, Spinnato JA, et al. Longitudinal study of platelet indices during normal pregnancy. Am J Obstet Gynecol. 1986;154:883-7.

Answer Statistics

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Average score: 67.68%

Times answered: 237