North American Registry of Midwives (NARM) Practice Exam

During pregnancy, when does cardiac output typically peak?

1. At 12 to 16 weeks

2. At 20 to 24 weeks

3. At 30 to 32 weeks

4. At term

The correct answer is: At 20 to 24 weeks

Cardiac output during pregnancy is largely influenced by changes in blood volume and the physiological adaptations that occur to support both the mother and the developing fetus. Typically, cardiac output begins to rise early in pregnancy due to increased plasma volume and hormonal changes, reaching its peak during the second trimester. The correct timing of peak cardiac output generally occurs between 20 to 24 weeks of gestation. This increase is crucial, as it supports the additional metabolic demands placed on the mother’s body and ensures adequate blood flow to the placenta and fetus. After this peak, while cardiac output remains elevated compared to non-pregnant levels, it typically stabilizes or may show less dramatic increases as pregnancy progresses toward term. Understanding this physiological change is essential for midwives and healthcare providers, as it helps in monitoring maternal health and ensuring optimal care during prenatal visits.