15 - Repro - Pregnancy Flashcards
Name the reaction which causes the regulation of the trophoblast invasiveness during implantation:
Decidualization reaction
What is the Decidualization reaction?
The secretion of factors from the endometrial stromal cells, to regulate the invasiveness of the trophoblast cells during implantation
Which cells of the blastocyst migrate into and line the spiral arteries of the endometrium after implantation has occurred?
Trophoblast
When does pre-eclampsia typically present?
After 20 weeks of gestation
What are the signs/symptoms of pre-eclampsia?
- High blood pressure
- Proteinuria
- Headaches
- Nausea/vomiting
- Heartburn
- Oedema
Name the main functional units of the placenta:
Chorionic villi
As the growing foetus has increasing demands, how is the interhaemal distance decreased in the placenta?
- Thinning of trophoblast layers
- Margination of foetal capillaries within the villi
- Increased branching of villus tree = Increased surface area
Define haemomonochorial placenta:
Placenta in which there is 1 layer of trophoblast tissue separating the mother’s blood from the blood capillaries of the foetus
Give some examples of drugs which can cross the placenta:
- Thalidomide
- Alcohol
- Nicotine
- Cocaine
- Lithium
- Warfarin
Give some examples of infectious agents which can cross the placenta:
- Varicella zoster virus
- Cytomegalovirus
- Treponema palladium
- Toxoplasma gonadii
- Rubella
Via which mechanism do some infectious agents cross the placenta?
Pinocytosis
Which antibody can cross the placenta?
IgG
Define teratogen:
A drug or other substance capable of interfering with the development of a fetus, causing birth defects
Name the arteries/veins which contribute to the maternal placenta:
Endometrial arteries
Endometrial veins
Which vessels are contained within the umbilical cord? State whether they carry oxygenated or deoxy- blood:
Umbilical vein - oxygenated blood
Umbilical arteries x2 - deoxygenated blood
Name the 3 main substances which are actively transported across the placenta:
1) Amino acids
2) Iron
3) Vitamins
Name the major substances produced by the placenta:
- Glycogen
- Cholesterol
- Fatty acids
- Steroid hormones (Progestogen + Oestrogens)
- Protein hormones (hCG, hPL, hCT, hCACTH)
Which hormone released from the placenta during pregnancy increases the mother’s appetite?
Progesterone
By which week of gestation does the placenta take over production of steroid hormones from the corpus luteum?
~ 11th week
Name the main protein hormones produced by the placenta:
- human placental lactogen
- human chorionic gonadotrophin
- human chorionic corticotrophin
- human chorionic thyrotrophin
What are the main functions of human placental lactogen?
- Increase maternal mammary gland development
- Increase glucose availability to foetus
When do levels of hCG peak?
10th week of gestation
What limits the transport of glucose across the placenta?
The maternal supply
What are the main functions of human chorionic gonadotrophin?
- Supports the corpus luteum
- Suppresses maternal IgA, IgG and IgM to prevent rejection
Name the substance which is measurable in the serum and urine, and used as the basis of most pregnancy tests:
Human chorionic gonadotrophin
List some causes of a high hCG level:
- Miscalculation of pregnancy dating
- Multiple pregnancies
- Molar pregnancy
- Choriocarcinoma
What is a Hydatidiform mole?
Rare mass or growth that forms inside the uterus at the beginning of a pregnancy, due to abnormal fertilization of the oocyte. The placenta grows with little or no foetal growth.
What is a choriocarcinoma?
Fast-growing tumour of the uterus, which occurs during pregnancy. Usually develops from the placental tissue of a hydatiform mole.
Maternal IgG moves across the placenta to offer the foetus some immunity. How is this passive immunity usually continued after birth?
Via breast milk
What is the primary reason for progesterone to relax maternal smooth muscle during pregnancy? What other effects may the mother notice due to this smooth muscle relaxation?
To decrease TPR, to prevent increase in blood pressure
- Hot flushes
- Nasal congestion
- Reflux
- Constipation
