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GIGU - Week 5/6 (STILL QUARANTINE) > 39- Physiology of Pregnancy & the Fetus > Flashcards

39- Physiology of Pregnancy & the Fetus Flashcards

1
Q

The main function of the placenta for the fetal ________ is to supply nutrients.

A

Gut

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2
Q

The main function of the placenta for the fetal ________ is to exchange O2 and CO2.

A

Lung

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3
Q

The main function of the placenta for the fetal _______ is to regulate fluid volumes and disposing of waste metabolites.

A

Kidney

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4
Q

The main function of the placenta for ________ _______ is to synthesize steroids and proteins that affect both maternal and fetal metabolism.

A

Endocrine Gland

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5
Q

The placental interface is organized to facilitate exchange between maternal and fetal circulations. There is a large surface area for exchange and highly developed _________ of both fetal and maternal components. Intimately juxtaposed, but physically separate.

A

Vascularity

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6
Q

What are the 3 main components of the placenta?

A

Chorionic Villi
Intervillous Space
Decidua Basalis

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7
Q

_______ _______ represent the functional unit of the placenta. They have extensive branching and increased surface area for exchange.

A

Chorionic Villi

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8
Q

_______ _______ from the maternal side empty into the Intervillous Space, which is drained by maternal veins.

A

Spiral Arteries

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9
Q

Maternal blood flow is arterial blood discharged from about 120 Spiral As. into the Intervillous Space. Filling of Intervillous Spaces dissipates the force and reduces blood velocity, allowing adequate time for what?

A

Exchange of nutrients

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10
Q

The maternal blood that fills the Intervillous Spaces drains through venous orifices and enters placental veins. No _________ are present.

A

Capillaries

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11
Q

Fetal blood flow originates from two ________ _______, which branch and penetrate the chorionic plate to form the chorionic villi capillary network. Obtain oxygen and nutrients and returns to the fetus from a single ________ ________.

A

Umbilical Arteries

Umbilical Vein

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12
Q

The _______ _______ in the fetal capillary network has slower blood flow for exchange of nutrients.

A

Terminal Villi

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13
Q

Umbilical As. carry (OXYGENATED/DEOXYGENATED) blood, and the Umbilical V. carries (OXYGENATED/DEOXYGENATED) blood.

A

Deoxygenated

Oxygenated

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14
Q

What are the gas levels of maternal blood entering the Intervillous Space?

A 
PO2 = 100 mmHg
PCO2 = 40 mmHg
pH = 7.4
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15
Q

Diffusion of O2 into the Chorionic Villi causes the PO2 of blood in the Intervillous Space to fall to ________ and lower in Umbilical V. of the fetus. Differences in hemoglobin ________ allows for sufficient Hb saturation.

A

30-35 mmHg

Structure

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16
Q

CO2 transfer is driven by a concentration gradient difference. Near term, PCO2 in Umbilical As. is _______ and in Intervillous Space is ________.

A

48 mmHg

43 mmHg

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17
Q

Fetal blood has a slightly lower affinity for CO2 than maternal blood, so all factors favor transfer of CO2 from (FETUS/MOTHER) to (FETUS/MOTHER).

A

Fetus

Mother

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18
Q

What is transferred via passive exchange?

A

– Non-protein nitrogen wastes (urea/creatinine) from fetus to mother

– Lipid soluble hormones transfer between mother, placenta, and fetus

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19
Q

_________ is transferred to the fetus via facilitated diffusion.

A

Glucose

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20
Q

What is transported to the fetus via primary and secondary active transport to support growth?

A

Amino Acids
Vitamins
Minerals

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21
Q

What is transported via receptor-mediated endocytosis?

A

Large molecule exchange

    • LDL
    • Hormones (i.e., insulin)
    • Antibodies (i.e., IgG)
22
Q

For endocrine function, the placenta plays a key role in manufacture of…

A
    • Steroid hormones
    • Amines
    • Polypeptides (Hormones and Neuropeptides)
    • Proteins/Glycoproteins
23
Q

Placenta can regulate in a _________ fashion via the release of local placental hormones, and the release of hormones into fetal or maternal circulations.

A

Paracrine

***Can alter nearby cells!

24
Q

This hormone is produced by syncytiotrophoblasts and is structurally related to LH. It binds with high affinity to LH receptors, glycosylation increases its half-life, and it rapidly accumulates in maternal circulation.

A

Human Chorionic Gonadotropin (hCG)

25
Q

How do serum levels of hCG change daily for up to 10 weeks?

A

Levels double daily (up to 10 weeks)

***Levels drop off after this!

26
Q

The primary function of _______ is to stimulate LH receptors in the Corpus Luteum. It prevents luteolysis and maintains high levels of luteal-derived progesterone.

A

hCG

27
Q

This is thought to be responsible for nausea associated with morning sickness.

A

hCG

28
Q

Small amounts of hCG enter fetal circulation to stimulate fetal ________ ________ to produce testosterone.

A

Leydig Cells

29
Q

This hormone is produced by syncytiotrophoblasts and is structurally related to growth hormone and prolactin.

A

Human Placental Lactogen (hPL)

***Also called Human Chorionic Somatomammotropin (hCS)

30
Q

What are the serum levels of hPL (hCS)?

A

Detected at day 10 in syncytiotrophoblasts and in maternal serum at 3 weeks

31
Q

This hormone has a role in coordinating the fuel economy of fetoplacental unit. Works in conversion of glucose to fatty acids and ketones, and can have an antagonistic action to maternal insulin, contributing to diabetogenicity of pregnancy.

A

hPL (hCS)

32
Q

The lipolytic actions of hPL (hCS) help the mother shift to _______ _______ _______ use for energy.

A

Free Fatty Acid

33
Q

This hormone promotes the development of maternal mammary glands during pregnancy.

A

hPL (hCS)

34
Q

This hormone is required in high levels throughout pregnancy. It is derived from the Corpus Luteum and required for implantation and early maintenance of pregnancy.

A

Progesterone

35
Q

Progesterone provides a “_______ _______ _______” where there are increased adhesion proteins in the endometrium for implantation. It also stimulates endometrial gland secretions for early nutrient transfer.

A

Window of Receptivity

36
Q

This hormone inhibits propagation of uterine contractions and induces mammary growth and differentiation.

A

Progesterone

37
Q

This hormone induces endometrial growth, progesterone receptor expression, and LH surge just prior to ovulation. It also increases uteroplacental blood flow.

A

Estrogen

***Levels gradually increase throughout pregnancy!

38
Q

Estrogen increases _______ receptor expression in syncytiotrophoblasts.

A

LDL

39
Q

Estrogen induces ________ and ________ receptors necessary for parturition. It also increases the growth and development of mammary glands.

A

Prostaglandins

Oxytocin

40
Q

During pregnancy, maternal levels of _________ and ________ rise to levels substantially higher than during a normal menstrual cycle. The placenta is an imperfect endocrine organ and cannot produce these alone.

A

Progesterones

Estrogens (Estradiol, Estrone, Estriol)

41
Q

Maternal-Placental-Fetal Unit is the coordination between the maternal, placental, and fetal tissues. The mother supplies _________ while the fetal _______ _______ and _______ supply enzymes the placenta lacks.

A

Cholesterol
Adrenal Gland
Liver

42
Q

The luteal-placental shift occurs around week 8, which begins the increased production of __________ from syncytiotrophoblasts. Its production is largely unregulated.

A

Progesterone

43
Q

Syncytiotrophoblasts import Cholesterol from maternal blood. They express ________ to convert Cholesterol to Pregnenolone. Then ________ is expressed to convert Pregnenolone to Progesterone.

A

CYP11A1

3ß-HSD1

44
Q

This hormone is released primarily into the maternal compartment, and the maternal serum levels rise throughout all of pregnancy.

A

Progesterone

45
Q

The ________ cannot produce Cholesterol, so it utilizes derivatives from the mother or fetus.

A

Placenta

46
Q

The placenta lacks the enzymes _________ and ________ needed to create DHEAS and ultimately Estrone and Estradiol. Instead, the fetal adrenal gland has these enzymes and provides DHEAS (converted to DHEA) to the placenta to make Estrone and Estradiol.

A

17a-Hydroxylase

17, 20-Desmolase

47
Q

The placenta lacks the enzyme _________ needed to convert DHEAS to 16a-OH-DHEAS, which ultimately becomes Estriol. Instead, the fetal liver has this enzyme and provides 16a-OH-DHEAS (converted to 16-OH-DHEA) to the placenta to make Estriol.

A

16a-Hydroxylase

48
Q

This occurs after week 20 of pregnancy and affects at least 5-8% of pregnancies. It is characterized by high blood pressure and signs of damage to another organ system, often the kidneys. Other symptoms include proteinuria and generalized edema.

A

Preeclampsia

***No definitive cause, likely related to a number of factors!

49
Q

Preeclampsia is associated with limited blood supply to _______ _______, causing ischemia and endothelial damage with release of cytokines. The _________ of women with preeclampsia is abnormal and characterized by poor trophoblastic invasion.

A

Uterine Arteries

Placenta

50
Q

If preeclampsia is left untreated, it can lead to serious or fatal complications for both the mother and the baby. These include…

A

Eclampsia

HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count)

51
Q

What functions in the formation of blood cells in the fetus?

A

Yolk Sac
Liver
Bone Marrow

GIGU - Week 5/6 (STILL QUARANTINE) (11 decks)

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