4.2 Placental metabolism, Pregnancy - Part 1 Flashcards

1
Q
  • what is the placenta?
  • comes from which word?
  • functions? (6)
A
  • large endocrine organ that develops in the uterus within the first several weeks of conception
  • PANCAKE! bc flat lol
    1. endocrine function: secreting vital hormones and neurohormones needed to growth and neurodevelopment + hormone catabolism
    2. fights infections by passing immunoglobulin G (IgG) antibodies to the fetus
    3. transport: exchanges nutrients and oxygen from mother to fetus + removing waste products from fetus to the mother’s blood supply
    4. metabolism: synthesis of glycogen, lactate, cholesterol
    5. nutrient storage
    6. protection against xenobiotics: acting as barrier to harmful substances (only large molecules though, placenta not really a good barrier bc drugs, CO, viruses, toxins can pass)
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2
Q
  • what is the amniotic sac/fluid made of?
  • functions? (3)
  • can be used to determine what?
A
  • the fetus’ urine
  • keeps baby safe from drying out + shock protection + allows movement
  • to determine risks later on for pregnancy
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3
Q

is there an exchange of blood supply between mother and fetus? explain how exchanges are made
- what is the fetal portion of the placenta called?

A

no! mother’s arteries and veins –> pool of mother’s blood –> placental villi (to increase surface area) where umbilical/fetus’ arteries and vein are behind ish
- chorion

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4
Q

do all nutrients from mother go towards the fetus?

A

no! 50% O2 + 65% glucose used by placenta to do its function! vs rest goes to actual fetus

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5
Q

what are the 4 types of transport mechanism across placenta? + which substances are transported

A
  1. PASSIVE DIFFUSION:
    - O2, CO2
    - some FA
    - steroids
    - electrolytes
    - fat soluble vitamins
  2. FACILITATED DIFFUSION:
    - sugars
    - long chain PUFA (arachidonic acid, eicosanoids, omega3/6)
  3. ACTIVE TRANSPORT:
    - amino acids
    - cations (Ca, Fe, I, PO4)
  4. SOLVENT DRAG (osmotic pressure):
    - electrolytes
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6
Q

what is special about the carriers for sugars and long chain PUFA?
- which type of transport?

A

facilitated diffusion!
1. sugar
- carriers can be saturated = protective (ie from mother’s high blood glucose)
- bc high levels of glucose in embryo is teratogenic (bc of glycation)
2. long chain PUFA:
- carriers allow them to go only 1 direction (from mother to fetus)
- allows desequilibrium –> good bc need fats for brain development of fetus –> allows for greater bioaccumulation

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7
Q

what are the 4 hormones produced by placenta? + extra

A
  1. human chorionic gonadotropin
  2. human chorionic somatomammotropin (placental lactogen):
  3. progesterone
  4. estrogen
    *leptin: regulates appetite + mobilizes fat stores + assists with nutrient transportation
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8
Q

describe hcg and human placental lactogen:
-secreted by what, when?
- functions

A
  1. human chorionic gonadotropin:
    - maintains corpus luteum which secretes estrogen and progesterone
    - stimulates growth of endometrium
    - secreted by blastocyst by day 7 –> after implantation, produced by placenta, peaks btw 10th and 11th week
  2. human chorionic somatomammotropin (placental lactogen):
    - produced in late gestation
    - influences fat and CHO metabolism
    - increases insulin resistance in mother
    - breaks down maternal fats for fuel
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9
Q

describe progesterone and estrogen:
-secreted by what, when?
- functions

A
  1. progesterone:
    - produced by corpus luteum until 10 weeks –> then placenta takes over
    - inhibits secretion of pituitary gonadotropins (LH and FSH) to prevent ovulation and supports endometrium
    - suppresses contractility in uterine smooth muscle
    - promotes lipid accumulation
  2. estrogen:
    - maximal toward end of gestation
    - stimulates myometrium growth
    - antagonizes myometrial suppression by progesterone
    - stimulates mammary gland development
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10
Q
  • placenta also does hormone (anabolism/catabolism) explain
A
  • hormone CATABOLISM –> breaks down thyroid and corticosteroids from mother –> if bad health and catabolism is impaired –> thyroids and corticosteroids pass through to fetus –> fetus grows faster but can disrupt its endocrine metabolism = long term consequences
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11
Q
  • how is fetal growth compared to placental growth during 3rd trimester
  • how to compensate?
    Which hormones?
A

3rd trimester: fetal weight more than doubles (last 10 weeks) but placental weight increases by only 50%
- placental blood flow increases to compensate (stimulated by prostaglandin and leukotriene) –> partially compensates for lower rate of placental growth

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12
Q

consequence of slower placental growth (vs fetal growth) in last 4 wks of gestation?

A
  • progressive decline in qty of nutrients transfers per unit fetal body mass per unit time
  • partially responsible for deceleration in fetal growth rate –> mechanisms to increase uterine blood flow to placenta needed
    *this is why if prolonged pregnancy, fetus might lose weight
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13
Q

how can maternal malnutrition lead to fetal growth retardation?
5 steps ish

A

maternal malnutrition –> reduced blood volume expansion (ie from anemia) –> inadequate increase in cardiac output –> decreased placental blood flow –> decreased placental size + reduced nutrient transfer –> fetal growth retardation/intrauterine growth retardation

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14
Q

what (2 ish) can cause placenta to fail?
- what generally causes placenta to fail?
- consequence?

A
  1. severe hypotension, renal disease, placental infarction
  2. Essential FA deficiencies (probs from low cal intake) –> defects in placental integrity and function (bc EFA are needed for local acting hormones + for cell membrane phospholipids)
    - often due to failure of uteroplacental blood vessels to deliver increased uterine blood flow
    - placental defects can cause intrauterine fetal growth retardation
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15
Q

low levels of (3 nutrients ish) can cause lower placental weight

A
  1. linoleic acid
  2. arachidonic acid
  3. docosahexaenoic acid (DHA, omega3)
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16
Q

what are the main roles of leukotriene and prostaglandin in pregnancy? ish
*big tableau!

A

maintain blood flow to placenta!

17
Q

explain the biomagnification of phospholipid DHA in human fetus

A
  • unidirectional diffusion of fats!
  • pregnancy accommodates to increase delivery of DHA
    % distribution of DHA:
    maternal RBC < fetal cord blood < fetal liver < fetal brain
  • more and more accumulation of fat in fetus brain = good thing!
18
Q

PUFA content in brain motor cortex grey matter
- 2 main ones?
- 2 functions

A
  • arachidonic acid (20:4 n-6) –> 15%
  • docosahexaenoic acid (22:6 n3) –> 21%
    1. critical for brain/cognitive development
    2. help in membrane fluidity –> helps neuronal transmission
19
Q

normal physiological changes during pregnancy:
1. anabolic phase: first ______ wks of pregnancy
- mother’s body builds what
- indicated by increased (2)
2. catabolic phase: last ___ wks of pregnancy
- what?
- indicated by increased what? + (2) help this phase

A
  1. anabolic phase: first 20 wks
    - mother’s body build capacity to deliver all the blood, oxygen and nutrients the fetus fill require during second half of pregnancy –> mother shouldn’t diet! need to build up fat supply/stores
    - indicated by increase appetite and anabolic hormones
  2. catabolic phase: last 20 wks:
    - mobilization of stored nutrients to the developing fetus
    - increased catabolic hormones + estrogen and placental lactogen help this phase
20
Q

what are the 2 phases for fuel disposition in pregnancy? describe what the fuel in each phase does.

A
  1. ANABOLIC:
    - glucose towards mother’s muscles and adipose tissue + some towards fetus
    - TGFA to mother’s adipose tissue
    - goal = build up stores bc fetus doesnt need that much fuel right now
  2. CATABOLIC:
    - glucose mainly to fetus + some to muscle and adipose tissue
    - TGFA and FFA to muscle and adipose tissue
21
Q

why does the pregnant mother have more insulin resistance as the fetus grows bigger? what causes it?

A
  1. hormones antagonistic to the action of insulin (estrogen and placental lactogen) block insulin’s entry to the liver & muscle = less glucose/glycogen in liver/muscle = less gluconeogenesis (?)
  2. therefore, dietary intake of CHO –> stays in blood = hyperglycemia
  3. glucose goes mainly towards placenta to feed fetus + slight spill of sugar in urine
22
Q

changes in body water during pregnancy:
- body water increase __-___L during pregnancy –> most goes towards what? during which trimester?
- plasma volume starts to increase/decrease within ______ weeks of pregnancy –> continues until ____ week with the steepest increase during _____ trimester
- women with high gains in fluid experience more (2) –> risk for what?

A
  • 7-10 L –> most goes toward building blood and tissues during first trimester
  • increase within first few weeks of pregnancy –> continues until 34th week with steepest increase during 2nd trimester
  • experience more edema and greater weight gain –> too much water –> risk of preeclampsia and gestational diabetes