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ETA 4: REPRODUCTION > 6: Pregnancy > Flashcards

6: Pregnancy Flashcards

1
Q

What is implantation? (2 things)

A
  1. Interstitial (within internal tissues)
  2. Uterine epithelium breached → conceptus implants within stroma
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2
Q

What happens to the placental membrane during pregnancy?

A

Becomes progressively thinner as the needs of the foetus increase

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3
Q

What is the property of placenta?

A

It is Haemomonochorial: only 1 layer of trophoblast separates maternal blood from foetal capillary wall

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4
Q

What are the aims of implantation (3 things)

A
  1. Establish basic unit of exchange
  2. Anchor placenta
  3. Establish maternal blood flow within placenta
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5
Q

How does implantation establish a basic unit of exchange?

A
  1. Primary Villi = Fingerlike projections of trophoblast
  2. Secondary Villi = Invasion of mesenchyme into core
  3. Tertiary Villi = Invasion of mesenchyme core by foetal vessels
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6
Q

How is the placenta anchored?

A

Through establishment of outermost cytotrophoblast shell

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7
Q

What happens regardless of fertilisation?

A

Endometrium preparation for implantation

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8
Q

What is the endometrium preparation for implantation signalled by?

A

Progesterone from ovary

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9
Q

What does the endometrium contain? (2 things)

A
  1. Pre-decidual cells
  2. Elaboration of Spiral artery blood supply
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10
Q

What is decidualisation?

A

The balancing force acting against the invasive force of the trophoblast at implantation

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11
Q

What do decidual cells do?

A

Prevent excessive invasion of Trophoblast at implantation

Decidual cells are the British soldiers stopping the Spanish Armada invasion

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12
Q

Why are ectopic pregnancies at the fallopian tube dangerous?

A

No decidual cells at fallopian tube

So implantation is so invasive → haemorrhage of fallopian tube

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13
Q

What are Spiral Arteries?

A

Arteries that temporarily supply blood to the endometrium in the luteal phase of menstrual cycle

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14
Q

How do Spiral Arteries meet the foetal demands?

A

Spiral arteries create low resistance vascular beds → maintains high flow

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15
Q

What are some implantation defects? (3 things)

A
  1. Ectopic Pregnancy
  2. Placenta Praevia
  3. Incomplete Invasion
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16
Q

Where do ectopic pregnancies usually occur?

A

Fallopian tube

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17
Q

What is Placenta Praevia?

A

Implantation in the lower uterine segment

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18
Q

What can Placenta Praevia cause?

A

Haemorrages

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19
Q

What does Placenta Praevia require?

A

C-section delivery

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20
Q

What can Incomplete Invasion cause? (2 things)

A
  1. Placental Insufficiency
  2. Pre-eclampsia
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21
Q

What is placental insufficiency and what does it cause?

A

Insufficient blood flow to the placenta → affects foetus CNS development

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22
Q

What are the risk factors of placental insufficiency? (3 things)

A
  1. Smoking
  2. Diabetes
  3. Hypertension
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23
Q

What is pre-eclampsia?

A

High blood pressure @ pregnancy / labour

24
Q

What is the difference between the placenta in the 1st trimester and at term?

A

1st Trimester

Thick (4 Layers)

  • Capillary Endothelium
  • Undifferentiated Mesoderm
  • Cytotrophoblast
  • Synciotrophoblast

Term

Thin (2 Layers)

  • Capillary Endothelium
  • Synciotrophoblast

Larger surface area for exchange

25
Q

What are the layers of the placenta in the 1st trimester?

A
  1. Capillary Endothelium
  2. Undifferentiated Mesoderm
  3. Cytotrophoblast
  4. Syncytiotrophoblast

Need CUCS to get pregnant at da beginningg

26
Q

What are the layers of the placenta at term?

A
  1. Capillary Endothelium
  2. Syncytiotrophoblast

Don’t need CUCS now it’s just its own CS

27
Q

What does the umbilical cord link?

A

Placental blood vessels → Developing foetus

28
Q

What does the umbilial cord contain?

A

2 Umbilical Arteries

1 Umbilical Vein

29
Q

What do the umbilical arteries carry?

A

Deoxygenated blood from foetus → placenta

Opposite to what arteries carry in adults innit

30
Q

What does the umbilical vein carry?

A

Oxygenated blood from placenta → foetus

Opposite to what arteries carry in adults innit

31
Q

What are the functions of the placenta? (3 things)

A
  1. Metabolic
  2. Endocrine
  3. Transport
32
Q

What does the placenta synthesise? (Metabolic Function) (3 things)

A
  1. Glycogen
  2. Cholesterol
  3. Fatty Acids
33
Q

What is the purpose of the glycogen synthesised by the placenta?

A

Storage of maternal glucose to be transferred to foetus

34
Q

What is the purpose of the cholesterol synthesised by the placenta?

A

Cholesterol is a precursor of Progesterone and Oestrogen

35
Q

What is the Fatty Acids synthesised in the placenta made from?

A

The breakdown products of fats in the maternal circulation

36
Q

What are the types of hormone that the placenta produces? (Endocrine function) (2 types)

A
  1. Proteins
  2. Steroids
37
Q

What are the protein hormones produced in the placenta? (4 things)

A
  1. hCG
  2. hCS
  3. hCT
  4. hCC

GSTC

38
Q

Where is hCG produced?

A

Syncytiotrophoblast in placenta

39
Q

What does hCG support?

A

The secretory function of the Corpus Luteum

40
Q

What is hCG used as and why?

A

Pregnancy tests because its secreted in maternal urine

41
Q

What do hCS and hPL do?

A

Increase glucose availability to the foetus by:

Switching mothers from glucose to F.A metabolism

They are CSI and PoLice agents that infiltrate and change the mums metabolism

42
Q

What are the 3 transport methods across the placenta? (Transport function)

A
  1. Simple diffusion
  2. Facilitaed diffusion
  3. Active transport
43
Q

What things use Simple Diffusion across the placenta? (4 things)

A
  1. Water
  2. Electrolytes
  3. Urea + Uric Acid
  4. Gases
44
Q

What uses Facilitated Diffusion across the placenta?

A

Glucose

45
Q

What things use Active Transport across the placenta? (3 things)

A
  1. A.A
  2. Iron
  3. Vitamins

They have specific transporters in the syncytiotrophoblast

46
Q

How is passive immunity acheived by the foetus?

A

By Receptor Mediated Endocytosis (RME)

  • Receptors are specific for igG (antibodies)
  • igG transported from maternal → foetal blood
47
Q

What are the physiological changes of pregnancy? (6 things)

A
  1. Respiratory System
  2. Immune System
  3. GI System
  4. CVS
  5. Urinary System
  6. Metabolic changes

RIGCUM

48
Q

What are the CVS changes of pregnancy?

(3 things: 5 increases, 2 decreases and 1 other change)

A

Increased:

  1. Plasma Volume
  2. CO
  3. Stroke Volume
  4. Heart Rate
  5. Coagulation factors and fibrinogen

Decreased

  1. Serum album concentration
  2. Blood pressure in first 2 trimesters

Compression of IVC by uterus

49
Q

What are the Urinary System changes of pregnancy? (2 things)

A

Increased:

  1. GFR
  2. Increased Renal Plasma Flow
50
Q

What are the Respiratory System changes of pregnancy?

(4 things: 2 increases, 2 decreases)

A

Increased:

  1. Tidal Volume
  2. pO2

Decreased

  1. pCO2
  2. Function Residual Capacity (because diaphragm displaced)
51
Q

What are the GI System changes of pregnancy? (4 things)

A
  1. Nausea and vomiting
  2. Delayed emptying
  3. GI reflux
  4. Appendix moves to RUQ
52
Q

What are the Metabolic changes of pregnancy? (1 thing)

A

Increased insulin resistance → body switches to gluconeogenesis and alternative fuels

53
Q

What are the signs and symptoms of pre-eclampsia? (2 things)

A
  1. Increased blood pressure
  2. Prroteinuria
54
Q

What is Gestational diabetes?

A

Insulin resistance in pregnancy

55
Q

What can gestational diabetes cause? (3 things)

A
  1. Macrosomic foetus (big baby)
  2. Still birth
  3. Congenital defects
56
Q

What causes anaemia in pregnancy? (2 things)

A
  1. Increase in plasma volume
  2. Iron deficiency

ETA 4: REPRODUCTION (10 decks)

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