Changes in Pregnancy

Question 1

What is a prominent hormone change in pregnancy

Answer 1

Human chorionic gonadotropin

Question 2

Where is hCG secreted from

Answer 2

Embryonic trophoblast cells from placenta

Question 3

What is the function of hCG

Answer 3

Signals corpus luteum to continue progesterone production in early pregnancy

Question 4

What is the plasma levels of hCG during pregnancy

Answer 4

Detected in maternal blood 7-9 days post conception
Peak at 10-12 weeks & remain elevated

Question 5

What 3 things are hCG used for diagnosis & management for complications

Answer 5

Incomplete abortion
Ectopic pregnancy
Trophoblastic tumours

Question 6

What is the effect of pregnancy on the kidneys

Answer 6

Increase GFR with 30% leading to lower plasma urea, creatinine & urate

Question 7

What also decreases urate

Answer 7

Anabolic mileu (fetal development)

Question 8

What is the effect of pregnancy on kidneys threshold for glucose

Answer 8

Lower threshold leading to glucosuria

Question 9

What is the effect of pregnancy on lipids

Answer 9

Oestrogen increase plasma triglycerides, LDL & HDL cholesterol

Question 10

What is the effect of pregnancy on glucose changes

Answer 10

Glucose & amino acids are preferentially used by fetus leasing to accelerated starvation of mother causing lower fasting blood glucose & ketosis
Placenta produces HPL that antagonize insulin causing higher postprandial glucose leading to gestational diabetes

Question 11

What is 2 contributing factors to gestational diabetes

Answer 11

HPL & insulin resistance

Question 12

What is 2 miscellaneous changes during pregnancy

Answer 12

Elevated ALP due to placental isoform
Elevated AFP as it acts as albumin & decrease later as replaced by albumin

Question 13

What is AFP used for to diagnose

Answer 13

Open neural tube defects