childbirth Flashcards

1
Q

Does high prostaglandin start labour

A

No. A drop in prostaglandin starts labour

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2
Q

What does high levels of prostaglandins in pregnancy cause?

A

Causes contractions

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3
Q

How does a muscle contraction occur?

A

An influx of calcium into the cell causes a chain of events that allows myosin and actin cross-bridging to occur

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4
Q

Explain how cervical ripening occurs

A

There is a reduction in collagen and increase in water, which allows the cervix to be thin and more pliable

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5
Q

What role does progesterone play during pregnancy

A

There is an increase in progesterone during pregnancy which promotes uterine quiescence (prevents contractions and has anti-inflammatory effects)

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6
Q

What happens to progesterone levels when approaching full term?

A

They drop off. This is essential for labour, but is not enough to actually cause labour

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7
Q

Where is CRH released from in pregnancy?

A

The placenta

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8
Q

Levels of CRH binding proteins increase or decrease approaching full term? What effect does this have?

A

Binding protein levels decrease, meaning more of the hormone is free and available to bind to its receptor

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9
Q

How does the CRH receptor change when you approach full term?

A

The CRH receptor typically promotes uterine relaxation, however as you approach full term, the receptor changes to promote contractions (converts to the contractile state)

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10
Q

Name 3 areas where oxytocin is synthesised

A

Posterior pituitary, uterine lining and placenta

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11
Q

High CRH stimulates production of what from the adrenal gland?

A

Cortisol

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12
Q

High cortisol stimulates a positive feedback loop, where the placenta increases production of which two molecules?

A

CRH and estrogen

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13
Q

Name the effects of cortisol on prostaglandins in child birth?

A

Cortisol promotes the production of prostaglandins which causes an increase in uterine contractions.

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14
Q

Increased prostaglandin release causes an increase in…

A

Oxytocin release and also causes up regulation of oxytocin receptors

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15
Q

Two molecules that are unregulated to allow for uterine contractions?

A

Prostaglandins and oxytocin

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16
Q

PGF2a is the prostaglandin responsible for…

A

Acts on the uterine myometrium to tighten gap junctions and increase depolarisation

17
Q

Which prostaglandin increases vasodilation to ensure there is good blood flow during child birth?

A

PGI

18
Q

Which prostaglandin facilitates cervical ripening by degrading cervical collagen

A

PGE2

19
Q

What effect does an increase in cortisol have on the foetus

A

It acts on the lungs of the baby to increase breathing movements and increases lung surfactant production

20
Q

Main use of tocolytics?

A

Prevention of preterm labour

21
Q

What drug class does nifedipine belong to?

A

It is a tocolytic

22
Q

Explain the MOA of nifedipine

A

It is a calcium channel blocker, and therefore prevents contractions.

23
Q

How does indomethacin work as a tocolytic

A

It prevents prostaglandin synthesis

24
Q

Define oxytocics

A

Drugs used to induce labour, enhance contractions and prevent postpartum haemorrhage

25
Q

Carbetocin is a synthetic version of which hormone?

A

Oxytocin

26
Q

Carbetocin is given via slow IV infusion. Why is it combined with other oxytocics?

A

To enhance its effects

27
Q

Misoprostol can be given to prevent haemorrhage, but it is more commonly used in…

A

The abortion pill

28
Q

Dinoprostone, a synthetic prostaglandin, is given locally to…

A

Induce labour

29
Q

Explain the MOA of ergometrine and what it is indicated for

A
Indication = postpartum haemorrhage 
MOA= causes contraction of uterus and reduction of uterine blood flow
30
Q

Which receptors does ergometrine antagonise?

A

5-HT and alpha-adreno receptors on smooth muscle