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Cardio > Endo-Repro L26 The Fetus and its Preparations for birth: > Flashcards

Endo-Repro L26 The Fetus and its Preparations for birth: Flashcards

1
Q

Pattern of fetal growth is: Determined by

A

Genome of fetus

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2
Q

Pattern of fetal growth is: Modulated by

A 
Placenta
Hormones
Environment
•	Nutrition
•	Health
Metabolic
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3
Q

Pattern of fetal growth is: Hormones

A

Glucocorticoids, insulin
Insulin-like growth factors (IGFs or sometomedins)
Thyroid hormones
Human placental lactogen

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4
Q

Growth Retardation → IUGR

A

Defined as birth weight that is more than two standard

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5
Q

Types of IUGR

A

Type 1 → symmetric
Type II → Asymmetric
Intermediate IUGR

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6
Q

Type 1 (symmetric IUGR )

A

Decreased growth potential ~20%

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7
Q

Type II (asymmetric) IUGR

A

Restricted growth ~ 70% cases

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8
Q

Intermediate IUGR

A

Combination of types I and II

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9
Q

The human placental interface →

A

Maternal and fetal circulations pass close to each other, but do not mingle, to facilitate the exchange of materials.

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10
Q

Transport Across the placenta types:

A
  1. Transported intact
  2. Partially consumed
  3. Metabolised
  4. Not Transported
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11
Q

The Oxyhaemoglobin Dissociation Curve and the Bohr Effect →

A

The oxygen–hemoglobin dissociation curve plots the proportion of haemoglobin in its saturated form on the vertical axis against the prevailing oxygen tension on the horizontal axis.

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12
Q

Rightward shift → decreased affinity

A
  • This makes it more difficult for haemoglobin to bind to oxygen (requiring a higher partial pressure of oxygen to achieve the same oxygen saturation)
  • It makes it easier for the haemoglobin to release oxygen bound to it.
  • The effect of this rightward shift of the curve increases the partial pressure of oxygen in the tissues when it is most needed, such as during exercise, or haemorrhagic shock.
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13
Q

The Double Bohr Effect:

A
  • Fetal demand for oxygen regulates fetal oxygenation.

* Increased ph leads to a left shift of curve and an increased affinity for oxygen uptake.

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14
Q

Fetus capacity for gluconeogenesis

A

Little

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15
Q

Glucose supply

A

Maternal

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16
Q

Maternal glucose levels depend on

A

Nutrition

Endocrine control mechanisms

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17
Q

Early pregnancy Glucose and Carbohydrates:

A

Progesterone:

  1. Increases maternal appetite
  2. Builds fat stores
18
Q

Late pregnancy Glucose and Carbohydrates:

A

Maternal tissues insulin insensitive:

  1. More glucose available to fetus
  2. Diabetes mellitus may develop in mother
19
Q

Glucose storage provides for

A

The metabolic neds of the newborn baby until feeding begins

20
Q

Glycogen is stored

A

In the liver and cardiac muscle

21
Q

Glycogen and Fat: Regulated by

A

Fetal adrenal cortex

22
Q

Which organ has no glycogen stores

A

The brain

23
Q

What regulates fetal fat stores

A

Insulin

24
Q

White fat stores

A

Fatty acids

25
Q

Brown fat

A

Heat generation (Nonshivering thermogenesis)

26
Q

Brown fat plays a crucial role in

A

Maintaining body temperature of the newborn baby after birth

27
Q

Brown fat location

A

Head, neck, back and chest

28
Q

White fat location

A

Lower back and buttocks

29
Q

Amino acids

A

No increase in materal protein intake

Progesterone increases maternal metabolism efficiency

30
Q

Fatty acids

A

Mother accumulates lipids in early pregnancy

Placental transfer and fetal synthesis meet fetal demands

31
Q

Salt and water

A

Oestrogen and progesterone stimulate maternal retention

Water exchanges at placenta and non-placental chorion

32
Q

Iron

A

Fetal blood has a 2-3 times higher concentration of iron

Maternal iron absorption is enhance

33
Q

Calcium

A

Fetal ossification demands much calcium from mother

Maternal absorption of calcium is more efficient

34
Q

Fetal development requires

A

Folic acid and vitamin B12

35
Q

Folic acid

A

Amino acid metabolism

36
Q

Vitamin B12
Made by
Provided by

A

Fatty acid and amino acid metabolism

Provided at expense of maternal stores

37
Q

Recommended weight gain

A

11.5-16 kg

38
Q

Weight gain from Intrauterine contents:

A

Fetus → 3.3 kg
Placenta → 0.7 kg
Amniotic fluid → 1.0kg

39
Q

Weight gain maternal contribution

A

Uterus → 0.7 kg
Blood → 1.3 kg
Breasts →2.0 kg
Adipose tissue and interstitial fluid → 5.0 kg

40
Q

Response of the Mother to Pregnancy: Cardiovascular changes

A

Blood volume expands

Cardiac output increases

41
Q

Response of the Mother to Pregnancy: Respiratory system

A

Alveolar ventilation increases

42
Q

Response of the Mother to Pregnancy: Nutrition

A

Maternal diet should be supplemented with iron and folic acid

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