Endocrine Flashcards
Energy Changes
Insulin sensitivity Earlier switch to fatty acid metabolism from decreased maternal glycogen hCG interacts w/thyroid Increased iodine requires
hCG
Maintains the corpus luteum, apoptosis of endometrial T-cells, cytotrop to syncytiotrop dif, Similar to TH, LH, and FSH Doubles every 2 days for 5 wks
hPL
Insulin insensitivity - increases beta cell insulin secretion Like GH and PRL Increases mom’s lipolysis and use of FAs
Placental Hormone Curves
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hPGH
Contributes to insulin resistance Like GH - replaces it Secreted tonically Regulates IGF-1 Decreased in growth resistant fetuses
CRH
Peaks later Role in parturition
Syncytiotrophoblast
Major site of protein/steroid production Hemochorioendothelial placentation - more in mom’s blood than baby’s
Progesterone
Critical to maintain pregnancy Synth depends on LDL receptors on trophoblast membrane Decidua formation, inhibits uterine contractions, modulate immune sys (can make autoimmune disease better), stimulates minute ventilation, smooth muscle relaxant, promotes lobular development in the breast,
Estrogen
High levels of placental aromatase 100x increase Growth of myometrium, hypercoag, induces protein synth, decreases SVR, increases CO, increased blood volume, increases renal perfusion and GFR, increases TG & LDL synth
Type 1 DM mothers
Often have placental insufficiency Baby has nutrient deficiency
GDM Baby Complications
Shoulders bigger than head Get severe hyperinsulinemia = hypoglycemia after birth Cardiac septal hypertrophy RDS
Thyroid
TSH goes down at first then stays lowish FT4 normal Thyroid binding globulin up from estrogen = total T4 high Hypothyroid more common
Hyperthroidism
Can be related to hyperemesis hCG-induced
Post-partum thyroiditis
High levels of antiperoxidase antibodies looks like Hashimotos = hyperthyroidism Destruction of gland and release of TH and can become hypothyroid
