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Endo/Repro Exam 2 > Endocrinology of Parturition > Flashcards

Endocrinology of Parturition Flashcards

1
Q

What is the mean duration of human singleton pregnancy?

A

280 days or 40 weeks from the first day of the last normal menstrual period

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2
Q

What is meant by “Term”?

A

Period from 37 to 42 weeks

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3
Q

What is meant by “Preterm”?

A

Delivery before 37 weeks

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4
Q

What is meant by “Post-term”?

A

Pregnancy beyond 42 weeks

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5
Q

Four phases of pregnancy:

A

Phase 1: Quiescence
Phase 2: Activation
Phase 3: Stimulation
Phase 4: Involution

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6
Q

Where is the majority of relaxin produced during pregnancy?

A

Corpus luteum

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7
Q

Which hormones play a role in phase 1?

A 
P4
Relaxin
hCG
CRH
NO
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8
Q

Which hormones play a role in phase 2?

A 
E3
P4
Ferguson reflex
CRH
Relaxin
PGE
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9
Q

Which hormones play a role in phase 3?

A 
PGE
OT
Relaxin
CRH
Inflammatory reaction
Surfactant Protein A
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10
Q

Which hormones play a role in phase 4?

A

OT

inflammatory reaction

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11
Q

How do estrogen and progesterone act in myometrial quiescence?

A

Through an increase in cGMP

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12
Q

Three major effects of prostaglandins:

A
  1. ) Stimulate uterine contraction
  2. ) PGF2alpha promotes formation of gap junctions between uterine SM cells for contractions
  3. ) Ripens, dilates, thins the cervix
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13
Q

What does PGE2 and PF2alpha do?

A

PGE2: dilates cervical blood vessels and leads to cervical ripening
PF2a: increases total GAGs activity

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14
Q

What occurs in phase 2?

A

Increased OT receptors

Estrodiol increased

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15
Q

Increased levels of CRH in phase 2 leads to what?

A

Fetal cortisol stimulation of prostaglandin synthesis

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16
Q

What is responsible for fetal lung maturation?

A

Glucocorticoids

17
Q

How can CRH induce spontaneous labor?

A

CRH stimulates fetal ACTH release stimulating GC production; once CRH stops GC production it means the babies lungs are ready and labor inducing forces begin

18
Q

Two way oxytocin induces uterine contractions:

A
  1. ) Stimulates release of PGE2 and PF2a by activation of PLC
  2. ) Directly causes myometrial contractions through PLC -> Ca2+ intracellularly
19
Q

What is puerperium?

A

From delivery of placenta through first few weeks after delivery (6 weeks)

20
Q

Repair processes post-partum occur in what three phases?

A

Immediate: 24 hours
Early: 7 days
Remote: 6 weeks

21
Q

What contributes to postpartum depression?

A

Precipitous drop in estrogen and progesterone

22
Q

Effect of P4 on milk production?

A

Suppress milk production during pregnancy by inhibiting PRL

23
Q

Most important galactopoietic hormone?

A

Prolactin

24
Q

Most important galactokinetic hormone?

A

Oxytocin

25
Q

What is the milk ejection reflex?

A

Stimulation by nipple sucking sends signals to the hypothalamus to release OT from posterior pituitary where it bind smooth muscle in mammary glands and they contract

26
Q

Four stages of lactation:

A

Stage I: Mammogenesis-preparation of the breasts
Stage II: Lactogenesis- synthesis and secretion of milk
Stage III: Galactopoiesis- maintenance of lactation
Stage IV: Involution- return to non-lactating breasts

27
Q

When does mammogenesis occur?

A

12 weeks before delivery; colostrum is present the first rich milk

28
Q

When does lactogenesis occur?

A

2-3 days after birth when the milk comes in; P4 drops PRL stays high

29
Q

What is the organization of secretory tissue in breast?

A

Alveolus organized into lobules which drain into ductules which widens at the ampulla and drain into the lactiferous duct

30
Q

What is contained in colostrum?

A

Protein and minerals (low in carbs/fats)
Antibodies to for passive immunity
Laxative for first bowel movements

31
Q

What is galactopoiesis?

A

Production of milk; a supply and demand system

32
Q

Effects of lactation on GnRH?

A

Inhibits GnRH release and therefore release of FSH and LH and the ovarian cycle is inhibited

33
Q

Medications that improve milk production?

A

Metoclopramide
Sulpurude
Intranasal oxytocin

34
Q

How does metoclopramide work?

A

Increases PRL levels

35
Q

How does sulpurude work?

A

Dopamine antagonist

36
Q

Drugs to suppress lactation?

A

Bromocriptine

37
Q

How does Bromocriptine work?

A

Dopamine agonist

Endo/Repro Exam 2 (18 decks)

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