Endocrinology of Pregnancy Flashcards
Early in pregnancy, women can become more sensitive to ________.
insulin; later, however, women become resistant to insulin
Pregnant women have an early conversion to ____________.
fatty acid metabolism (because of the increased energy demands)
Although systemic vascular resistance decreases throughout pregnancy, ______________ stays the same.
pulmonary vascular resistance
Risk of aspiration pneumonia increases in pregnancy due to _______________.
the decreased tone in the LES from progesterone
Describe the hormone timeline of pregnancy.
hCG peaks first around 10 weeks and then hPL and hPGH rise from twenty weeks on.
When does the placenta take over hormonal regulation?
About 9 weeks’ gestation
Hormones greater than ___________ do not cross the placental barrier.
1,200 Daltons
List two functions of relaxin.
- Relax the blood vessels, lowering SVR
* Increase renal blood flow and GFR
Explain how hCG can be used to evaluate for trisomies.
Down’s presents with raisd hCG and Edward’s presents with lowered hCG.
hPGH is very similar to GH, but because it is different by 13 amino acids it ________________.
is not regulated by the hypothalamus or pituitary
_____________ appears to be the main insulin resistance hormone of pregnancy.
hPGH
The only compound that you see exclusively in pregnancy is ____________.
estriol
The placenta converts DHEA to 16-OH DHEA which then gets converted to estriol.
Estrogen increases 100-fold during pregnancy due to _________________.
placental aromatase
Part of what makes thromboemboli in pregnancy so dangerous is _______________.
that they often develop in the pelvis and are asymptomatic (unlike those that develop in the legs)
Which placental cells accomplish most of the protein/steroid production?
Syncytiotrophoblasts
Syncyntio = Steroid… it also makes sense because these are the cells directly in contact with maternal blood
The corpus luteum is the primary producer of progesterone until _____________.
the placenta takes over at week 11
___________ stimulates relaxin.
hCG
Why do high levels of hCG cause hyperthyroidism?
The beta subunit of hCG is identical to TSH.
Why does hPL cause diabetes?
hPL has weak activity at the GH receptor.
Although hPGH does not cross the placenta, it can still ______________.
increase the levels of IGF in the maternal serum
Why does the placenta need maternal LDL?
The placenta lacks HMG CoA reductase, so it cannot make cholesterol. Thus, all steroid hormones are synthesized from maternal precursors.
Fetuses lack the enzyme _________, so they are protected from excess progesterone.
3-beta hydroxysteroid dehydrogenase
_____________ increases the resting potential of the uterine myocyte.
Progesterone
Gastroparesis typically ____________ due to the effects of progesterone.
worsens
Progesterone is a smooth muscle relaxant.
