Endocrinology of Pregnancy

Question 1

Early in pregnancy, women can become more sensitive to ________.

Answer 1

insulin; later, however, women become resistant to insulin

Question 2

Pregnant women have an early conversion to ____________.

Answer 2

fatty acid metabolism (because of the increased energy demands)

Question 3

Although systemic vascular resistance decreases throughout pregnancy, ______________ stays the same.

Answer 3

pulmonary vascular resistance

Question 4

Risk of aspiration pneumonia increases in pregnancy due to _______________.

Answer 4

the decreased tone in the LES from progesterone

Question 5

Describe the hormone timeline of pregnancy.

Answer 5

hCG peaks first around 10 weeks and then hPL and hPGH rise from twenty weeks on.

Question 6

When does the placenta take over hormonal regulation?

Answer 6

About 9 weeks’ gestation

Question 7

Hormones greater than ___________ do not cross the placental barrier.

Answer 7

1,200 Daltons

Question 8

List two functions of relaxin.

Answer 8

• Relax the blood vessels, lowering SVR

* Increase renal blood flow and GFR

Question 9

Explain how hCG can be used to evaluate for trisomies.

Answer 9

Down’s presents with raisd hCG and Edward’s presents with lowered hCG.

Question 10

hPGH is very similar to GH, but because it is different by 13 amino acids it ________________.

Answer 10

is not regulated by the hypothalamus or pituitary

Question 11

_____________ appears to be the main insulin resistance hormone of pregnancy.

Answer 11

hPGH

Question 12

The only compound that you see exclusively in pregnancy is ____________.

Answer 12

estriol

The placenta converts DHEA to 16-OH DHEA which then gets converted to estriol.

Question 13

Estrogen increases 100-fold during pregnancy due to _________________.

Answer 13

placental aromatase

Question 14

Part of what makes thromboemboli in pregnancy so dangerous is _______________.

Answer 14

that they often develop in the pelvis and are asymptomatic (unlike those that develop in the legs)

Question 15

Which placental cells accomplish most of the protein/steroid production?

Answer 15

Syncytiotrophoblasts

Syncyntio = Steroid… it also makes sense because these are the cells directly in contact with maternal blood

Question 16

The corpus luteum is the primary producer of progesterone until _____________.

Answer 16

the placenta takes over at week 11

Question 17

___________ stimulates relaxin.

Answer 17

hCG

Question 18

Why do high levels of hCG cause hyperthyroidism?

Answer 18

The beta subunit of hCG is identical to TSH.

Question 19

Why does hPL cause diabetes?

Answer 19

hPL has weak activity at the GH receptor.

Question 20

Although hPGH does not cross the placenta, it can still ______________.

Answer 20

increase the levels of IGF in the maternal serum

Question 21

Why does the placenta need maternal LDL?

Answer 21

The placenta lacks HMG CoA reductase, so it cannot make cholesterol. Thus, all steroid hormones are synthesized from maternal precursors.

Question 22

Fetuses lack the enzyme _________, so they are protected from excess progesterone.

Answer 22

3-beta hydroxysteroid dehydrogenase

Question 23

_____________ increases the resting potential of the uterine myocyte.

Answer 23

Progesterone

Question 24

Gastroparesis typically ____________ due to the effects of progesterone.

Answer 24

worsens

Progesterone is a smooth muscle relaxant.

Question 25

Two things happen to the kidney during pregnancy (related to the endocrine system): _______________.

Answer 25

glucosuria and decreased ureteral peristalsis (leading to risk of pyelonephritis)

Question 26

_____________ induces apoptosis in endometrial T cells.

Answer 26

hCG

This is important for the protection of the fetus, which is an allograft to the mother.

Question 27

New research indicates that ____________ may have a more prominent role in causing gestational diabetes.

Answer 27

hPGH

Question 28

_________________ is given to women with luteal phase defects.

Answer 28

Progesterone

Question 29

are ketones in pregnant women worrisom?

Answer 29

no because they have an earlier shit to fatty acid metabolism because of decreased glycogen stores from the fetal-placental glucose demands.