Endocrinology of Prego Flashcards by Lindsey Herrera

hCG levels altered in _____ and ______.

trisomies; placental insufficiency

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Most placental hormones are secreted almost exclusively into the maternal circulation due to “________.”

hemochorioendothelial placentation

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Name the hormone: likely to be the main insulin resistance hormone in pregnancy to increase nutrient availability to the fetus

hPGH (human placental growth hormone)

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______ is the leading cause of maternal death.

Pulmonary embolism

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Name the hormone: it’s admin. reduces preterm birth in women with recurrent preterm labor

progesterone

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Name the hormone: value reflects placental mass

hPL (human placental lactogen)

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Name the hormone: low in growth restricted fetuses

hPGH (human placental growth hormone)

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Name the hormone: Stimulates mammary epithelial cell proliferation and breast development

estrogen

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Name the hormone: Facilitates mobilization and utilization of free fatty acids for energy

hPL (human placental lactogen)

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When do pregnancy tests read positive for bhCG?

8-9 days post fertilization

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Name the hormone: Inhibits milk secretion during pregnancy but promotes lobular development in the breast

progesterone

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Name the hormone: Increases myometrial cells and decreases Connexin-43 (Cx-43) to down regulate gap junctions.

hCG

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If no cardiac activity and hCG >9000 IU/ml→ consider ______.

missed abortion

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Name the hormone: improves some autoimmune diseases during pregnancy

progesterone

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If no gestational sac on US and hCG >1500 IU/L→ consider ______.

abnl or ectopic pregnancy

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The placenta is more permeable to ______ molecules and this permeability is inversely correlated with molecular weight.

lipid-soluble

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If hCG does not double every 48 hours for the first 5-6 weeks→ probable ______.

missed abortion

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What enables an embryo’s attachment to the uterus?

hCG and progesterone

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Name the hormone: Traditionally, has been identified as the placental hormone responsible for the development of insulin resistance in pregnancy.

hPL (human placental lactogen)

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What keeps the embryo arrested in the repro. tract?

hCG and progesterone

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Name the hormone: modulates immune system to prevent rejection

progesterone

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Name the hormone: Increases minute ventilation (tachypnea of pregnancy) and cause respiratory alkalosis (↓ CO2).

progesterone

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What determines when the fetus is ready for delivery?

fetal cortisol

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Name the hormone: stimulates maternal IGF-2, which promotes placental angiogenesis and uterine vasculature remodeling

hPGH (human placental growth hormone)

How does misoprostone work?

it's a progesterone antagonist that promotes gap junction formation between myometrial cells, as well as calcium channel biosynthesis

In trisomy 21, hCG levels are \_\_\_\_\_\_.

increased

Name the hormone: it induces hypertriglyceridemia --\> may induce pancreatitis

estrogen

Name the hormone: most abundant secretory product of the placenta

hPL (human placental lactogen)

The placenta is more permeable to lipid-soluble molecules and this permeability is _______ correlated with molecular weight.

inversely

Changes in _______ may explain why humans go into labor without any significant changes in progesterone concentrations.

Progesterone receptor activity

What does PTH-related protein do?

stimulates placental calcium transport, ↑ 1-OHase from the placenta to ↑ 1,25-OH Vit D resulting in increased maternal Ca absorption and higher fetal calcium levels for skeletal formation

Name the hormone: Induces pituitary lactotrophs to increase prolactin production by inhibiting DA

estrogen

Name the hormone: Mimics effect of LH, stimulating the corpus luteum to continue progesterone production until 11 weeks gestation when the placenta takes over production of progesterone

hCG

The onset of labor is regulated by placental CRH, which likely alters placental production of _____ and \_\_\_\_\_.

progesterone and estriol

Name the hormone: competes for aldosterone receptor

progesterone

What creates the maternal insulin resistance?

primarily hPGH (human placental GH), hPL (human placental lactogen), TNFα, cortisol, estrogen, progesterone, perhaps leptin

What hormones does the Syncytiotrophoblast make?

ALL of the steroid hormones and most of the peptide hormones

The onset of labor is regulated by \_\_\_\_\_, which likely alters placental production of progesterone and estriol.

placental CRH

Name the hormone: Stimulates production of relaxin and inhibin

hCG

Name the hormone: Substrate for synthesis of cortisol and aldosterone in the fetal adrenal cortex

progesterone

What signals the presence of the embryo to the mother?

hCG

What is progesterone synthesized from?

maternal cholesterol

Name the hormone: Stimulates gluconeogenesis, with recent evidence showing that it causes insulin resistance

hPGH (human placental growth hormone)

What causes hyperthyroidism of pregnancy?

hCG

Name the hormone: Stimulates insulin secretion and islet cell number in animals, along with lactogens such as prolactin

hPL (human placental lactogen)

Name the hormone: Stimulates Leydig cells in fetal testes to produce testosterone to promote masculinization of the male external and internal genitalia

hCG

What does relaxin do?

may ↑ GFR and renal clearance and ↓ SVR; softens cervix, remodels collagen, lengthens interpubic ligament, ↓ uterine contractility

Does GFR increase or decrease in pregnancy?

increase

What part of the placenta synthesizes ALL of the steroid hormones and most of the peptide hormones?

Syncytiotrophoblast

Name the hormone: induces hypercoagulable state of pregnancy (increases clotting factors, decreases Prot S, increases fibrinogen to increase clotting risk 5-10X)

estrogen

Name the hormone: Binds to TSH receptor and has TSH activity at high levels

hCG

Placenta is unable to synthesize steroid hormones de novo due to low levels of \_\_\_\_\_\_.

HMG CoA Reductase

Name the hormone: may ↑ GFR and renal clearance and ↓ SVR; softens cervix, remodels collagen, lengthens interpubic ligament, ↓ uterine contractility

relaxin

Name the hormone: Increases mucosal edema (sinus congestion, epistaxis, ↑ risk of bacterial sinusitis)

estrogen

Name the hormone: Induces hepatic protein synthesis (↑ SHBG, TBG, CBG→↑T4, T3, total Cortisol)

estrogen

What releasing hormone stimulates hCG?

GnRH

Name the hormone: stimulates maternal IGF-1, which regulates transplancental glucose and amino acid transport

hPGH (human placental growth hormone)

Name the hormone: stimulates placental calcium transport, ↑ 1-OHase from the placenta to ↑ 1,25-OH Vit D resulting in increased maternal Ca absorption and higher fetal calcium levels for skeletal formation

PTH-related protein

Placenta unable to synthesize estrogen without fetal adrenals because placenta lacks \_\_\_\_\_\_.

17-OHase