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Reproductive System > Fetal Physiology > Flashcards

Fetal Physiology Flashcards

1
Q

What does the umbilical vein carry?

A

Oxygenated blood

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2
Q

What do the umbilical arteries carry?

A

Deoxygenated blood

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3
Q

Compare the partial pressure of O2 of fetal blood to maternal

A

Lower partial pressure of O2 in fetal
Allows gradient of transfer from mother to fetus

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4
Q

How can a pregnant mother develop physiological respiratory alkalosis?

A

Progesterone causes physiological hyperventilation

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5
Q

Where does materno-fetal exchange occur?

A

At the placenta

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6
Q

What facilitates the movement of O2 from maternal to fetal blood?

A
  • relative partial pressure difference
  • higher affinity of fetal haemoglobin for O2
  • double Bohr effect
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7
Q

How does fetal haemoglobin have a higher affinity for oxygen than maternal Hb

A

HbF doesnt bind 2,3-BPG as effectively as HbA

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8
Q

Composition of fetal haemoglobin

A

2 alpha subunits
2 gamma subunits

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9
Q

Describe the double Bohr effect in materno-fetal gas exchange

A

Maternal:
- CO2 passes into intervillous blood > pH decreases
- decreasing affinity of maternal Hb for O2

Fetal:
- relative decrease in CO2 on fetal side > pH increases
- increased affinity of fetal Hb for O2

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10
Q

Outline fetal circulation

A
  • receives oxygenated blood from mother via placenta in umbilical vein
  • lungs are non function > by passes lungs
  • returns to placenta via umbilical arteries
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11
Q

Describe the double Haldane effect in materno-fetal gas exchange

A

Mother:
- as maternal Hb gives up O2, it can accept more CO2

Fetal:
- as fetal Hb gives up more CO2, it can accept more O2

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12
Q

What is fetal bradycardia a sign of?

A

Fetal distress

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13
Q

What are the shunts in fetal circulation?

A

Ductus venosus
Foramen ovale
Ductus arteriosus

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14
Q

What does ductus venosus do?

A

Between umbilical Vein and IVC
Bypasses the liVer

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15
Q

What does foramen ovale do?

A

From RA to LA
Bypasses right ventricle + lungs

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16
Q

What does ductus arteriosus do?

A

Between pulmonary trunk + aorta
Bypasses lungs

17
Q

What does chronic hypoxaemia in fetus cause?

A

Growth restriction
Reduced Fetal movements

18
Q

Fetal response to hypoxia

A
  • fetal heart rate slow in response to hypoxia
  • reduces O2 demand
  • fetal chemoreceptors detect decreased pO2 or increased pCO2 > vagal stimulation > bradycardia
19
Q

Function of amniotic fluid

A

Protection
Contributes to development of lungs

20
Q

What is amniocentesis?

A
  • Aspiration of amniotic fluid for analysis
  • used for fetal karyotyping e.g. diagnosis of Down’s syndrome
21
Q

Signs of fetal distress

A

Meconium staining
Fetal bradycardia

22
Q

How is amniotic fluid produced?

A
  • hydrostatic pressure pushes water out from fetus’ skin (transudative)
  • then composed of fetal urine from week 9
23
Q

How is amniotic fluid recycled?

A
  • fetus inhales amniotic fluid (practicing breathing movements) > helps production of lungs (surfactant)
  • fetus swallows amniotic fluid > enters fetal GI tract > meconium
24
Q

Composition of amniotic fluid

A
  • 98% water
  • Plus electrolytes,creatinine, urea, bile, glucose…
25
Q

What is a sign that a baby has passed meconium in utero?

A

Water breaking discolouration
(Meconium in amniotic fluid)

26
Q

What is intermittent auscultation?

A
  • listening to heart rate for 1 minute using Doppler every 15 mins in first stage
  • every 5 mins in second stage
27
Q

Two methods of intrapartum monitoring during labour

A

Intermittent auscultation
Cardiotocograph

28
Q

When is a cardiotocogrpah used?

A

Higher risk pregnancies
e.g worry for fetal wellbeing, if mum had previous C section or has diabetes

29
Q

What is physiological jaundice in newborns?

A

Baby can appear jaundice due to delay in newborn ability to conjugate + excrete bilirubin

30
Q

How is placental circulation investigated?

A

Doppler ultrasound scan

Reproductive System (20 decks)

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