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Reproductive System > Foetal Physiology > Flashcards

Foetal Physiology Flashcards

1
Q

What type of blood is carried in the umbilical vein?

A

Oxygenated blood

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2
Q

What type of blood is carried in the umbilical arteries?

A

Deoxygenated blood

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3
Q

How does gas exchange take place at the placenta?

A

Thin diffusion distance

Down gradient of partial pressures

So foetal pO2 needs to be lower than maternal pO2

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4
Q

What is the normal pO2 of foetal blood?

A

4kPa

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5
Q

What factors promote O2 exchange at the placenta?

A

Increased maternal production of 2,3 DPG
Foetal haemoglobin
Double Bohr effect

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6
Q

What makes up foetal haemoglobin?

A

2 α subunits + 2 γ subunits

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7
Q

Why does foetal haemoglobin have greater affinity for oxygen?

A

Doesn’t binf to 2,3-DPG as effectively as adult Hb

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8
Q

What is the double bohr effect?

A

Bohr effect on both mother’s haemoglobin and foetal haemoglobin

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9
Q

What happens to the mother with the double bohr effect?

A

CO2 passes into intervillous blood
pH decreases
Bohr effect
Decreases affinity of Hb for O2

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10
Q

What happens to the foetus with the double Bohr effect?

A

CO2 is lost
pH rises
Bohr effect
Increases affinity of Hb for O2

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11
Q

How is CO2 transferred?

A

Double Haldane effect

Progesterone driven hyperventilation = lower maternal pCO2
- down concentration gradient

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12
Q

What is the double Haldane effect?

A

As Hb gives up O2, it can accept more CO2
Foetus gives up CO2 as O2 is accepted
No changes in local CO2

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13
Q

What are the foetal circulation shunts?

A

Ductus venosus
Ductus arteriosus
Foramen ovale

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14
Q

What is ductus venosus?

A

Connects umbilical vein to IVC

  • blood enters directly into RA
  • shunts blood around liver
  • maintains saturation
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15
Q

What is ductus arteriosus?

A

Shunt from RV to aorta

  • joins aorta distal to supply of head
  • minimises drop in O2 sats
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16
Q

What is foramen ovale?

A

Hole between RA + LA

  • pressure in RA > pressure in LA
  • blood flows into left atrium
  • heart + brain get good supply of oxygen
17
Q

Which shunts bypass the lungs?

A

Foramen ovale

Ductus arteriosus

18
Q

What is the foetal response to hypoxia?

A

Redistribution of flow to supply heart and brain

Heart rate decreases to reduce O2 demand

19
Q

What are the effects of chronic hypoxaemia?

A

Growth restriction

Behavioural changes

20
Q

What hormones are necessary for foetal growth?

A

Insulin
IGF
Leptin

21
Q

What is symmetrical growth restriction?

A

Small head + small body

22
Q

What is asymmetrical growth restriction?

A

Normal head + small body

23
Q

What is the dominant cellular growth mechanism in weeks 0-20?

A

Hyperplasia

24
Q

What is the dominant cellular growth mechanism in weeks 20-28?

A

Hyperplasia + hypertrophy

25
Q

What is the dominant cellular growth mechanism in weeks 28- term?

A

Hypertrophy

26
Q

What is amniotic fluid?

A

FLuid that makes up amniotic sac

27
Q

What is the role of amniotic fluid?

A

Protection

Contributes to lung development

28
Q

What is volume of amniotic fluid at 8 weeks?

A

10ml

29
Q

What is the volume of amniotic fluid at 38 weeks?

A

1L

30
Q

What is the composition of amniotic fluid?

A 
98% water
Electrolytes
Creatinine 
Urea
Renin 
Foetal cells
31
Q

What happens to amniotic fluid during pregnancy?

A

Foetus swallows fluid to absorb water + electrolytes

Most is excreted as urine

32
Q

What makes up meconium?

A

Debris from amniotic fluid + intestinal secretions

33
Q

What is amniocentesis?

A

Sampling of amniotic fluid

34
Q

What is oligohydramnios?

A

Lack of amniotic fluid production

35
Q

What can cause oligohydramnios?

A

Foetal kidney malfunction
Premature membrane rupture
Placental insufficiency

36
Q

What is polyhydramnios?

A

Increased amniotic fluid production

37
Q

What can cause polyhydramnios?

A

Excessive urine production
Gestational diabetes
Maternal hypertension

38
Q

How is bilirubin metabolised in the foetus?

A

Clearance of bilirubin handled by placenta

Foetus cannot conjugate bilirubin

Reproductive System (22 decks)

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