HD Flashcards
Thelarche
Onset of breast growth
Menarche
Onset of menstruation
Pubarche
Onset of pubic hair growth
Adrenarche
onset of androgen secretion from the adrenal glands
Average age for menarche
12.5
Average age for puberty
11 in girls
12 in boys
Symptoms of early pregnancy
Amenorrhoea Nausea Vomiting Breast enlargement Breast tenderness Increased urinary frequency Tiredness
Tests for pregnancy
Monoclonal antibody test for presence of beta subunit of hCG
Ultrasound
Methods of assisted conception
IVF ICSI IUI Ovulation induction Donor sperm treatment Sperm washing Surrogacy Donor egg
Causes of primary amenorrhoea
Mullerian agenesis Turner's syndrome Imperforate hymen Kallman syndrome Hypogonadism
Causes of secondary amenorrhoea
Pregnancy Breastfeeding Menopause Asherman's syndrome Sheehan's syndrome Polycystic ovary disease Chronic illness Weight loss Stress
Antenatal screening for maternal health
Weight and height
Blood pressure
Urine test for glucose, proteins
Blood test for infections, antibodies, haemoglobin
Antenatal screening for foetal health
Ultrasound for structural abnormalities
Blood tests for sickle cell anaemia, thalassaemia, chromosomal abnoramlities
Cardiotocography for heart beat
Nuchal test for Downs syndrome
Signs of onset of labour
Rupture of membranes
Regular painful contractions
Cervical dilatation
Passage of bloodstain mucous plug
Protection of foetus in utero
Thickened myometrium Abdominal muscles Cushioning from amniotic fluid Mucous plug for infections Pubic bones Placenta
Ferguson’s reflex
Baby applies pressure to the top of the cervix Causes oxytocin release Causes myometrial contractions Pushes baby further into cervix Increased oxytocin release More contractions
Function of relaxin
Aids cervical dilatation and vagina
Aids relaxation of pelvic floor muscles
Functions of the placenta
Nutrient supply Waste removal Gaseous exchange Detoxification of drugs and metabolites Synthesis of hormones Long chain fatty acid production
Which substances cannot cross the placenta?
Insulin, heparin
Amniotic fluid formation
By the amnion
Ultrafiltrate of blood
Supplemented by secretions from the baby’s lungs and kidneys as urine
Function of amniotic fluid
Cushioning Development of lungs and GI system Formation of meconium Allows movement Temperature regulation
Foetal metabolic adaptations at birth
560g of fat
34g of glycogen
Rely on FFAs initially and ketones in for the brain
Respiratory changes at birth
Inflation of the lungs
Clearance of lung fluid
Decrease in pulmonary vascular resistance
Secretion of pulmonary surfactant
What does the heel prick test look for?
Sickle cell disease - haemoglobinopathies
CHT - TSH
Cystic fibrosis - immune reactive trypsinogen
PKU - phenylalanine
MCADD - octanoylcarnitine
Advantages of breast feeding
Free Always available Right temperature Correct balance of nutrients Reduces foetal risk of infection, SCIDS and allergies Helps baby develop immune system Reduced maternal risk of breast and ovarian cancer and osteoporosis Helps mother with weight loss Promotes bonding
Problems with breastfeeding
Sore nipples Can't tell amount Father can't help Have to be with baby Inadequate milk supply Social stigma Embarrassment Can't return to work
Why can’t cow’s milk not be used?
Excessive protein, sodium and phosphate leading to dehydration
Why can’t soy based products be used?
Contains phyto-oestrogens
Can harm fertility
What does breast milk provide that infant formula does not?
IgA
Long chain fatty acids
Lysozyme
Whey protein
Hormones involved in breastfeeding
Human placental lactogen, oxytocin, prolactin, oestrogen and progesterone in breast development
Oestrogen and progesterone block lactogenic effects of prolactin
Prolactin stimulates milk secretion
Oxytocin stimulates milk ejection when suckling
5 mesenchymal swellings leading to facial development
Frontonasal prominence
Maxillary prominence
Mandibular prominence
What causes cleft lip?
Failure of maxillary and medial nasal prominences to fuse correctly
What causes cleft palate?
Failure of palatine shelves to fuse correctly
Short term menopause symptoms
Hot flushes and night sweats Palpitations Breast tenderness Urge incontinence Vaginal dryness Fatigue Mood swings Lowered libido Worsening PMS
Average age for menopause
52
Routes of HRT administration
Patches Gels Implants Pessaries Creams Nasal sprays
Side effects of HRT
Heavy cyclical bleeding Bloating Fluid retention Weight gain Mastalgia Headaches Muscle pain Depression
Complications of HRT
Thrombo-embolic events
Increased breast and ovarian cancer risk
Physiology of menopause
Reduction of oestradiol secretion from ovaries
Loss of feedback inhibition on pituitary
Increased FSH and LH levels
