Intrauterine Programming of Adult Disease

Question 1

3 common pregnancy complications

Answer 1

1. preterm labour
2. pre-eclampsia
3. intrauterine growth restriction

Question 2

red flag for pregnancy complications?

Answer 2

any bleeding?

Question 3

preterm labour is when?

Answer 3

labour before 37 weeks

Question 4

etiology of preterm labour?

Answer 4

infection?
mostly unknown
rupture of membranes
twins
polyhydramnios

Question 5

what is polyhydramnios?

Answer 5

excess amniotic fluid

Question 6

what is Pre-Eclampsia?

Answer 6

high maternal BP causing proteinuria and edema

Question 7

implication for fetus with Pre-Eclampsia?

Answer 7

placental dysfunction and IUGR due to maternal BP

Question 8

what is full eclampsia?

Answer 8

maternal convulsions and renal failure

Question 9

Pre-Eclampsia treatment if mother is compromised?

Answer 9

deliver baby

Question 10

etiology of Pre-Eclampsia?

Answer 10

unknown

dependent on insufficient trophoblast invasion?

Question 11

definition of intrauterine growth restriction?

Answer 11

<2SD below population mean ~10% of babies

Question 12

common cause of intrauterine growth restriction?

Answer 12

placental insufficiency

Question 13

incidence of intrauterine growth restriction?

Answer 13

2-10%

Question 14

what is oligohydramnios?

Answer 14

insufficient amniotic fluid

Question 15

3 big factors controls fetal growth:

Answer 15

1. genetic
2. hormonal
3. environmental

Question 16

3 main hormones controls fetal growth

Answer 16

IGFs
Thyroid
insulin

Question 17

what hormones inhibits fetal growth

Answer 17

glucocorticoids (eg. mother’s stressed)

Question 18

in developing countries, most common cause of fetal growth restriction?

Answer 18

maternal undernutrition

Question 19

babies born small: advantage and disadvantage?

Answer 19

1. helps baby survive in short term if was maternal malnutrition
2. more susceptible to adult disease

Question 20

Fetal programming?

Answer 20

small babies survive short term but more incidence of adult diseases

Question 21

early versus late accelerated growth for post birth intrauterine growth restriction is better?

Answer 21

early accelerated growth (first 6mo) protective effect: matched lactation to baby’s demands

Question 22

male or female affect more from intrauterine growth restriction?

Answer 22

males more affected by birth weight

Question 23

after weaning, how should nutrition be?

Answer 23

Not excessive

Question 24

with suboptimal fetal environment, fetus changes set points to ‘predict’ postnatal environment, what can go wrong?

Answer 24

if mismatch between set points and environment

Question 25

rat model intrauterine growth restrictions affected F1 generation how?

Answer 25

Males more metabolic, cardio, nephron problems

Question 26

rat model intrauterine growth restrictions affected F2 generation how?

Answer 26

both males and preg F1 females had more problems including both male and female F2 generation