L13: Endocrinology Of Pregnancy And Parturition Flashcards by selcan icli

What are the 2 types of hormones

Lipid base

Protein

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Which hormones are lipid base

Oestrogen
Progesterone
Cortisol
Androgen

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Which hormones are protein

Gonadotrophic- LH, FSH, HCG
Somatomammotrohpic- prolactin, GH
GNRH, Oxytocin

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What are the important hormones in the menstrual cycle

Oestrogen

Progesterone

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What hormones are the oestrogen and progesterone under the influence of

FSH

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What causes ovulation to occur

LH surge

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What structure is left behind in the ovaries when an oocyte ovulates

Corpus luteum

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What hormones does the corpus luteum produce

Oestrogen

Progesterone

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Which hormones causes the corpus luteum to produce oestrogen and progesterone

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What happens to the levels of the oestrogen and progesterone as corpus luteum degrades into the corpus Albicans due to no fertilisation

Progesterone and oestrogen decrease

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What does the decrease in oestrogen and progesterone cause

Menstruation

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If fertilisation/pregnancy has occurred what hormone is produced by the placenta

Hcg

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What other hormones does HCG have a similarity with

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Which subunit of HCG and LH are similiar

Alpha subunit

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When there is hcg what receptor does it bind to

LHCGR on the corpus luteum

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If the hcg binds to the corpus luteum LHCGR what does the corpus luteum do

Secrete progesterone and oestrogen to maintain pregnancy

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Which layer of the embryo secretes HCG

Syncitiotrophoblast

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What are the 3 functions of HCG

Maintain the corpus leteum
Stimulate DHEA production in the fetal adrenal
If males is stimulates testosterone production

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Apart from pregnancy what can high levels of HCG indicate

Molar pregnancy

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What is a molar pregnancy

Not a real pregnancy, it is a rapidly growing embryonic cell type that can become cancerous tumour

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What happens to the HCG levels every 2 days

Doubles

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How can we test for pregnancy

By doing a hcg test and looking if it doubles after 2 days

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Which cells secrete progesterone

Granulosa lutein cells
Theca lutein cells
In the corpus lutein

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What is the function of the progesterone

Maintain the decidua

Relaxes myometrium

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If progesterone causes the relaxation of the myometrium what happen when the progesterone levels fall in labour

Myometrium contract

How does progesterone relax the myometrium

Progesterone down regulates the synthesis of contractile associated proteins e.g GAP junctions, oxytocin receptors

What is the main derivative of steroids

Cholesterol

In the placenta what enzyme does it lack that cannot convert progesterone to DHEA

17 alpha hydroxylase

In the fetus what enzyme does it lack that cannot covert pregnelone to progesterone

3 beta hydroxy steroid dehydrogenase

What does these modification in the placenta and fetus result in

Different pathway for oestrogen synthesis

What are the 3 types of oestrogen

E1 E2 E3

What are the types of oestrogen for

E1: after menapause E2: regulates menstruation E3: during pregnancy

When implantation occurs what is the main souse of oestrogen

Placenta | Fetal liver

What is the role of oestrogen

- vasodilation - Increase in prothrombotic mechanism (we don’t give oestrogens contraception to people with blood clots) - breast development - increase in contractile associated proteins

What is the most potent oestrogen

Which hormone is produced in the fetus for growth

Placental growth hormone

How does placental growth hormones work

- By modifying receptors that transport glucose from maternal to fetus - stimulate gluconeogenesis

Which hormone produced in the fetus regulates insulin sensitivity

Human placental lactogen (HPL)

Where is the HPL secreted from

Syncitiotrophoblast

If HPL can drive insulin sensitivity what can it cause

Gestational diabetes

How does the HPL cause insulin sensitivity

By increasing IGF1 in the maternal liver

What other effects does HPL have

Lobuloalveolar development and maturation of the maternal breast

Overall then what is the role of human placental lactogen and placental growth hormone

Increase glucose for fetus

Which addition hormone apart from oestrogen and progesterone does the corpus luteum produce

Relaxin

When does the levels of relaxin increase

In parturition

What is the role of relaxin

Increase cardiac output Increase renal blood flow Relax pelvic ligament

During pregnancy which 2 hormones should have a balance

Progesterone | Oestrogen

Why does oestrogen and progesterone have to be balanced in pregnancy

Progesterone is a myometrium relaxor | Oestrogen is a pro-contractile

What occurs in labour to the levels of progesterone

Decrease

In clinical practice what can we give to induce labour

Progesterone antagonist

What are the 2 phases of labour

1) latent phase | 2) active phase

What is the latent phase

Cervix is changing by softening, thinning and relaxin is acting on the pubic symphysis

What is the active phase

Strong rhythmic contractions of the uterus to pass baby out

Which phase induces the cervical dilation

Active phase

What produced prolactin

The anterior pituitary gland

When does prolactin increase

During pregnancy

What is the role of prolactin

- prepare breast for lactation - lung maturation for baby - milk biosynthesis within the alveolar cells

What after pregnancy i.e the delivery of the baby, what stimulates the prolactin secretion from the anterior pituitary gland

Baby suckling at the nipple

What produced oxytocin

Posterior pituitary gland

What is the level of oxytocin during pregnancy

Low

When does oxytocin levels increase

In labour

What is the role of oxytocin

- myometrium contractions - maintain uterine contraction after birth to help uterus shrink back - ejects milk out

Which pro contractile prostaglandin is produced during brith

PGF2 alpha

Does the fetus itself contribute to labour

Yes

Describe how the fetus contributes to labour

1) placental cortical releasing hormone increases 2) DHEA production increases in the fetal adrenal gland 3) DHEA converts into oestrogen in the placenta 4) oestrogen is pro-contractile and initiates contraction of the myometrium

What are the 2 hormones involved in lactation

Prolactin : Produces milk | Oxytocin : milk Out

Which hormone induces the prolactin production in the anterior pituitary gland

Oestrogen

What are the 2 ways oestrogen causes prolactin

- Directly Or - suppressing dopamine

What happens to the levels of dopamine when the baby suckles on the nipple

Decreases

What are the advantages of breastfeeding

- protects against infection

What are the advantages of breastfeeding to the mother

Contraception i.e lactational ammenorhhea Reduces cancer risk Emotional health Weight loss muscle