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RED > L13: Endocrinology Of Pregnancy And Parturition > Flashcards

L13: Endocrinology Of Pregnancy And Parturition Flashcards

1
Q

What are the 2 types of hormones

A

Lipid base

Protein

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2
Q

Which hormones are lipid base

A

Oestrogen
Progesterone
Cortisol
Androgen

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3
Q

Which hormones are protein

A

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

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4
Q

What are the important hormones in the menstrual cycle

A

Oestrogen

Progesterone

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5
Q

What hormones are the oestrogen and progesterone under the influence of

A

LH

FSH

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6
Q

What causes ovulation to occur

A

LH surge

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7
Q

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

A

Corpus luteum

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8
Q

What hormones does the corpus luteum produce

A

Oestrogen

Progesterone

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9
Q

Which hormones causes the corpus luteum to produce oestrogen and progesterone

A

LH

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10
Q

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

A

Progesterone and oestrogen decrease

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11
Q

What does the decrease in oestrogen and progesterone cause

A

Menstruation

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12
Q

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

A

Hcg

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13
Q

What other hormones does HCG have a similarity with

A

LH

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14
Q

Which subunit of HCG and LH are similiar

A

Alpha subunit

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15
Q

When there is hcg what receptor does it bind to

A

LHCGR on the corpus luteum

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16
Q

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

A

Secrete progesterone and oestrogen to maintain pregnancy

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17
Q

Which layer of the embryo secretes HCG

A

Syncitiotrophoblast

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18
Q

What are the 3 functions of HCG

A

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

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19
Q

Apart from pregnancy what can high levels of HCG indicate

A

Molar pregnancy

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20
Q

What is a molar pregnancy

A

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

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21
Q

What happens to the HCG levels every 2 days

A

Doubles

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22
Q

How can we test for pregnancy

A

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

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23
Q

Which cells secrete progesterone

A

Granulosa lutein cells
Theca lutein cells
In the corpus lutein

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24
Q

What is the function of the progesterone

A

Maintain the decidua

Relaxes myometrium

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25
Q

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

A

Myometrium contract

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26
Q

How does progesterone relax the myometrium

A

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

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27
Q

What is the main derivative of steroids

A

Cholesterol

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28
Q

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

A

17 alpha hydroxylase

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29
Q

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

A

3 beta hydroxy steroid dehydrogenase

30
Q

What does these modification in the placenta and fetus result in

A

Different pathway for oestrogen synthesis

31
Q

What are the 3 types of oestrogen

A

E1
E2
E3

32
Q

What are the types of oestrogen for

A

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

33
Q

When implantation occurs what is the main souse of oestrogen

A

Placenta

Fetal liver

34
Q

What is the role of oestrogen

A
  • vasodilation
  • Increase in prothrombotic mechanism (we don’t give oestrogens contraception to people with blood clots)
  • breast development
  • increase in contractile associated proteins
35
Q

What is the most potent oestrogen

A

E2

36
Q

Which hormone is produced in the fetus for growth

A

Placental growth hormone

37
Q

How does placental growth hormones work

A
  • By modifying receptors that transport glucose from maternal to fetus
  • stimulate gluconeogenesis
38
Q

Which hormone produced in the fetus regulates insulin sensitivity

A

Human placental lactogen (HPL)

39
Q

Where is the HPL secreted from

A

Syncitiotrophoblast

40
Q

If HPL can drive insulin sensitivity what can it cause

A

Gestational diabetes

41
Q

How does the HPL cause insulin sensitivity

A

By increasing IGF1 in the maternal liver

42
Q

What other effects does HPL have

A

Lobuloalveolar development and maturation of the maternal breast

43
Q

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

A

Increase glucose for fetus

44
Q

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

A

Relaxin

45
Q

When does the levels of relaxin increase

A

In parturition

46
Q

What is the role of relaxin

A

Increase cardiac output
Increase renal blood flow
Relax pelvic ligament

47
Q

During pregnancy which 2 hormones should have a balance

A

Progesterone

Oestrogen

48
Q

Why does oestrogen and progesterone have to be balanced in pregnancy

A

Progesterone is a myometrium relaxor

Oestrogen is a pro-contractile

49
Q

What occurs in labour to the levels of progesterone

A

Decrease

50
Q

In clinical practice what can we give to induce labour

A

Progesterone antagonist

51
Q

What are the 2 phases of labour

A

1) latent phase

2) active phase

52
Q

What is the latent phase

A

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

53
Q

What is the active phase

A

Strong rhythmic contractions of the uterus to pass baby out

54
Q

Which phase induces the cervical dilation

A

Active phase

55
Q

What produced prolactin

A

The anterior pituitary gland

56
Q

When does prolactin increase

A

During pregnancy

57
Q

What is the role of prolactin

A
  • prepare breast for lactation
  • lung maturation for baby
  • milk biosynthesis within the alveolar cells
58
Q

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

A

Baby suckling at the nipple

59
Q

What produced oxytocin

A

Posterior pituitary gland

60
Q

What is the level of oxytocin during pregnancy

A

Low

61
Q

When does oxytocin levels increase

A

In labour

62
Q

What is the role of oxytocin

A
  • myometrium contractions
  • maintain uterine contraction after birth to help uterus shrink back
  • ejects milk out
63
Q

Which pro contractile prostaglandin is produced during brith

A

PGF2 alpha

64
Q

Does the fetus itself contribute to labour

A

Yes

65
Q

Describe how the fetus contributes to labour

A

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

66
Q

What are the 2 hormones involved in lactation

A

Prolactin : Produces milk

Oxytocin : milk Out

67
Q

Which hormone induces the prolactin production in the anterior pituitary gland

A

Oestrogen

68
Q

What are the 2 ways oestrogen causes prolactin

A
  • Directly
    Or
  • suppressing dopamine
69
Q

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

A

Decreases

70
Q

What are the advantages of breastfeeding

A
  • protects against infection
71
Q

What are the advantages of breastfeeding to the mother

A

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

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