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3. Development and Aging > Late Development and Parturition > Flashcards

Late Development and Parturition Flashcards

1
Q

How does embryo-fetal nutrition occur?

A
  • histotrophic
  • haemotrophic
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2
Q

How does the placenta develop?

A

cytotrophoblasts —> chorionic villi —> infiltrate trophoblastic lacunae —> extra-villus trophoblasts —> open up spiral arteries

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3
Q

What are the fetal membranes?

A
  • amnion
  • chorion
  • allantosis
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4
Q

What are the 3 stages of chorionic villi development?

A
  1. Primary —> outgrowth
  2. Secondary —> fetal mesoderm
  3. Tertiary —> umbilical a+v into villus
    mesoderm
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5
Q

How is blood supplied to the endometrium?

A

ovarian + uterine artery —> arcuate —> radial —> basal —> spiral

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6
Q

What is spiral artery re-modelling?

A

infiltrated by endovascular EVT —> open up spiral artery —> low pressure, high capacity

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6
Q

Which 6 nutrients are exchanged across the placenta to the foetus?

A
  1. Oxygen
  2. Glucose
  3. Water
  4. Electrolytes
  5. Calcium
  6. Amino acids
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7
Q

What are the maternal changes that occur to facilitate maternal fetal oxygen exchange?

A

CO inc
PVR inc
Blood vol inc
Ventilation inc

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8
Q

What are the placenta and fetal changes that occur to facilitate maternal fetal oxygen exchange?

A

Placenta consumes most O2 and glucose
Fetal O2 sat similar to maternal
Embryonic and fetal Hb —> greater affinity

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9
Q

How does the fetal circulatory system mature?

A

gas exchange at placenta
ventricles act parallel not series
shunts bypass pulmonary and hepatic close as birth

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10
Q

How does the fetal respiratory system mature?

A

air sacs at 20 weeks, vasculature at 28 weeks
surfactants at 20 weeks
1-4hr/day rapid respiratory movements in REM sleep

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11
Q

How does the fetal gastrointestinal system mature?

A

endocrine pancreas start at 2T (insulin mid 2T)
liver glycogen deposited
amniotic fluid swallowed —> debris + bile salts to
meconium

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12
Q

How does the fetal nervous system mature?

A

movement late 1T —> detect from 14 weeks
stress from 18 weeks
thalamus-cortex connections from 24 weeks
always in slow-wave or REM sleep

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13
Q

What is fetal organ maturation driven by?

A

corticosteroids

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14
Q

What are the 4 phases of labour?

A
  1. Quiescent
  2. Activation —> prep
  3. Stimulation —> labour
  4. Involution —> recovery
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15
Q

What are the 3 stages of stimulation?

A
  1. First —> latent and active cervix dilation
  2. Second —> contractions
  3. Third —> placenta, fetal membrane out, repair
16
Q

What are the 4 stages of cervical re-modelling?

A
  1. Softening
  2. Ripening
  3. Dilation
  4. Post-partum repair
17
Q

How is labour initiated?

A

Fetal HPA —> CRH —> fetal ACTH + cortisol + DHEAS
—> placenta CRH

18
Q

How does progesterone contribute to labour?

A

normally inhibits —> PR-A switch to PR-B/C —> not active —> ‘blinded’

19
Q

How does oestrogen contribute to labour?

A
  • inc oxytocin
  • activate activates phospholipase A2 —> inc
    arachidonic acid —> inc prostaglandin
20
Q

How does oxytocin contribute to labour?

A
  • syncytium
  • membrane potential —> lower threshold
  • inc Ca2+ release
21
Q

Which 3 prostaglandins contribute to labour?

A
  1. PGE2 —> cervical remodelling (+NO, relaxin)
  2. PGF2α —> myometrial contractions
  3. PGI2 —> myometrium relax
22
Q

How do hormones control labour?

A
  1. Fetal CRH —> cortisol
    —> DHEAS
  2. Cortisol —> placental CRH —> inc fetal CRH
  3. DHEAS —> maternal oestrogen —> oxytocin
23
Q

How do myometrial contractions facilitate labour?

A

Contract fundus down
Brachystatic
—> pull uterus up

24
Q

How does the fetus facilitate labour?

A

Chin to chest —> fetus rotates (belly to spine) —> head out

25
Q

What happens after labour?

A
  • uterus shrink —> placenta less contact with
    endometrium —> fetal membranes fold
  • clamp umbilical cord —> stop fetal blood to placenta
  • expel placenta and fetal membranes
  • uterine vessel thrombosis —> involution

3. Development and Aging (5 decks)

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