Lecture 14

Question 1

FGR term

Answer 1

can reach full term

Question 2

Premature babies

Answer 2

do not reach full term

born before due date

Question 3

FGR stats

Answer 3

weight below 10th percentile 
increased risk of CV as an adult
lack of vascular adaptions
detectable in utero 
no treatments

Question 4

lack of vascular adaptations (FGR)

Answer 4

increased vascular resistance

decreased blood flow

Question 5

Screening

Answer 5

75% of cases for FGR missed 
90% still births are FGR 
USS at 20 weeks 
SFH 
foetal movements

Question 6

placenta function

Answer 6

nutrient and gas exchange
hormone production and release
protective barrier

Question 7

placental structure

Answer 7

villous branches
highly branched
highly vascularised
specialised SYNC layer

Question 8

placental circulation

Answer 8

maternal blood to intervillous space
blood leaves space by maternal veins
baby has umbilical cord which projects into space

Question 9

does blood mix

Answer 9

NEVER

Question 10

uterine blood artery

Answer 10

provides into intervillous space
barrier to stop entry of RBCs and WBCs
underlying cytotrophic layer

Question 11

what does placental dysfunction cause

Answer 11

FGR 
impaired placental blood flow 
impaired vascular function 
reduced nutrient transport 
lower hormone levels

Question 12

reduced placental cell turnover in FGR

Answer 12

decrease cytotrophic prolif
increased apoptosis
increase syncytial knots
reduced growth and SYN growth

Question 13

reduced cell turnover leads to

Answer 13

smaller placenta
less branched
less o2 and nutrients to foetus
damaged SYNC

Question 14

reduced villous branching in FGR

Answer 14

decreased branching of villous tree
smaller and fewer terminal villi
reduced surface area
thicker SYNC so less diffusion

Question 15

reduced nutrient transport in FGR

Answer 15

impaired placental amino acid transport

AGA less active

Question 16

system A function

Answer 16

amino acid transporter in cells

Question 17

reduced placental vascularisation

Answer 17

especially in peripheral regions

may effect feto-placental flow

reduced density of blood vessels so reduced oxygen

Question 18

foetal blood flow

Answer 18

foetal heart 
umbilical arteries 
placenta (adds o2)
umbilical vein 
foetus

Question 19

low resistance blood flow

Answer 19

causes UNIMPEDED blood flow

Question 20

low resistance o2

Answer 20

deoxygenated

Question 21

umbilical artery dopple USS FGR

Answer 21

reverse end diastolic flow

absent end diastolic flow

Question 22

systole

Answer 22

peak blood flow

Question 23

diastole

Answer 23

resisted blood flow

Question 24

reverse end diastolic flow in FGR

Answer 24

undershoot

c-section to deliver baby immediately

Question 25

placental arteries in FGR

Answer 25

constrict more more pressure more damage to foetus

Question 26

maternal blood perfusion

Answer 26

blood delivered via uterine spiral arteries to placenta high volume blood flow to placenta transformed in early pregnancy by EVT

Question 27

EVT | extravillous trophoblast

Answer 27

enlarged sinus high volume low resistance blood flow trophoblast remodels arteries

Question 28

abnormal blood flow in FGR

Answer 28

``` reduced flow high resistance diastolic notching reduced o2 and nutrients doppler of uterine artery ```

Question 29

placental hormones

Answer 29

lower conc used as marker hPL PTL PIGF

Question 30

KO IGF I | MOUSE

Answer 30

reduction in weight by 40% compared to WT

Question 31

KO IGF I and II

Answer 31

reduction in weight by 70% to WT | hard to survive

Question 32

IGF I KO

Answer 32

FGR

Question 33

IGF II KO

Answer 33

FGR and placenta growth restriction

Question 34

P0

Answer 34

placental specific

Question 35

PO IGF2 KO

Answer 35

KO placental IGF2 but rest stays normal | leads to FGR and PGR

Question 36

PO IGF2 KO properties

Answer 36

global reduction of spongitrophoblast and labyrinth 50% reduction in labyrinth surface area morphological abnormalities

Question 37

placental transport in IGF2 KO

Answer 37

placenta has decrease passive permeability | radiolabel

Question 38

radiolabels

Answer 38

C-14 | cobalt 51

Question 39

IGF2 KO system A

Answer 39

activity increased in KO to make up for loss

Question 40

IGF KO | HUMANS

Answer 40

stimulates proliferation of cytotrophoblast stained with BrdU if IGF decreases, cell turnover increases

Question 41

Glucocorticoids and FGR | HUMANS

Answer 41

cortisol synthetics (Dex) 9/11 antenatal GC administration

Question 42

increase in GC

Answer 42

decrease in birth weight

Question 43

antenatal GCs

Answer 43

threatened preterm labour to promote lung maturation maternal conditions like asthma or AIDS

Question 44

reduced placental barriers in FGR

Answer 44

foetus protected from cortisol contains 11B-HSD2 to convert cortisol to cortisone

Question 45

where is cortisone expressed

Answer 45

sync forms protective barrier reduces 11B-HSD2 in FGR

Question 46

MICE given synthetic GCs

Answer 46

FGR and PGR

Question 47

GC on IGF2

Answer 47

inhibits IGF2

Question 48

where are GC receptors expressed

Answer 48

on placenta

Question 49

GCRs

Answer 49

nuclear steroid receptor | binds to transcriptional region

Question 50

11B-HSD2 KO | MOUSE

Answer 50

reduced foetal weight - FGR | reduced placental weight - PGR

Question 51

abundance of mRNA in 11B-HSD2 KO

Answer 51

reduced VegF

Question 52

veg-f

Answer 52

promotes angiogenesis in placenta

Question 53

system A and Dex GC

Answer 53

reduced activity

Question 54

placenta cells models for GC | HUMANS

Answer 54

GC impairs angiogenesis decreased by 40% reduced VegF for branching reduced IGF-1 expression

Question 55

dysregulated vasodilation in blood vessels of FGR placenta | HUMANS

Answer 55

pressure remains high blood vessels do not dilate elevated resistance

Question 56

Ca2+ channels

Answer 56

TPRV4 PIEZO P2X4

Question 57

effects of endothelial cell on underlying blood vessels

Answer 57

relaxation of blood vessel

Question 58

how does blood vessel relax

Answer 58

COX eNOS AA