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HUNT243 > Lecture 3 > Flashcards

Lecture 3 Flashcards

Pregnancy and physiological changes

1
Q

Conception/Fertilization (5 important steps)

A

1- Ovulation
2-Fertilisation
3-Cleavage
4-Blastocyst
5-Implantation

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2
Q

Ovulation

A

development of follicles which end up turning into an egg and through the release of chemicals during the hormonal stages, once a follicle is developed chemicals are released and this tells the fallopian tube that and egg is ready to be collected

Fallopian tube is where fertilisation occurs

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3
Q

Fertilisation

A

after fertilisation has occured we have what is called a zygote and a zygote is genetically complete

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4
Q

Cleavage

A

Cleavage through mitosis - dividing of the cell which ends up in a morula 16-cell stage and the morula brings nutrients into the cell

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5
Q

Blastocyst

A

trophoblast outer (placenta) has a lot of specialised cells that create finger like structures which helps the now blastocyst to implant into the uterus
Embryoblast inner (fetus)

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6
Q

Implantation

A

Implantation of the blastocyst onto the uterus lining

pregnancy hormonal changes occurs through this time which stops the release of more eggs

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7
Q

EDD

A

Estimated Date of Delivery typically counted from the first day of last menstrual period: 40 weeks from LMP or 38 weeks after conception

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8
Q

1st trimester

A

Conception to 12th week

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9
Q

2nd trimester

A

13th to 28th week

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10
Q

3rd trimester

A

28th week until birth

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11
Q

Pre-trem (premature)

A

<37 weeks

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12
Q

Term

A

37-42 weeks

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13
Q

Post-Term (postmature)

A

> 42 weeks

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14
Q

How many births occur on the due date

A

<10%

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15
Q

Perinatal varies from

A

20-24 weeks and there is a 50% survival chance at 24 weeks

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16
Q

Placenta

A

An organ that starts forming at implantation of the balstocyst

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17
Q

Placenta carries

A

Oxygen, nutrients and antibodies from mother to fetus and waste materials including CO2 from fetus to mother

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17
Q

The placenta is fully formed by

A

18-20 wks but continues to grow throughout pregnancy. At delivery is weighs about 0.5kg

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18
Q

The placenta takes over the hormonal roles of the

A

Ovary

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19
Q

The placenta is connected to the … by the

A

Connected to the embryo/ fetus by an umbilical cord

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20
Q

3 components to the umbilical cord

A

Umbilical vein
Umbilical cord
Umbilical arteries

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21
Q

Teratogens

A

Any agent that can disturb the development of an embryo or fetus. May cause a birth defect in the child or halt the pregnancy.

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22
Q

The classes of teratogens include

A

radiation, maternal infections, chemicals and drugs

23
Q

Hormonal changes during pregnancy

A

Progesterone and oestrogen rise continually throughout pregnancy, suppressing the hypothalamic axis and thus the menstrual cycles

24
Q

High circulating levels of oestrogen promote

A

prolactin production (pituitary gland enlargement by 50%).

25
Q

what does prolactin production mediate

A

This mediates a change in the structure of the mammary gland from ductal to lobular-aveolar =milk hormone

26
Q

Parathyroid hormone change

A

is increased to enhance calcium uptake in the gut and reabsorption by the kidney

27
Q

adrenal hormones such as ……. also

A

adrenal hormones such as cortisol and aldosterone also increase

28
Q

Human placental lactogen is produced by the

A

Placenta

29
Q

HPL decreases

A

Maternal insulin sensitivity and maternal glucose utilisation which raises maternal blood glucose levels, which helps to ensure adequate fetal nutrition

30
Q

HPL increases

A

Gluconeogensis to increase maternal glucose levels so more glucose is available for the fetus

31
Q

chronic hypoglycemia leads to rise in

A

HPL induces lipolysis with the release of free fatty acids which become available for the maternal organism as fuel, so that relatively more glucose can be utilised by the fetus. Also, ketones formed from free fatty acids can cross the placenta and be used by the fetus.

32
Q

Hematological changes - Blood volume increases

A

40-45% (proportionally with cardiac output)

33
Q

Plasma volume increases early in pregnancy and faster than

A

RBC volume, the hematocrit falls until the end of the second trimester, when the increase in the RBC is synchronised with the plasma volume increase - Hematocrit then stabilises

34
Q

If plasma volume increases during pregnancy

A

The haemoglobin will be lower (this is called dilution anemia)

35
Q

Gastrointestinal changes - as pregnancy progresses, pressure from the enlarging uterus

A

uterus on the rectum and lower portion of the colon commonly causes constipation

36
Q

GI motility decreases because

A

elevated progesterone levels relax smooth muscle

37
Q

Heartburn and belching are common possibly resulting from

A

delayed gastric emptying and gastroesophageal reflux due to relaxation of the lower esophageal sphincter

38
Q

hydrochloric acid production ….

A

decreases thus peptic ulcer disease is uncommon during pregnancy and preexisting ulcers often become less severe

39
Q

Morning sickness

A

Nausea & vomiting in pregnancy (NVP)

definition spans from slight dizziness and dry retching to continuous vomiting

40
Q

Morning sickness commonly occurs between

A

5 and 18 weeks of pregnancy with between a 50% to 80% of women reporting some degree of nausea with or without vomiting

41
Q

Severe morning sickness

A

Hyperemesis gravidarum (HP)

42
Q

Hyperemesis gravidarum (HP)

A

Extreme form of NVP accompanied by weight loss, electrolyte imbalance and dehydration requiring hospitalisation

43
Q

Recent research of HP has found a link between the hormone

A

Growth Differentiation Factor 15 (GDF15) and NVP

GDF15 plays a crucial role in NVP severity

44
Q

women who have lower levels of GDF prior to pregnancy will not

A

be as tolerant to it during pregnancy so may not be able to handle it as well during pregnancy

45
Q

Pregnancy outcomes when experiencing NVP or NP (4)

A

Pelvic girdle pain, high blood pressure, proteinuria, preeclampsia, gestational diabetes

46
Q

Delivery and birth outcomes of NVP or NP (4)

A

Gestational length, C-section delivery, mortality, growth of infant

47
Q

Women with NVP or NP more likely to develop pregnancy complications but do

A

exhibit mostly favourable delivery and birth outcomes

48
Q

Management of NVP

A

1- Reduce symptoms via changes in diet/environment and by medication

2- Correct/prevent consequences or complication of NVP

3-Minimise fetal effects pf maternal NVP and their treatment

49
Q

Management of NVP: diet

A

Eat what appeals- avoid trigger foods and odours

Eat slowly and small amounts every 1-2 hours: avoid a full and empty stomach

Frequent small CHO meals such as dry toast: evidence that consistent protein intake is key to prevent nausea

Fluids better tolerated if cold, clear, carbonated or sour

Ginger and B6 supplements

50
Q

NVP: Ginger and Vitamin B6

A

Ginger improved general NVP symptom, reduced severity of nausea but did not reduce vomiting

Ginger more effective than B6 on reducing nausea but not significantly different

51
Q

what does of ginger is safely prescribe ?

A

The total dose is usually approximately 1 g per day, divided into 3-4 per day

52
Q

What do some cultures do with the placenta

A

bury the placenta for varoius reasons. Maori traditionally bury the placenta from a newborn child to emphasize the relationship between humans and the earth

53
Q

In the western world, the placenta is most often

A

incinerated….. or more recently encapsulated

54
Q

Placental encapsulation benefits

A
  • Improved lactation
    -Prevent postpartum depression
    -Relieve pain
    -Bonding with your baby
    -Increasing iron stored
    -Increasing energy
55
Q

Placental encapsulation concerns

A

-Safe release of placenta from hospital setting
-Introducing harmful bacteria through processing

56
Q

placentophagia should be

A

discouraged as exposes mothers and offspring to infectious risks

HUNT243 (29 decks)

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