MATERNAL NUTRITION; IMPACT ON PLACENTA FUNCTION Flashcards
DOES PLACENTA START DEVELOPING BEFORE OR AFTER IMPLANTATION?
SHORTLY AFTER
PLACENTA DEVELOPS WHEN THE EMBRYO IS AT WHICH STAGE OF DEVELOPMENT?
BLASTOCYST
MAIN FUNCTIONS OF THE PLACENTA?
- RESPIRATION
- EXCRETION
- NUTRITION
- IMMUNITY
+ IT IS AN ENDOCRINE ORGAN
BASIC PLACENTA STRUCTURE:
FETAL SIDE; CHORIONIC PLATE
INTERVILLOUS SPACE; EXCHANGE OF OXYGEN AND NUTRIENTS
MATERNAL SIDE; BASAL PLATE
SPIRAL ARTERY REMODELLING?
Begins in the first few weeks of pregnancy and modifies the arteries from low-flow, high-resistance to high-flow, low-resistance vessels capable of meeting the demands of the developing fetus
WHAT IS THE SYNCYTIOTROPHOBLAST?
THE MOST IMPORTANT CELL TYPE IN THE PLACENTA
FORMS AN EPITHELIAL LAYER ON THE SURFACE OF CHORIONIC VILLI
PRODUCES HORMONES, MEDIATES NUTRIENT TRANSFER AND FORMS A PHYSICAL AND IMMUNOLOGICAL BARRIER BETWEEN THE FETAL AND MOTHER’S CIRCULATION
WHICH MEMBRANE OF THE SYNCYTIOTROPHOBLAST FACES THE MOTHER BLOOD AND WHICH THE FETUS’ BLOOD?
MOTHERS: APICAL MEMBRANE
FETUS’: BASAL MEMBRANE
PLACENTA’S TRANSPORT MECHANISMS ARE SIMILAR TO THOSE OF WHICH PART OF THE GI TRACT?
SMALL INTESTINE
WHICH SUBSTRATE IS THE MAIN ENERGY SOURCE OF THE FETUS AND PLACENTA?
GLUCOSE
IS FAT AN ENERGY SOURCE FOR FETUS?
NO
WHAT IS THE MOST IMPORTANT SIGNALLING MOLECULES IN THE PLACENTA FOR NUTRIENT SENSING?
mTOR
WHICH TRANSPORT MECHANISM IS USED FOR GLUCOSE TO CROSS THE PLACENTA?
FACILITATED DIFFUSION
WHICH MOLECULES CAN CROSS THE PLACENTA VIA PASSIVE DIFFUSION?
CO2, O2, H2O, ALCOHOL, STEROIDS, ELECTROLYTES, FREE FATTY ACIDS, FAT SOLUBLE VITAMINS..
WHICH MOLECULES CROSS THE PLACENTA VIA ACTIVE TRANSPORT?
AMINO ACIDS, WATER SOLUBLE VITAMINS, CALCIUM, IRON, IODINE…
PHOSPHOLIPIDS AND LIPOROTEINS CROSS THE PLACENTA VIA WHICH MECHANISM?
ENDOCYTOSIS
SIZE AT BIRTH IS A PREDICTOR FOR LIFE EXPECTANCY. THIS CORRELATION CAN BE EXPLAINED BY THE PHENOMENON CALLED:
DEVELOPMENTAL PROGRAMMING OF FETAL OUTCOMES
IMPACT OF UNDERNUTRITION, STRESS, PREECLAMPSIA, T1D ON THE PLACENTA AND FETUS?
- PLACENTA: DECREASED SUPPLY OF NUTRIENTS, SMALLER PLACENTAS, SMALLER EXCHANGE AREA LEADING TO SGA BABIES AND IUGR, ALTERATIONS OF VASCULOGENESIS AND ANGIOGENESIS, PLACENTAL MASS STRONGLY ASSOCIATED WITH DIETARY INTAKE
- ADULT HEALTH OUTCOMES: HIGH BP, INSULIN RESISTANCE, INCREASED ADIPOSITY, DECREASED BETA CELLS..
IMPACT OF INSULIN RESISTANCE, OBESITY, OVERNUTRITION, T2D ON THE FETUS?
- CHANGES IN FETAL GROWTH, MASS, NUTRIENT LEVELS, STRESS LEVELS, GESTATIONAL AGE..
- ADULT HEALTH OUTCOMES: FERTILITY IMPACTED, METABOLIC SYNDROME, CVD, OBESITY
IS PLACENTAL MASS ASSOCIATED WITH DIETARY INTAKE?
YES
WHICH RATIO IS THE PROXY FOR PLACENTA EFFICIENCY?
BW (BIRTH WEIGHT)/ PW (PLACENTA WEIGHT)
HUMAN PLACENTAL ADAPTATION CAN OVERCOME ENVIRONMENTAL STRESSORS IF THEY OCCURRED AT WHICH STAGE OF PREGNANCY?
EARLY, 1ST TRIMESTER
WHICH PART OF THE PLACENTA INTEGRATES MATERNAL AND FETAL SIGNALS TO REGULATE PLACENTAL FUNCTION?
SYNCYTIOTROPHOBLAST
WHICH PERCENTILES DO BABIES NEED TO FALL INTO TO BE CONSIDERED:
SGA?
NORMAL?
LGA?
BELOW 10TH
10TH-90TH
ABOVE 90TH
GLUT EXPRESSION IS INCREASED ON BASAL OR APICAL SIDE OF THE PLACENTAL VILLI?
BASAL
HOW DOES PCOS INFLUENCE A WOMAN’S CHANCE TO DEVELOP GESTATIONAL DIABETES?
IT INCREASES IT
PREECLAMPSIA STARTS DEVELOPING AFTER WHICH WEEK OF PREGNANCY?
20
CHARACTERISTICS OF PRE-ECLAMPSIA?
ONSET OF HIGH BP, OFTEN A SIGNIFICANT AMOUNT OF PROTEIN IN THE URINE + IN SEVERE CASES RBCs BREAKDOWN, LOW PLATELETE COUNT, IMPAIRED LIVER AND KIDNEY FUNCTION, SWELLING, SHORTNESS OF BREATH..
IN PRE-ECLAMPSIA, URINE CONTAINS HIGH LEVELS OF:
PROTEIN
IF PREECLAMPSIA IS UNTREATED IT LEADS TO?
SEIZURES, AND IT IS THEN CALLED ECLAMPSIA
RISK FACTORS FOR PRE ECPLAMPSIA?
OBESITY, HIGH BP, OLDER AGE, DIABETES..
UNDERLYING MECHANISMS OF PREECLAMPSIA?
ABNORMAL FORMATION OF THE BLOOD VESSELS IN THE PLACENTA DUE TO INAPPROPRIATE SPIRAL ARTERY REMODELLING MEANING THE ARTERIES ARE NOT TRANSFORMED SUFFICIENTLY TO COPE WITH INCREASED BLOOD FLOW TO SUPPORT PREGNANCY (LEADS TO PLACENTAL INSUFFICIENCY AND IUGR + IMPAIRED BLOOD SUPPLY TO THE FETUS AND MOTHER’S MAJOR ORGANS; KIDNEYS, BRAIN, HEART)
