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Nutrition through life Part 1 > PART 3 - Placental Metabolism > Flashcards

PART 3 - Placental Metabolism Flashcards

1
Q

What does placenta mean in latin?

A

circular cake

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2
Q

The placenta grows fastest at what time during the pregnancy and why?

A

First half of pregnancy, to get ahead of fetal growth spurt in second half. needs to be prepared to give all the nutrients

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3
Q

What is the placenta?

A

Interface between microcirculatory systems of mother and fetus.

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4
Q

What is the placenta responsible for?

A

exchange of nutrients, respiratory gases, metabolic waste, protection of fetus, source of hormones

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5
Q

What does the amniotic fluid do?

A

prevent desiccation (drying out), shock absorber, provides room for movement, assists in body temp regulation

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6
Q

TRUE or FALSE. The blood of the mother and fetus mix in the placenta.

A

FALSE. There is a maternal and fetal portion, they don’t mix

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7
Q

What are cytotrophoblasts?

A

cells from placenta that connect mother and fetus

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8
Q

How are the fetal and maternal placenta anchored?

A

cytotrophoblastic shell and anchoring villi, also provides large surface exchange area

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9
Q

What is the major functioning unit of the placenta?

A

the chorionic villus

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10
Q

Where is the maternal blood located?

A

in the intervillous spaces, flows around the villi

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11
Q

What are IUGR infants?

A

infants with IntraUterine Growth Restriction, less branching of the villi

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12
Q

The mechanism of the placenta is found in what other system?

A

Small intestine

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13
Q

What are the placenta functions?

A

Metabolism (glycogen, lactate, cholesterol) and transport

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14
Q

TRUE or FALSE. Fetal hemoglobin has greater binding capacity for oxygen.

A

TRUE

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15
Q

How does the placenta transport nutrients?

A

With concentration gradient

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16
Q

What does the placenta move with passive diffusion?

A

Oxygen, CO2, Fatty acids, steroids, electrolytes, fat soluble vitamins

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17
Q

What does the placenta move with facilitated diffusion?

A

sugars and long chain PUFA

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18
Q

What does the placenta move with active transport?

A

AA, cations and water soluble vitamins

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19
Q

What does the placenta move with solvent drag?

A

Electrolytes (osmotic pressure, water movement that drags solutes with it)

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20
Q

Why are fatty acids moved with passive diffusion and carrier mediated transfer?

A

otherwise we would not get enough

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21
Q

Why are sugars transported with carrier mediated facilitated diffusion?

A

To protect the fetus, you don’t want the fetus to have the same glucose fluctuations as the mother.

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22
Q

How are minerals and other nutrients transported? (Fe, folate)

A

Pinocytosis, invagination of the membrane

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23
Q

What is a placental infarction?

A

the blood supply to the placenta is obstructed and the part where there is no blood flow leads to death of the tissue

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24
Q

What is the result of maternal malnutrition?

A

reduction in blood volume expansion which leads to inadequate increase in cardiac output. This decreases placental blood flow and placenta size. reduces nutrient transfer and leads to restrictive fetal growth

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25
Q

How does the placenta compensate for its decreases growth rate when the fetus’ growth rate increases drastically?

A

Increase in blood flow to give more nutrients

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26
Q

When does the placenta need to increase blood flow due to increased fetal growth?

A

3rd trimester

27
Q

In the last 4 weeks of gestation, fetal growth declines, why?

A

there is a progressive decline in nutrients transferred/fetal body mass unit/ time unit
need increased uterine blood flow to placenta

28
Q

Why would the placenta fail?

A

Usually due to the uteroplacental blood vessels failing to deliver increased uterine blood flow

29
Q

EFA deficiencies can lead to what problems?

A

defects in placental integrity and function, also fetal growth restriction

30
Q

Low concentrations of EFA can lead to what?

A

short gestation and small head circumference

31
Q

Why are lipids so important for the brain?

A

lipids are 50-60% of the brain structural matter

32
Q

The placenta also has major endocrine functions, what hormones does it produce?

A
  • human chorionic gonadotropin (HCG)
  • Human chorionic somatotropin (placental lactogen)
  • progesterone
  • estrogen
33
Q

What does the HCG hormone do? (human chorionic gonadotropin)

A

maintains corpus luteum which secretes estrogen and progesterone which is detected in pregnancy tests

34
Q

What does the Human placental lactogen do (chorionic somatotropin)?

A

produced in late gestation to influence fat and CHO metabolism. breaks down maternal fat for fuel

35
Q

What does progesterone do and what is it secreted by?

A

secreted by corpus luteum until the placenta takes over about 10 weeks in. inhibits secretion of pituitary gonadotropins (LH/FSH) to prevent ovulation and support endometrium. also suppress contractibility in uterine muscle

36
Q

At what point if estrogen production maximal?

A

At the end of gestation

37
Q

What does estrogen do?

A

stimulate mammary gland development, stimulate myometrium growth, antagonizes myometrial-suppression by progesterone

38
Q

The placenta limits the access of certain hormones to the fetus. Which hormones are metabolized to inactive forms?

A

Glucocorticoids, insulin and thyroxine

39
Q

Which EFA are biomagnified in the fetal brain?

A

Omega 3 and 6

40
Q

How does pregnancy affect the kidneys?

A

increase in glomerular filtration rate and decrease in tubular re-absorption capacity (more excretion for fetal waste)

41
Q

How does pregnancy affect the stomach?

A

Decreased stomach function and relaxed cardiac sphincter by decreasing histamine and pepsin

42
Q

Why do pregnant women tend to get heartburn?

A

relaxed cardiac sphincter

43
Q

Why are pregnant women at risk of constipation?

A

there is a decrease in GI motility and there is insufficient fluids. this increases efficiency of nutrient absorption

44
Q

What happens to the cardiac system during pregnancy?

A

size of heart increases (more cardiac output)

45
Q

What happens to the respiratory system during pregnancy?

A

increased ventilation due to oxygen demands (increased BMR)

46
Q

What happens to the circulatory system during pregnancy?

A

increase in plasma lipids since the mother needs to conserve glucose for the baby

47
Q

What happens to the muscle system during pregnancy?

A

decreased muscle breakdown, increase placental uptake of alanine so less alanine availability –> imparied hepatic gluconeogenesis

48
Q

What happens during the anabolic phase of the pregnancy and when is this phase?

A

at the first half, fetal growth is still small so don’t need that much glucose. the extra glucose is stored as glycogen or converted to fat (TG) (means a sharp rise in insulin after eating). also muscle synthesis increases

49
Q

What happens during the catabolic phase?

A

Fat is mobilized to conserve glucose for the fetus (also glycogen and protein). so more ketones and cholesterol in the blood. the placenta makes hormones that are antagonistic to the action of insulin (estrogen, progesterone, placental lactogen) remember the placenta doesn’t rely on insulin

50
Q

How much of the fat gained goes to the fetus, placenta and amniotic fluid?

A

about 40%

51
Q

What are the obligatory weight gains?

A

fetus, placenta, enlarged uterine, breast tissue, expanded blood volume

52
Q

TRUE or FALSE. It is normal to maintain you weight in the 1st trimester.

A

TRUE

53
Q

What causes morning sickness?

A

increase in estrogen and human chorionic gonadotropin

54
Q

TRUE or FALSE. Nausea and vomiting during pregnancy is a bad thing.

A

FALSE. positive predictor of pregnancy outcome and decreased risk of fetal death

55
Q

What are the most important determinants of birth weight?

A

gestational age, maternal weight gain, preconception weight

56
Q

TRUE or FALSE. Weight gain is the best clinical indicator to judge pregnancy progress because it has the strongest influence on wt gain.

A

TRUE

57
Q

At what point is a baby premature?

A

37 weeks or less

58
Q

What complication are common in extremely preterm babies?

A

blindness and immature lungs

59
Q

A disproportionate growth restriction is likely caused by what?

A

maternal malnutrition, FAS or uteroplacental insufficiency

60
Q

A proportionate growth restriction is likely caused by what?

A

extreme fetal malnutrition or decreased growth potential (genetic, environmental toxins or congenital infection)

61
Q

What risks does a low birth weight have?

A

CVD problems , diabetes, impaired glucose metabolism

62
Q

What does the maternal system due in the case of under-nutrition to protect the baby?

A

increase coricosteroid production to increase fetal maturation of lungs and other organs

63
Q

What is wrong with increase corticosteroid production?

A

placenta isn’t as developed so can’t break down insulin, thyroxine or corticosteroids into inactive forms, so it reaches the fetus in much higher concentration than normal. increased risk of hypertension later in life

Nutrition through life Part 1 (6 decks)

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