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OBGYN rotation review > phys- pregnancy > Flashcards

phys- pregnancy Flashcards

1
Q

what are the 4 stages of pregnancy

A
  1. initiation
    • fertilization
    • implantation
    • secretion of HCG to rescue the corpus luteum
  2. gestation
  3. parturition
  4. lactation
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2
Q

____ and ____ relax and soften pelvic ligaments

A

estrogen and relaxin

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3
Q

why does lactation not occur during pregnancy

A

inhibition by placental estrogen and progesterone

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4
Q

when is the blastocyst formed (fertilization)

A

days 3-4

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5
Q

estrogen and progesterone levels ___ pregnancy

A

increase throughout

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6
Q

the normal optimal menstrual cycle days of implantation are what and why

A

days 20-24 because of progesterone

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7
Q

what is parturition (stage 3 of pregnancy)

A

labor, delivery, and birth

mucus plug dislodges, cervical canal dilates, uterine myometrium contracts

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8
Q

what is pitocin

A

pharmaceutical synthetic form of OT

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9
Q

fertilization must occur within ___ of ovulation

A

24 hours

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10
Q

which hormone stimulates production (secretion) of milk

A

prolactin

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11
Q

how does inflammation cause premature labor

A

increased macrophages (due to increased pulmonary surfactant), uterine stretching, bacterial infections, allergic reactions, and multi-fetus pregnancies

⇒ activation of NF-kB in the uterus

⇒ increased production of IL-8 inflammatory cytokines and prostaglandins

⇒ cervical softening

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12
Q

what is involution

A

when the uterus shrinks to its pregestational size after delivery

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13
Q

____ makes estrogen and progesterone during the first trimester

____ makes estrogen and progesterone after that

A

corpus luteum makes estrogen and progesterone during the first trimester

placenta makes estrogen and progesterone after that

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14
Q

how long does sperm survive in the female reproductive tract

A

usually 48 hours but up to 5 days

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15
Q

in non-lactating women, how long does it take for ovulation to resume

A

7 to 10 weeks postpartum

*** not to be used as a contraceptive method ***

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16
Q

levels of maternal ___ may be used as an index of fetal health

A

maternal urine hCG

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17
Q

early on, the placenta makes ____ but as it matures it makes ____

A

early on, the placenta makes hCG but as it matures it makes estrogen and progesterone

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18
Q

what is the zona reaction

A

a structural change in the zona pellucida- happens when fertilin on the sperm fuses to the integrin receptor on ovum’s membrane:

cortical granules released and ZP3 degraded so that no polyspermy

⇒

2nd ovum meiosis completed

⇒

fusion of sperm and ovum

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19
Q

how does the female reproductive tract aid in sperm migration

A

myometrium contractions

oviduct smooth muscle contractions

allurin (chemical that attracts sperm to the ampulla so it can reach the egg)

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20
Q

withdrawal of placental estrogen and progesterone at parturition initiates

A

lactation

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21
Q

prolactin (the major hormone resoponsible for lactogenesis) is synthesized/ secreted by lactotrophs in ____, and then released under the control of ___ and ___

A

prolactin (the major hormone resoponsible for lactogenesis) is synthesized/ secreted by lactotrophs in the pituitary, and then released under the control of thyrotopin releasing hormone (stimulatory) and dopamine (inhibitory)

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22
Q

how does CRH affect fetal lungs?

A

placenta secretes CRH ⇒ increases fetal ACTH ⇒ fetal cortisol ⇒ promotes fetal lung maturation

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23
Q

only the placenta makes ___

while the placenta and the fetus make ___

A

only the placenta makes progesterone

while the placenta and the fetus make estrogen

24
Q

when does the placenta become functional

what are these functions

A

5 weeks after implantation

functions:

  • organ of exchange- digestive, respiratory, renal
  • prevents immunologic rejection
  • secretes hCG (2nd and 3rd tri), estrogen, progesterone
25
Q

what hormones stimulate the synthesis of milk enzymes during gestation

A

prolactin

26
Q

which hormone causes milk ejection

A

OT

27
Q

when and what is gestation (stage 2 of pregnancy)

A

about 38 weeks from conception or 40 weeks from LMP

when the physical changed in the mother meet the demands of pregnancy

28
Q

where is the site of fertilization

A

oviduct

normally the ampulla (upper third)

29
Q

hormone that helps form the cervical plug

A

progesterone

30
Q

when does the blastocyst embed and become the trophoblast

A

days 6 to 8

embeds b/c of enzymes

31
Q

when is labor initiated

A

when OT receptor concentration reaches a critical threshold that permits the onset of strong coordinated contractions in response to ordinary levels of circulating OT

32
Q

____ are needed to synthesize estrogen during pregnancy

A

both the fetus and the placenta

33
Q

what is the outcome of the high estrogen levels during labor that increase the production of prostaglandins

A

collagen fibers are degraded by enzymes causing cervical ripening (softening)

increased OT receptors in the myometrium causing increased responsiveness to OT

34
Q

what is the outcome of the high estrogen levels during labor that increase the concentration of myometrial receptors for OT

A

an increased responsiveness to OT

35
Q

what initiates parturition

A

increased estrogen

36
Q

the most important estrogen of pregnancy

A

estriol

37
Q

what levels in maternal plasma act as a placental clock for timing parturition based on fetal lung maturation

A

Corticotrophin-Releasing Hormone (CRH)

high = premature deliveries

low = late deliveries

38
Q

where is OT made and stored

A

produced in the hypothalamus

stored in the posterior pituitary

39
Q

who makes progesterone

A

weeks 6-12 : corpus luteum

after week 12 : placenta

40
Q

what is the outcome of the high estrogen levels during labor that promote synthesis of connexons for gap junctions within uterine smooth muscles

A

cells are linked to create a coordinated contraction

41
Q

when does fertilization happen

A

days 1-2

42
Q

what are the stages of labor (parturition)

A
  1. cervical dilation- few to 24 hours (longest stage)
  2. delivery of baby- 30 to 90 minutes
  3. delivery of placenta- 15 to 30 minutes
43
Q

prior to onset of labor, circulating OT levels are ___ but ___

A

are constant

but uterine responsiveness is 100 x greater due to increased myometrial OT receptors

44
Q

what hormones promote development of mammary glands during gestation

A

estrogen and progesterone

45
Q

what does hCG do

A

maintains pregnancy

stimulates the corpus luteum to secrete progesterone and estrogen

46
Q

what do hCG levels look like with an ectopic pregnancy

A

a slower hCG level rise

47
Q

what do hCG levels look like w/ a hydatidiform mole

A

slow, continuous rise

48
Q

stages of fertilization

A

capacitation

acrosomal reaction

zona reaction

49
Q

how is sperm activated and what is this called

A

capacitation

while sperm goes through reproductive tract, the cholesterol cap comes off so that it can penetrate

50
Q

when is hCG detected

where does it come from

A

after implantation is complete (8-11 days after conception)

from the primitive placenta

51
Q

what is the acrosomal reaction

A

sperm penetrates corona radiata

⇒

acrosin is released to allow sperm to penetrate the zona pellucida

⇒

sperm binds to the ZP3 receptors on the zona pellucida

52
Q

what do hCG levels NORMALLY look like

A

peak at weeks 9-12

then decline

then plateau

53
Q

in lactating women, how long does it take for ovulation to resume

A

27 weeks (7 months)

*** not to be used as a contraceptive method ***

54
Q

anovulation occurs after lactation due to

A

GnRH inhibition ⇒ FSH and LH release

55
Q

what do hCG levels look like with fetal death

A

levels rise normally, then fall with a half life of 24 hours

56
Q

____ is needed to synthesize progesterone during pregnancy

A

maternal cholesterol

OBGYN rotation review (14 decks)

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