Physiological Changes in Pregnancy- important

Question 1

What releases beta HCG?

Answer 1

from trophoblast from blastocyst

Question 2

What does beta HCG do?

Answer 2

Supports corpus luteum which allows progesterone to still be produced, sustain uterus,

Beta HCG and corpus luteum needed to sustain progesterone until placental production is sufficient (10-12 weeks)

Question 3

What is the cause of morning sickness?

Answer 3

Beta HCG

Question 4

Which hormone is measured in pregnancy tests?

Answer 4

Beta HCG

Question 5

High persistence in Beta HCG can lead to what?

Answer 5

Ectopic pregnancy

Question 6

What is an ectopic pregnancy?

Answer 6

Fertilised egg implants itself outside of the womb, usually in fallopian tubes

Question 7

High persistence of Beta HCG can be a sign of what?

Answer 7

Pineal tumours, trophoblastic tumours

Question 8

When does the placenta take over from the corpus luteum?

Answer 8

At 10-12 weeks

Question 9

What are the effects of progesterone on the uterus?

Answer 9

Smooth muscle relaxation- prevent fetal expulsion
Cervical plug formation- microbial barrier
Also relaxes other smooth muscle in body: blood vessels, GIT, ureters, bronchi
Inhibit uterine contractility

Question 10

What are the effects of progesterone on homeostasis?

Answer 10

Respiratory centre- hyperventilation

Renin-angiotensin- Na reabsorption

Question 11

What are the effects of progesterone on the breast?

Answer 11

Lobular tissue development- but inhibits milk production

Question 12

What are the effects of oestrogen on the uterus?

Answer 12

Myometrial cell growth- for growing fetus

Connexin insertion- electrochemical links (gap junctions) between myometrial cells- unified, strong uterine contractions

Oxytocin receptor insertion-prepared for labour- unified, strong uterine contractions

PGE2 (prostaglandins) production stimulated- softens cervix

Question 13

What are the effects of oestrogen on the breast?

Answer 13

Breast duct development- but inhibits milk production

Question 14

How is cortisol stimulated to be released from adrenal cortex?

Answer 14

Hypothalamus release corticoptropin releasing hormone
Cause anterior pituitary gland to release corticotropin which is adrenocorticotrophic hormone
Causes adrenal cortex to release cortisol

Question 15

How is oestrogen produced in pregnant women?

Answer 15

By placenta and fetus interaction
Corticotropin releasing hormone released from placenta
Adrenocorticotrophic hormone released from APG from fetus and mother
Cause cortisol to be released from adrenal cortex from mother
Cayse cortisol and DHEA to be released from fetus
DHEA cause oestrogen to be released from placenta
DHEA travel across placenta cause oestrogen production from placenta, go to mother

Question 16

A sudden surge in which hormone is thought to act as a trigger for onset of labour?

Answer 16

Corticotropin releasing hormone

Question 17

What are the maternal effects of human placental lactogen?

Answer 17

Insulin resistance- decreases glucose utilization, increases blood glucose
Lipid breakdown- FFA production
Breast development

Question 18

What are the fetal effects of human placental lactogen?

Answer 18

Promotes growth- more glucose available for this

Question 19

How does clotting change during pregnancy?

Answer 19

Anti-thrombin falls

Question 20

How does oestrogen effect HR?

Answer 20

Increases contractility
Increases SV
Increases cardiac output
Increases heart rate

Question 21

What makes a mother flushed?

Answer 21

Progesterone generates vasodilation

Question 22

What causes varicose veins when pregnant?

Answer 22

Venous compression by expanding uterus

Question 23

What makes mum short of breath?

Answer 23

Diaphragm pushed up by uterus and pregnancy
Diaphragm not main muscle of respiratory action
Central chemoreceptors have increased sensitivity causing increased ventialtion, make mum feel breathless

Question 24

How does carbondioxide control of ventilation change?

Answer 24

Central chemoreceptors drive up respiratory sensationon- progesterone affected this
Make mum feel breathless
Ventilation increases
CO2 decreases 
Homeostasis reached

Question 25

Why does mother need to go to toilet more frequently?

Answer 25

1) Renal blood flow increased as increased plasma volume so decreased renovascular resistance 2) Increased perfusion= increased GFR 3) Increased GFR, not all able to absorb, mum need to go to toilet more 1) Pressure on bladder by enlarging uterus

Question 26

Breast changes during pregnancy?

Answer 26

Darkening of areola Increased vascularity Hyperplasia of fat deposits- draw on these to sustain baby shortly after birth Increase glandular tissue- give enlarged breasts

Question 27

What does prolactin do?

Answer 27

Increases milk production | Inhibits ovulation when breast feeding

Question 28

What inhibits prolactin?

Answer 28

Oestrogen and progesterone

Question 29

What are all the different hormones that affect the breast during pregnancy?

Answer 29

Oestrogen- mammary duct development Progesterone-lobular tissue development Prolactin- stimulates milk production (not able during pregnancy, inhibited) Oxytocin- stimulates milk ejection from mum

Question 30

How is prolactin stimulated to be released?

Answer 30

Prolactin releasing hormone released from hypothalamus | Prolactin released from anterior pituitary gland

Question 31

Why does oestrogen and progesterone levels fall after pregnancy?

Answer 31

Placenta lost from mum

Question 32

Where is oxytocin released from?

Answer 32

PPG

Question 33

When is oxytocin also signalled to be produced?

Answer 33

Nipple stimulation | Cervix/vaginal distension during labour