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Endocrine and reproductive system > Physiological changes of pregnancy and delivery > Flashcards

Physiological changes of pregnancy and delivery Flashcards

1
Q

Negative feedback

A

Maintains constant level of activity

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2
Q

Positive feedback

A

When temporary boost in activity is needed

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3
Q

Positive feedback in reproduction

A

Prolactin secretion in breast-feeding
Oxytocin secretion in labour
Oestrogen secretion by follicle to trigger ovulation

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4
Q

Process of ovulation

A

Hypothalamus releases GnRH which acts on anterior pituitary to stimulate it to produce FSH which causes ovary to produce follicle and release it. Surge of LH triggers ovulation and corpus luteum

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5
Q

What happens in the luteal phase?

A

Oocyte excreted, corpus luteum developing to produce progesterone which prepares uterus. Corpus luteum not sustained in absence of fertilisation - leads to period. If fertilisation occurs, oocyte generates blastocyst (stem cells)

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6
Q

What happens post-fertilisation?

A

Blastocysts produce hCG which stimulates corpus luteum to grow. This creates more progesterone and sustain uterus. At 10-12 weeks, placenta produces sufficient progesterone levels

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7
Q

Why is hCG an indicator of pregnancy?

A

Big spike in first few months - CL and oocyte

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8
Q

Cause of morning sickness

A

beta hCG

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9
Q

Why do women miscarry?

A

Not enough progesterone = miscarriage when endometrium and embryo are shed

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10
Q

What does the placenta produce?

A

Oestrogen, progesterone, hCG and placental lactogen

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11
Q

Effect of progesterone on uterus

A

Smooth muscle relaxation and forms cervical plug

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12
Q

Effect of progesterone on homeostasis

A

Respiratory centre, renin-angiotensin

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13
Q

Effect of progesterone on breast

A

Lobular tissue development but inhibits milk production

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14
Q

Oestrogen

A
  • Myometrial cell growth: growing fetus
  • Connexin insertion: electrochemical links (gap junctions) between myometrial cells
  • Oxytocin receptor insertion (prepares for labour)
  • PGE2 production stimulated (softens cervix)
  • Breast duct development (inhibits milk production though)
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15
Q

How is oestrogen produced

A

Oestrogen production: hypothalamus (CRH) → anterior pituitary (corticotropin) → adrenal cortex (cortisol)

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16
Q

Effect of placental lactose on mother

A

Insulin resistance (decreases glucose utilization and increases blood glucose), lipid breakdown (FFA production), breast development (mechanism/extent unsure)

17
Q

Effect of placental lactose on baby

A

Promotes growth

18
Q

How does vascular system change in pregnancy

A
  • Vascular capacity expanded by utero-placenta circulation
  • Blood loss expected in delivery
  • Baby needs more O2
  • Haemostasis required when placenta delivered
  • RBC capacity increases 20%, plasma increases 50%
  • Can lead to functional anaemia
  • Demand for iron is 3x greater in pregnancy
  • Folate demand is 20x greater in pregnancy (folic acid)
  • Expanding fetus moves heart upwards and outwards
19
Q

How does clotting change in pregnancy?

A

Levels of anti-thrombin fall in pregnancy, creating pro-thrombotic state

20
Q

How to calculate BP

A

Cardiac output x systemic vascular resistance

21
Q

How to calculate cardiac output

A

Stroke volume x heart rate

22
Q

What impact does oestrogen have on the heart?

A

Increases contractility, stimulates heart rate

23
Q

What happens to blood pressure in pregnancy?

A

Systolic BP little change

Diastolic BP falls slightly in middle trimester

24
Q

What impact does progesterone have on circulation?

A

It is a vasodilator

25
Q

What impact does pregnancy have on kidneys?

A

Increases plasma flow, decreased resistance, increased cardiac output
Higher using output
Glucose can appear in urine

26
Q

Which hormone increases sodium reabsorption?

A

Aldosterone

27
Q

How much weight is gained in pregnancy?

A

10-12 kg

28
Q

Where is prolactin released?

A

Anterior pituitary

29
Q

What impact does prolactin have on breasts?

A
  • Oestrogen and progesterone drop after delivery
  • Prolactin stimulates milk delivery
  • Prolactin released from anterior pituitary gland
  • Prolactin suppresses ovulation, increases breast tissue development and increases milk production (inhibited by oestrogen in pregnancy)
  • Nipple stimulation increases prolactin release
30
Q

Why is prolactin released?

A

Oestrogen and progesterone drop after delivery

Nipple stimulation increases release

31
Q

What impact does oxytocin have on breasts?

A

Milk ejection

32
Q

What impact does oxytocin have on uterus?

A

Contraction

Endocrine and reproductive system (25 decks)

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