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REPRO > Physiology of Lactation and Pregnancy > Flashcards

Physiology of Lactation and Pregnancy Flashcards

1
Q

What changes occur to the fertilized ovum from point of fertilization to implantation?

A
  • the F.ovum divides and differentiates into a BLASTOCYST as it moves from fertilization site in UPPER oviduct to implantation site in UTERUS
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2
Q

What helps in the transfer of the ovum to the uterus?

A
  • fimbriae sweeps the ovum into the oviduct

- —-ovum is then carried along the duct by smooth muscle and cilia

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3
Q

What is the role of the trophoblasts in the blastocyst?

A
  • accomplishes implantation

- develops into fetal portions of the placenta

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4
Q

Site of fertilisation?

A
  • ampulla of the fallopian tube
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5
Q

What occurs within the 3-8 days of fertilization?

A
  • 3-5 days: transport of the blastocyst into the uterus

- 5-8 dsy: blastocyst attaches to endometrium

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6
Q

After attachment of the blastocyst to the endometrium, what occurs next?

A
  • the INNER cell mass of the blastocyst develops into an embryo
  • the outer cells BURROW into the uterine wall and BECOME the placenta
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7
Q

What is the placenta responsible for?

A
  • prodn of several hormones to maintain the pregnancy
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8
Q

How does the blastocyst implant itself to the endometrium?

A

—cords of trophoblastic cells penetrate the endometrium

—advancing cords of the trophobl. cells tunnel DEEPER into the endometrium; carving a hole for the blastocyst (for it to sit in) ——boundaries between cells disintegrate

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9
Q

When the burrowing is done; the blastocyst is completely burried in the endometrium. At what day since fertilisation is the blastocyst completely buried?

A
  • day 12
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10
Q

How does the deicidua form?

A
  • after implantation; the maternal endometrium undergo a decidual reaction
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11
Q

What are the 3 types of decidua?

A
  1. Decidua Capsularis- around the chorion
  2. Decidua Parietalis - opp. uterus wall
  3. Decidua Basalis
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12
Q

What occurs in the 4th month to cause the uterine cavity to obliterate?

A
  • the fetus becomes so large that the decidua capsularis comes in contact with decidua parietalis
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13
Q

Where does the placenta derive from?

A
  • both trophoblast and decidual tissue
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14
Q

How does the placental villi come about ?

A
  • trophoblast differentiate into synctiotrophoblast which invade the decidua and break down capillaries to form cavities filled with maternal blood
  • —-developing embryo sends capillaries INTO the synctiotrophoblast projections to form placental villi
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15
Q

What contains within a villus?

A
  • each villus contains FETAL capillaries separated from the maternal blood by a THIN LAYER OF TISSUE
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16
Q

What occurs at the placental villi?

A

2 way exchange of resp. gases, nutrients, metabolites between Mother and fetus

  • functional at 5th week of pregnancy
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17
Q

How does the placental villi act as an arteriovenous shunt?

A
  • as the placenta develops; it extends hair-like projections into the uterine wall—-this increases the contact area between the uterus and the placenta ; allowing MORE nutrients to be exchanged
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18
Q

Where is the exact arteriovenous shunt?

A
  • Circulation within the intervillous space
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19
Q

Up until which gestational week, does the Corpus luteum produce progesterone?

A

week 10

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20
Q

What cells secrete HCG during pregnancy?

A
  • trophoblast tissue
21
Q

What is is structurally important about HCG with relation to other hormones?

A
  • it shares the alpa-subunit as LH , TSH and FSH
  • —–it can bind to LH receptors in the CORPUS luteum to helps drive the progesterone release and maintain the C.Luteum
22
Q

Importance of maintaining the corpus luteum? `

A
  • release of progesterone MAINTAINS the pregnancy by maintaining the endometrial lining and PREVENTING menstruation to occur!
    (for first 10 weeks of pregnancy)
23
Q

What do the pregnancy tests detect?

A
  • beta subunit of HCG (antibofy variant test)
24
Q

Which is more sensitive for testing hCG levels- serum or urine?

A

SERUM hCG levels !—best to RULE OUT PREGNANCY
—-can detect very low levels at 1-2 mIU/mL …POSITIVE within a week of conception

URINE hCG levels only detects 20-50 mIU/mL (not positive until 2 weeks or more)

25
Q

What carries on secreting progesterone after the 10 weeks of secretion by the Corpus Luteum?

A

-the synctiotrophoblast

26
Q

Name another hormone released by the synctiotrophoblast>

A
  • Human Placental Lactogen (hPL)

- –higher levels as placenta grows

27
Q

What is the main role of the hPL (aka HCS) hormone?

A
  • resp. for making as much energy sources available for the fetus to grow
  • BLOCKS the effects of insulin (raising blood glucose level/fatty acid breakdown and protein breakdown)
28
Q

Why may diabetes develop during pregnancy or DM worsen during this time?

A
  • because pregnancy is an insulin-resistant state
29
Q

How is GDM excluded in women?

A
  • through obtaining BLOOD glucose

- NOT checking for glycosuria (normal in pregnancy)

30
Q

Why does total body volume expland?

A

as maternal blood is diverted to fill the placenta; there will be a RISE in renin leading to salt/water retention

31
Q

Why may mild anemia occur in pregnancy?

A
  • the rise in volume will be greater than the rise in red cell
  • lowering hematocrit level.
32
Q

Define lactation.

A
  • process by which milk is synthesized and secreted from the mammary glands
    (in resp. to infant sucking at the nipple)
33
Q

The mammary gland expands extensively during pregnancy, in response to which hormones?

A
  • estrogen
  • GH
  • Cortisol
  • prolactin
34
Q

When do prolactin levels begin to increase?

When does it plateau?

A
  • Near the 5th week of gestation

- prolactin plateaus at a level high in LATE pregnancy (enough to initiate milk prodn)

35
Q

Why does milk prodn only begin till after the pregnancy?

A
  • estrogen, progesterone and others INHIBIT prolactin-mediated milk synthesis
    (inhibition is lifted when placenta is expelled)
36
Q

What neuroendocirne reflex occurs with infant suckling?

A
  • post. pituitary release of oxytocin which stimulates the myoepithelial cells to squeeze milk from the alveoli ….allowing the milk to drain into the lactiferous ducts, into the lactiferous sinsuses and discharge through the nipple
37
Q

What occurs to prolactin level after chilbirth?

A
  • DROPS sharply

restored for a 1-hr SPIKE during each feeding —-stimulates the PRODN of milk for the next feeding

38
Q

How does the placenta play the role of fetal lungs?

A
  • exchange between maternal blood (oxygen rich) and umbilical blood
  • oxygen diffuses from the maternal into FETAL circulation
  • carbon dioxide follows a reverse gradient
39
Q

Which vessel carries the oxygen rich blood- umbilical Vein or artery?

A
  • Umbilical Vein reaches the fetus with oxygen rich blood
40
Q

What 3 factors facilitate the supply of oxygen to the fetus?

A
  1. fetal Hb (increased affinity for O2)
  2. Higher Hb in fetal blood (50% more than adults)
  3. Bohr Effect
41
Q

What is the Bohr effect?

A
  • fetal Hb can carry more O2 in LOW pCO2 than in High pCO2
42
Q

How does water and electrolytes get transported to the placenta?

A
  • water diffuses by OSMOTIC gradient
  • —-exchange increases during pregnancy up to the 35th week
  • electrolytes follow H20
43
Q

WHich 2 electrolytes can only only be transported to the fetus?

A

-iron and calcium

44
Q

WHat products diffuse across the placenta?

A
  • free diffusion of FATTY ACIDS

- diffusion of waste products based on conc. gradient

45
Q

Drugs are the cause of 3% of congenital malformations. What drugs can cross the placenta?

A
  1. thalidomides, carbamazepine, tetracycline, courmarins

2. Alcohol, nicotine, heroin, cocaine, caffeine

46
Q

What does HCG prevent?

A
  • the involution of Corpus Luteum

- —-has an effect on the development of sex organs

47
Q

What does human chorionic somatomammotropin bring about?

A
  • GH like effects (protein tissue formation)
  • —-decr. insulin sensitivity in moms
  • involved in breast development
48
Q

What is progesterone responsible for during pregnancy>

A
  • development of DECIDUAL cells
  • decr. the uterus contractility
  • preparation for lactation
49
Q

What are estrogens resp. for during pregnancy?

A
  • enlargement of uterus
  • breast development
  • relaxation of ligaments

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