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BI0005 > Physiology of Motherhood > Flashcards

Physiology of Motherhood Flashcards

1
Q

What are the two parts of the uterus

A

Endometrium and myometrium

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2
Q

Describe the endometrium

A

Inner layer has good blood supply. Is the maternal contribution to the placenta

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3
Q

Describe the myometrium

A

Muscle layer, no contractions during pregnancy, contractions for labour

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4
Q

What is partuition

A

Labour, delivery of the baby, placenta and associated membranes

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5
Q

What initiates paruition

A

Chemical and physical factors

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6
Q

What is parturition physically associated with

A

Regular, painful uterine contractions

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7
Q

What is parturition physiologically associated with

A

Cervical ripening- cervix softens, shortens and dilates

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8
Q

Where do contractions occur

A

In the myometrium

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9
Q

What inhibits contractions during pregnancy

A

Progesterone

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10
Q

What type of muscles are used for contractions

A

Smooth muscles (involuntary control)

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11
Q

What happens in the last few weeks of pregnancy in terms of contractions

A

Braxton-Hicks practice contractions. They are painless and last a few seconds

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12
Q

Why do Braxton-Hicks contractions occur

A

Due to increased levels of oestrogen

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13
Q

How is parturition initiated

A

Complex interplay of local regulators, hormones and physical factors.

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14
Q

What are the physical factors associated with the initiation of parturition

A

Progressive stretching of the myometrium and placental insufficiency

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15
Q

What does progressive stretching of the myometrium result in

A

It becomes thinner and increases in excitability. At a critical level of excitability spontaneous contractions occur which squeeze the foetus towards the cervix.

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16
Q

What does placental “insufficiency” result in

A

The placenta is no longer able to provide sufficient nutrients and oxygen. Foetal capillaries in the placenta are blocked with blood clots and debris

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17
Q

What is involved in the chemical initiation of parturition

A

Hormone levels (in mother and foetus) and possibly other bioactive factors

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18
Q

What are the 4 hormone initiators of labour

A

Less progesterone. More oestrogen, prostaglandins and oxytocin

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19
Q

Which two chemical stimulate the release of oestrogen

A

Corticotropin-releasing hormone (CRH) and cortisol

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20
Q

Where is CRH secreted from and how does it increase oestrogen levels

A

It is released from the placenta and pituitary gland and releases oestrogen building blocks

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21
Q

Where is cortisol secreted from and how does it increase oestrogen levels

A

Secreted from foetal adrenal gland. Increases the oestrogen: progesterone ratio. It removes the inhibitory effect of progesterone on the myometrium

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22
Q

What happens to oestrogen levels towards the end of pregnancy

A

There is a large increase

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23
Q

What does the increase in oestrogen levels do

A

Increases the sensitivity of the uterus to contractile stimuli, increases the number of receptors for oxytocin in the uterus. Stimulates the release of prostaglandins

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24
Q

Where is oxytocin produced

A

In the posterior pituitary gland of the mother and foetus

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25
Q

What does oxytocin do

A

Stimulates powerful contractions of the uterus and stimulates the production of prostaglandins during pregnancy.

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26
Q

What does oxytocin do following delivery

A

It reduced blood loss

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27
Q

What are prostaglandins synthesised by

A

The placenta and myometrium

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28
Q

What can prostaglandins be used for

A

Inducing labour

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29
Q

What do prostaglandins do

A

Enhance contractions. One way is by releasing the calcium required for contractions

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30
Q

What happens to the baby before labour can begin

A

The baby has rotated, dropped low in the pelvis and head has “engaged” with the cervix. Results in stretching of the cervix

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31
Q

What does stretching of the cervix result in

A

Stretch receptors send messages to release oxytocin

32
Q

What are the 3 stages of labour

A
  1. Dilation
  2. Explusion
  3. Placental
33
Q

How long does dilation last

A

6-12 hours

34
Q

When does dilation occur

A

From the onset of labour until full cervical dilation (10cm)

35
Q

What happens during dilation

A

Opening up and thinning of the cervix. The cervix stretches around the engaged head. Uterine contractions increase in strength and frequency.

36
Q

How long does explusion last

A

Minutes-hours

Usually less than 2 hours

37
Q

When does explusion occur

A

Time from full cervical dilation until birth

38
Q

What does the baby do during expulsion

A

Rotate to make birth easier

39
Q

What happens during explusion

A

Continuous strong contractions force the foetus down and out of the uterus and vagina. Contractions alone are sufficient for delivery yet sometimes need to push

40
Q

What happens to blood flow in the umbilical chord after birth

A

Blood continues to pass for a short time until blood pressure drops and blood flow stops

41
Q

When can you cut the umbilical chord and why

A

Only once blood flow has stopped as useful nutrients is passed to the baby during this short time

42
Q

How long does placental last

A

5-30 minutes

43
Q

When does placental occur

A

From birth until delivery of the placenta

44
Q

What happens during placental

A

Powerful contractions result in: explusion of placenta and membranes and closure of uterine blood vessels to reduce blood loss

45
Q

What is lactation

A

Supply of milk to feed baby

46
Q

Where is milk supplied from

A

The mammary glands

47
Q

What happens to the mammary glands during pregnancy

A

Hormone induced changes occur

48
Q

What stimulates the delivery of milk

A

Part hormonal part suckling

49
Q

What is initially secreted from the breasts

A

Colostrum

50
Q

Why do the breasts enlarge during pregnancy

A

Ducts proliferate, increasing in cell number and secretion. Fat is deposited between the lobules

51
Q

Which hormones stimulate milk production

A

Combination of progesterone, oestrogen and placental lactogen

52
Q

Why is milk production inhibited during pregnancy

A

Due to high levels of oestrogen and progesterone. Both decrease at birth

53
Q

What hormone is secreted after birth

A

Prolactin

54
Q

What is milk production stimulated by

A

A rise in prolactin and oxytocin

55
Q

What further stimulates prolactin and oxytocin

A

Suckling

56
Q

Where is prolactin secreted from

A

The anterior pituitary gland

57
Q

What is the function of prolactin

A

Stimulates milk-producing epithelial cells

58
Q

What is needed to maintain milk production

A

High levels of prolactin

59
Q

Where is oxytocin secreted from

A

The posterior pituitary gland

60
Q

What is the function of oxytocin

A

It stimulates milk ejecting epithelial cells

61
Q

Describe the milk production and ejection reflex

A

Suckling -> sensory input -> hypothalamus ->

a. ) posterior pituitary -> oxytocin -> milk ejection
b. ) anterior pituitary -> prolactin -> milk production

62
Q

When does lactation end

A

2-3 weeks after weaning

63
Q

How long it’s colostrum present for

A

Until day 4

64
Q

What is colostrum

A

A yellow fluid

65
Q

What is the composition of colostrum

A

High in protein, low in fat, rich in immune molecules especially IgA, rich in some vitamins: A, D, E, K, rich in mnerals

66
Q

What is the main source of energy in milk

A

Fat

67
Q

What sugar is contained in milk

A

Lactose in high levels

68
Q

What protein is contained in milk

A

Casein

69
Q

What is found in milk apart from protein, sugar and fat

A

Calcium, minerals and vitamins

70
Q

Which cells that fight against infection are found in breast milk

A

White blood cells

71
Q

Which molecules are found in breast milk

A

IgA antibody, interferon and lysozyme

72
Q

What properties do interferon and lysozyme have

A

They are antibacterial

73
Q

What affect does breast feeding have on the infant later in life

A

Slight reduction in lymphoma, heart disease, allergies, respiratory and GI infections

74
Q

What affect does breastfeeding have on mother

A

Protects against osteoporosis and breast cancer

75
Q

How much milk does a baby weight 5-6kg consume a day

A

0.8-1 litre

76
Q

How many calories does each litre of milk contain

A

750

77
Q

What effect does the high calorie content of breast milk have on the mother

A

She needs extra nutrient in take, especially calcium and phosphate

BI0005 (21 decks)

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