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Obstetrics > Physiology of Pregnancy > Flashcards

Physiology of Pregnancy Flashcards

1
Q

Where does fusion of sperm and oocyte occur?

A

ampulla of fallopian tube

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2
Q

Summarise the key steps in fertilization

A
  1. Sex
  2. Sperm acrosomal release
    Sperm and oocyte adhesion and entry
  3. Membrane fusion (cortical reaction)
  4. Meiosis 2
  5. Syngamy and mitosis
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3
Q

Describe the key events in embryonic development for the following timelines:
@ day 6-7
@ Week 3
@ Week 3-8
@ Week 4
@ Week 23

A

Day 6/7 - Implantation of blastocyte into endometrium
Week 3 - Gastrulation - Formation of trilaminar disc ( Endoderm, Mesoderm, Ectoderm
Week 3-8 - Beginning of development of organ systems
Week 4 - Neurulation ( formation of neural tube from extoderm)
Week 23 - Threshold of viability

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4
Q

What are the functions of the placenta

A

1 - EXCHANGE
Gas Exchange (HbF readily accepts O2 gradient)
Nutrition Exchange (glucose, Fatty acids, amino acids)

2-ENDOCRINE
hCG human chorionic gondotrophin
hPL human placental lactogen
Progesterone
Oestrogen

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5
Q

What are the functions of the placenta?

A

Resp - Gas exchange
Nutrition - Glucose, Fatty acids, AA
Renal - Excretes and purify blood
Immunity - IgG can cross placenta
Hormonal - hCG, Oest, Prog, hPL

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6
Q

What are the functions of placental hCG?

A

Produced by trophoblast cells
Maintains corpus luteum to allow for sufficient progesterone production until the placenta takes over.

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7
Q

What is corpus luteum and its function

A

Formation
The corpus luteum is a temporary organ that forms after ovulation when the ovarian follicle ruptures and fills with blood.

The corpus luteum produces hormones that prepare the uterus for pregnancy, including progesterone, inhibin A, and estradiol.

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8
Q

what are the functions of placental hPL

A

hPL human placental lactogen
Increase maternal free fatty acid and insulin levels as well as inducing maternal insulin resistance

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9
Q

What are the functions of placental oestrogen

A

Stimulates myometrial growth (myometrium is the muscular middle layer of the uterus that’s responsible for uterine contractions)
oxytocin receptor synthesis
and pregnancy related breast changes

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10
Q

What are the functions of placental progesterone

A

Inhibits uterine contractility
thickens endometrium (tissue lining utereus / womb)

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11
Q

What Maternal changes occur during pregnancy with regards to CVS

A

TPR Reduction (Total peripheral resistance)
Increased cardiac output

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12
Q

What Maternal changes occur during pregnancy with regards to heamtology

A

Clotting factors increase
WBC Increase
RBC Mass increase (due to hPL & erythropoietin)

Decrease in platelets

= Physiological anaemia due to increased plasma volume

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13
Q

What Maternal changes occur during pregnancy with regards to Renal

A

Increased eGFR = Lower Serum urea and creatinine
Increased sodium resporbtion

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14
Q

What Maternal changes occur during pregnancy with regards to Resp

A

Medulla sensitised to PaCO2 = Increased minute ventilation

this is to help a steeper foetal maternal concentration

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15
Q

What Maternal changes occur during pregnancy with regards to Immunology

A

General maternal immunosupression
+ Trophoblast(only one in contact with maternal circulation directly) is immunologically innert

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16
Q

What Maternal changes occur during pregnancy with regards to gyne

A

Uterus hypertrophy (40-100g ->800-1kg)
Uterine arteries hypertrophy and dilation = increases uterine blood flow)
cervix and vagina become more vascularised, more water and glycosaminoglycans and lose collagen = MORE STRECTHY
Cervical mucus thicken - operculum (mucus plug)

17
Q

What Maternal changes occur during pregnancy with regards to breasts

A

Ductal proliferation (in response to high oestrogen levels)
Alveoli growth (Due to progesterone and prolactin)

After pregancy
Prolactin induces milk production. This was inhibited during pregnancy by oestrogen and progesterone

18
Q

What Maternal changes occur during pregnancy with regards to GID

A

Progesterone is a smooth muscle relaxant
thus
Gastroemptying is slowed = gastric reflux and constipation

19
Q

What Maternal changes occur during pregnancy with regards to Skin

A

Increased pigmentation of face / areola / abdo (linea nigra)
strech marks

20
Q

What Maternal changes occur during pregnancy with regards to Endocrine

A

Oestorgen and progesterone rise during pregnancy
Corticotropin releasing hormone also rises third terms-

21
Q

Summarise the maternal changes in pregnancy

A

CV - Low BP
Haem- Anemia // Hypercoagulability

GI - Dysmotility // GORD // Constipation

Immunity- Reduced immune response

Endo - Poor Glycemic control: Increased Hypos // DM

GU - Increased Renal Excretion // uti %

Hormones - Increased Oest/prog/prl/BhCG/ALP/prl

Obstetrics (12 decks)

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