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Obs and Gynae > Physiology of Pregnancy > Flashcards

Physiology of Pregnancy Flashcards

1
Q

What happens on day 1?

A

fertilisation takes place

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2
Q

Where does fertilisation take place?

A

Ampulla of fallopian tube

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3
Q

What happens on day 3-5?

A

transport of the blastocyst into the uterus

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4
Q

What is a blastocyst?

A

fertilised ovum on day 4

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5
Q

How does a fertilised ovum divide?

A

zygote - 2 cell stage - 4 cell stage - 8 cell stage - morula - blastocyst (4 days)

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6
Q

What occurs on day 5-8?

A

blastocyst attaches to lining of uterus

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7
Q

What do the inner cells of the blastocyst become?

A

embryo

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8
Q

What do the outer cells of the blastocyst become?

A

placenta

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9
Q

What happens when the blastocyst adheres to the endometrial lining?

A

Cords of trophoblastic cells begin to penetrate the endometrium
Tunnel deeper into endometrium, creating hole for blastocyst

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10
Q

By what day is implantation finished?

A

12 - blastocyst is completely buried in endometrium

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11
Q

What is the placenta derived from?

A

Trophoblast and decidual tissue

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12
Q

By what week is the placenta functional?

A

week 5

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13
Q

What hormone signals the corpus luteum to continue to make progesterone?

A

human chorionic gonadotrophin (HCG)

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14
Q

What increases the contact area between uterus and placenta?

A

Placenta extends villi into uterine wall - more nutrients and waste material can be exchanged

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15
Q

Describe the oxygen transport between mother and fetus?

A

through placenta

  • between maternal oxygen rich blood and umbilical oxygen poor blood (mixed arterial and venous)
  • O2 diffuses from maternal to fetal circulation (PO2 maternal > PO2 fetal)
  • CO2 follows reversed gradient (partial pressure increased in fetal blood)
  • fetal oxygen saturated blood returns to fetus via umbilical vein
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16
Q

What facilitates the supply of oxygen to the fetus?

A

1 - fetal Hb (increased ability to carry oxygen)
2 - higher Hb concentration in fetal blood
3 - Bohr effect -

17
Q

What is the Bohr effect?

A

fetal Hb can carry more oxygen in lower pCO2 than high pCO2

18
Q

Describe what happens to progesterone production during pregnancy.

A

HCG prevents breakdown of corpus luteum and stimulates progesterone production

19
Q

What does progesterone do during pregnancy?

A

Decreases smooth muscle excitability (uterus, gut, ureters)

and raises body temperature

20
Q

What do oestrogens do during pregnancy?

A

Mainly estriol

increase breast and nipple growth, water retention and protein synthesis

21
Q

What hormone decreases insulin sensitivity in mother? Why?

A

HCS (human chorionic somatomammotrophin)

More glucose for fetus

22
Q

What happens to cardiac output in pregnancy?

A

Increases and peaks at 24 weeks (due to demands of uteroplacental circulation)
Decreases in last 8 weeks

23
Q

What happens to heart rate in pregnancy?

A

Increases - up to 90/min

24
Q

What happens to blood pressure during pregnancy?

A

Falls during second semester

Rises to non pregnancy levels by term

25
Q

What are some haemodynamic changes that occur during pregnancy?

A

Plasma vol increases (proportional with CO)
Increase in erythropoiesis
Hb decreases (by dilution)
Iron requirements increase

26
Q

What respiratory changes are made?

A

O2 consumption increases (to meet metabolic needs of mother fetus and placenta)
Progesterone signals brain to decrease CO2 levels:
- resp rate increases
- tidal vol increases
- pCO2 slightly decreases
- vital capacity and Po2 stay the same

27
Q

What happens to the renal system in pregnancy?

A

Increased GFR
Increased reabsorption of ions and water
Increased urine formation

28
Q

When and what is the anabolic phase of pregnancy?

A

Weeks 1-20 - small nutritional demands of conceptus

  • normal or increased insulin sensitivity
  • lipogenesis and increased glycogen stores
29
Q

When and what is the catabolic phase of pregnancy?

A

Weeks 21-40 - increased metabolic fetal demands

  • maternal insulin resistance
  • increased transport of nutrients transplacentally
  • lipolysis
30
Q

How many extra calories does the mother need during pregnancy?

A

250-300 extra kcal/day

Obs and Gynae (27 decks)

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