Physiology of pregnancy

Question 1

Fertilised egg =

Answer 1

Zygote

Question 2

Length of human pregnancy =

Answer 2

38 weeks

Question 3

When is pregnancy clinically measured from?

Answer 3

Last menstrual period

Question 4

If measured from LMP, when is fertilisation and implantation?

Answer 4

Fertilisation = week 3 
Implantation = week 4

Question 5

T1 =

Answer 5

Week 1 - 12

Question 6

T2 =

Answer 6

Week 13 -26

Question 7

T3 =

Answer 7

Week 27 - 40

Question 8

Fetus in T1 =

Answer 8

Fertilisation
Implantation
Initial development
Placentation

Question 9

Mother in T1 =

Answer 9

Weight gain

Nausea/vomiting

Question 10

Fetus in T2 =

Answer 10

Nervous system
Pain
Spine straightens
Pain
Proportions change

Question 11

Mother in T2 =

Answer 11

Placental growth
Hypervolemia
Cardiac remodelling
Breast remodelling
Bump
Quickening

Question 12

Fetus in T3 =

Answer 12

Growth
Fat deposition
brain electrical activity
Blood cells
Lungs

Question 13

Mother in T3 =

Answer 13

Braxton-hicks
Tiredness
Restricted breathing
Lactation

Question 14

HR in mother

Answer 14

Increases

Question 15

Blood vol in mother

Answer 15

Increases

Question 16

Bp in mother

Answer 16

Stays same, decreases slightly

Question 17

HTC in pregnancy

Answer 17

Decreases. Blood volume increases, RBC increase but can’t keep up

Question 18

Fetal HR rises until

Answer 18

Week 12 (end of T1)

Question 19

Fetal HR in T1 =

Answer 19

160-180 bpm

Question 20

Fetal HR after T1

Answer 20

140 bpm

Question 21

Trophoblasts change into =

Answer 21

Syncitiotrophoblasts

Cytotrophoblasts

Question 22

By what day is the blastocyst fully implanted?

Answer 22

day 9

Question 23

Implantation coincides with which phases of uterine and ovarian cycle?

Answer 23

Luteal phase

Secretory phase

Question 24

Syncytium is a

Answer 24

Multicellular structure. Outer layer of trophoectoderm cells lose cell membrane and make a large, multi-nucleated structure

Question 25

Cytotrophoblasts =

Answer 25

Unicellular structure. Single nucleated.

Question 26

Tropoblastic lacunae are found in ...

Answer 26

The syncytial trophoblasts

Question 27

Lacunae are originally filled with ...

Answer 27

Clear liquid that provides histotrophic support

Question 28

Lacunae become filled with what later?

Answer 28

Maternal blood

Question 29

What produces hCG in weeks 3-4

Answer 29

Syncitiotrophoblasts

Question 30

Progesterone and oestrogen contribute to what symptoms of early pregnancy?

Answer 30

``` Suppression of menses Tender breasts Fatigue Nausea Constipation ```

Question 31

Ectoderm =

Answer 31

- Epidermis - Nervous system - Cornea and lenses - Nasal, oral and anal epithelium - Pituitary gland

Question 32

Mesoderm =

Answer 32

- Heart - Muscles - Bones - Connective tissue - Blood - Urogenital organs - Lymphatics

Question 33

Endoderm =

Answer 33

- Respiratory epithelium - GI tract - GI organs (liver, pancreas) - Urogenital epithelium

Question 34

Pluriblasts become ...

Answer 34

Epiblast and hypoblast

Question 35

Epiblasts =

Answer 35

Precursors of ectoderm

Question 36

Hypoblasts =

Answer 36

Precursors of endoderm

Question 37

Yolk sac membrane is formed from ...

Answer 37

Mesoderm and endoderm

Question 38

Allantois is the precursor to ...

Answer 38

Umbilical cord

Question 39

Amnion formed from =

Answer 39

Mesoderm and ectoderm

Question 40

Chorion =

Answer 40

Trophoblasts and mesoderm

Question 41

How are spiral arteries remodelled?

Answer 41

Infiltrated by syncitio and cytotrophoblasts

Question 42

Why are maternal spiral arteries remodelled?

Answer 42

Decrease BP to not harm embryo

Question 43

What forms in the lacunae to link maternal blood to foetal blood?

Answer 43

Villi

Question 44

Primary villi =

Answer 44

Solid trophoblast (syncitiotrophoblast)

Question 45

Secondary villi =

Answer 45

Invasion with mesoderm

Question 46

Tertiary villi =

Answer 46

Fetal blood vessels penetrate villi

Question 47

How long does the placenta take to fully develop?

Answer 47

12 weeks

Question 48

Villi at week 3 =

Answer 48

Primary stem villi penetrated by mesoderm. Blood bessels and CT develop from mesoderm to become teritary villi

Question 49

Villi at week 9 =

Answer 49

Tertiary stem villi lengthen form mesenchymal villi

Question 50

Villi at week 16 =

Answer 50

Maximum length. Forms immature intermediate villi

Question 51

Villi at week 32 =

Answer 51

Secondary branches form - terminal villi. | Final structure.

Question 52

Placenta is covered by ...

Answer 52

Cytotrophoblasts

Question 53

Outside/inside: Chorion, Amnion

Answer 53

``` Chorion = outer Amnion = inner ```

Question 54

Fetal Hb chains =

Answer 54

2x alpha | 2x gamma

Question 55

Foetal RBCs are

Answer 55

Nucleated

Question 56

Hormones produces by placenta:

Answer 56

- Progesterone - oestrogen - hCG Somat-mammotrophin

Question 57

hCG acts to

Answer 57

Maintain CL | Stimulate thyroid

Question 58

Oestrogens cause:

Answer 58

Weight gain Breast remodelling Relaxation of pelvic ligaments

Question 59

Progesterones cause:

Answer 59

- Decidualization - Increase uterine secretions - Decrease uterine contraction

Question 60

Feeling baby kick is called

Answer 60

Quickening

Question 61

Oestrogen effect on fluid:

Answer 61

- Increase NO, decrease endothelin 1 | - Increase angiotensin II, renal re-absoption and aldosterone

Question 62

Progesterone effect on fluid:

Answer 62

- Increase vasodilation - Decrease peripheral resistance - Increase aldosterone - Increase thirst centre

Question 63

Cardiac remodelling:

Answer 63

HR increases Stroke vol increases Size of heart increases

Question 64

Lungs: what decreases?

Answer 64

Vital capacity

Question 65

Lungs: what increases?

Answer 65

Tidal volume

Question 66

What hormone increases tidal volume?

Answer 66

Progesterone, relaxes ligaments

Question 67

Renal system =

Answer 67

``` Kidneys enlarge Ureters enlarge Decrease bladder tone Increase reflux Urinary stasis ```

Question 68

Increased urinary stasis leads to:

Answer 68

Increased UTIs

Question 69

Progesterone and breast =

Answer 69

Growth of alveoli and ducts

Question 70

Oestrogen and breast =

Answer 70

Stimulate growth and development of milk ducts

Question 71

HPL and breast =

Answer 71

Breast, nipple and areola enlarge

Question 72

What is produced from breast in T3?

Answer 72

Colostrum

Question 73

Average weight gain during pregnancy =

Answer 73

24 lb (11 kg)

Question 74

Additional caloric intake =

Answer 74

100-300 calories

Question 75

Weight gain in T1

Answer 75

Ideally 2-4lb per week

Question 76

Weight gain in T2-T3

Answer 76

Ideally 1 lb per week