Physiology of pregnancy Flashcards

1
Q

Fertilised egg =

A

Zygote

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2
Q

Length of human pregnancy =

A

38 weeks

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3
Q

When is pregnancy clinically measured from?

A

Last menstrual period

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4
Q

If measured from LMP, when is fertilisation and implantation?

A
Fertilisation = week 3 
Implantation = week 4
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5
Q

T1 =

A

Week 1 - 12

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6
Q

T2 =

A

Week 13 -26

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7
Q

T3 =

A

Week 27 - 40

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8
Q

Fetus in T1 =

A

Fertilisation
Implantation
Initial development
Placentation

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9
Q

Mother in T1 =

A

Weight gain

Nausea/vomiting

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10
Q

Fetus in T2 =

A
Nervous system
Pain
Spine straightens
Pain
Proportions change
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11
Q

Mother in T2 =

A
Placental growth
Hypervolemia
Cardiac remodelling
Breast remodelling
Bump
Quickening
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12
Q

Fetus in T3 =

A
Growth
Fat deposition
brain electrical activity
Blood cells
Lungs
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13
Q

Mother in T3 =

A

Braxton-hicks
Tiredness
Restricted breathing
Lactation

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14
Q

HR in mother

A

Increases

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15
Q

Blood vol in mother

A

Increases

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16
Q

Bp in mother

A

Stays same, decreases slightly

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17
Q

HTC in pregnancy

A

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

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18
Q

Fetal HR rises until

A

Week 12 (end of T1)

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19
Q

Fetal HR in T1 =

A

160-180 bpm

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20
Q

Fetal HR after T1

A

140 bpm

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21
Q

Trophoblasts change into =

A

Syncitiotrophoblasts

Cytotrophoblasts

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22
Q

By what day is the blastocyst fully implanted?

A

day 9

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23
Q

Implantation coincides with which phases of uterine and ovarian cycle?

A

Luteal phase

Secretory phase

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24
Q

Syncytium is a

A

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

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25
Q

Cytotrophoblasts =

A

Unicellular structure. Single nucleated.

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26
Q

Tropoblastic lacunae are found in …

A

The syncytial trophoblasts

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27
Q

Lacunae are originally filled with …

A

Clear liquid that provides histotrophic support

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28
Q

Lacunae become filled with what later?

A

Maternal blood

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29
Q

What produces hCG in weeks 3-4

A

Syncitiotrophoblasts

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30
Q

Progesterone and oestrogen contribute to what symptoms of early pregnancy?

A
Suppression of menses
Tender breasts
Fatigue
Nausea
Constipation
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31
Q

Ectoderm =

A
  • Epidermis
  • Nervous system
  • Cornea and lenses
  • Nasal, oral and anal epithelium
  • Pituitary gland
32
Q

Mesoderm =

A
  • Heart
  • Muscles
  • Bones
  • Connective tissue
  • Blood
  • Urogenital organs
  • Lymphatics
33
Q

Endoderm =

A
  • Respiratory epithelium
  • GI tract
  • GI organs (liver, pancreas)
  • Urogenital epithelium
34
Q

Pluriblasts become …

A

Epiblast and hypoblast

35
Q

Epiblasts =

A

Precursors of ectoderm

36
Q

Hypoblasts =

A

Precursors of endoderm

37
Q

Yolk sac membrane is formed from …

A

Mesoderm and endoderm

38
Q

Allantois is the precursor to …

A

Umbilical cord

39
Q

Amnion formed from =

A

Mesoderm and ectoderm

40
Q

Chorion =

A

Trophoblasts and mesoderm

41
Q

How are spiral arteries remodelled?

A

Infiltrated by syncitio and cytotrophoblasts

42
Q

Why are maternal spiral arteries remodelled?

A

Decrease BP to not harm embryo

43
Q

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

A

Villi

44
Q

Primary villi =

A

Solid trophoblast (syncitiotrophoblast)

45
Q

Secondary villi =

A

Invasion with mesoderm

46
Q

Tertiary villi =

A

Fetal blood vessels penetrate villi

47
Q

How long does the placenta take to fully develop?

A

12 weeks

48
Q

Villi at week 3 =

A

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

49
Q

Villi at week 9 =

A

Tertiary stem villi lengthen form mesenchymal villi

50
Q

Villi at week 16 =

A

Maximum length. Forms immature intermediate villi

51
Q

Villi at week 32 =

A

Secondary branches form - terminal villi.

Final structure.

52
Q

Placenta is covered by …

A

Cytotrophoblasts

53
Q

Outside/inside: Chorion, Amnion

A
Chorion = outer
Amnion = inner
54
Q

Fetal Hb chains =

A

2x alpha

2x gamma

55
Q

Foetal RBCs are

A

Nucleated

56
Q

Hormones produces by placenta:

A
  • Progesterone
  • oestrogen
  • hCG
    Somat-mammotrophin
57
Q

hCG acts to

A

Maintain CL

Stimulate thyroid

58
Q

Oestrogens cause:

A

Weight gain
Breast remodelling
Relaxation of pelvic ligaments

59
Q

Progesterones cause:

A
  • Decidualization
  • Increase uterine secretions
  • Decrease uterine contraction
60
Q

Feeling baby kick is called

A

Quickening

61
Q

Oestrogen effect on fluid:

A
  • Increase NO, decrease endothelin 1

- Increase angiotensin II, renal re-absoption and aldosterone

62
Q

Progesterone effect on fluid:

A
  • Increase vasodilation
  • Decrease peripheral resistance
  • Increase aldosterone
  • Increase thirst centre
63
Q

Cardiac remodelling:

A

HR increases
Stroke vol increases
Size of heart increases

64
Q

Lungs: what decreases?

A

Vital capacity

65
Q

Lungs: what increases?

A

Tidal volume

66
Q

What hormone increases tidal volume?

A

Progesterone, relaxes ligaments

67
Q

Renal system =

A
Kidneys enlarge
Ureters enlarge
Decrease bladder tone
Increase reflux
Urinary stasis
68
Q

Increased urinary stasis leads to:

A

Increased UTIs

69
Q

Progesterone and breast =

A

Growth of alveoli and ducts

70
Q

Oestrogen and breast =

A

Stimulate growth and development of milk ducts

71
Q

HPL and breast =

A

Breast, nipple and areola enlarge

72
Q

What is produced from breast in T3?

A

Colostrum

73
Q

Average weight gain during pregnancy =

A

24 lb (11 kg)

74
Q

Additional caloric intake =

A

100-300 calories

75
Q

Weight gain in T1

A

Ideally 2-4lb per week

76
Q

Weight gain in T2-T3

A

Ideally 1 lb per week