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1. Reproduction > Physiology of Pregnancy > Flashcards

Physiology of Pregnancy Flashcards

1
Q

What happens during day 1 of fertilisation?

A

fertilisated ovum is in the ampulla

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2
Q

What happens during days 3-5 of fertilisation?

A

the blastocyst is transported to the uterus

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3
Q

What happens during days 5-8 of fertilisation?

A

the blastocyst attaches to the lining of the uterus

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4
Q

What do the inner cells of the blastocyst turn into?

A

embryo

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5
Q

What do the outer cells (trophoblasts) of the blastocyst turn into?

A

placenta (they burrow into the uterine wall)

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6
Q

What is the role of the trophoblasts on the outer surface layer of the blastocysts?

A

form cords of trophoblastic cells and penetrate the endometrium carving out a hole for the blastocyst

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7
Q

What happens on day 12 of fertilisation?

A

implantation is finished and the blastocyst is completely burried in the endometrium

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8
Q

What is the placenta derived from?

A

decidual and trophoblast tissue

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9
Q

What is decidual tissue?

A

mucosal lining of the uterus in pregnancy

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10
Q

What do trophoblast cells differentiate into?

A

syncytiotrophoblasts

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11
Q

What do syncytiotrophoblasts do?

A

invade the decider and break down capillaries to form cavities filled with maternal blood - developing embryos send capillaries into these to form placental villi

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12
Q

What makes up a placental villi?

A

maternal blood and foetal blood separated by a thin layer of tissue eg NO DIRECT CONTACT

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13
Q

By what week in pregancy is the placenta functional by?

A

week 5

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14
Q

What stimulates the corpus luteum to keep secreting progesterone?

A

HCG

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15
Q

What is the role of progesterone on the decidual cells?

A

makes them concentrate glycogen, proteins and lipids for nutrition of the placenta

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16
Q

What do the placental villi do as it develops?

A

extend into the uterine wall to provide more nutrients and exchange of materials

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17
Q

What does the intervillious space act as?

A

atriovenous shunt - thin membrane develops between mothers and babies blood

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18
Q

How does the placenta take on the role of the foetal lungs?

A

allows the supply of oxygen and removal of CO2 between the uterine veins and the umbillical veins

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19
Q

What goes from the maternal -> foetal circulation - O2 or CO2?

A

O2

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20
Q

What goes from the foetal -> maternal circulation - O2 or CO2?

A

CO2

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21
Q

What 3 factors lead to the foetus being supplied with oxygen?

A

increased ability of foetal Hb to carry CO2
50% higher Hb conc in foteal blood
Bohr effect - foetal Hb can carry more oxygen

22
Q

Why does lung function change in pregnant mothers?

A

progesterone signals to the brain to lower CO2 levels therefore: resp rate increases, PCO2 decreases, tidal and minute volume increases

23
Q

What percentage must O2 consumption increase to meet demands in a pregnant mother?

A

20%

24
Q

How much does cardiac output increase in a pregnant woman?

A

40% - due to demands of uteroplacental circulation

25
Q

What haematological changes occur in a pregnant mother?

A

plasma volume increases
25% increase in erythropoesis
Hb decreases
blood viscosity decreases

26
Q

How much iron is needed a day in the 2nd half of pregnancy?

A

6-7mg

27
Q

Why does the BP drop in 2nd trimester?

A

uteroplacental circulation expands and peripheral resistance decreases

28
Q

From what day of pregnancy is HCG detectable?

A

day 8

29
Q

What is HCGs effect on males?

A

development of male sex organs - the testes

30
Q

When does HCG levels peak during pregnancy?

A

day 60

31
Q

What is Human Placental Lactogen?

A

secreted by the placenta/chorion

32
Q

When is HPL produced?

A

from week 5 of pregnancy

33
Q

When does HPL peak?

A

32 weeks

34
Q

What is the role of HPL?

A

growth hormone like effect
decreased insulin sensitivity in the mother - leads to GESTATIONAL DIABETES
involved in breast development

35
Q

Where is betaHCG secreted from?

A

placenta from the synctiotrophoblastic cells

36
Q

What would HCG levels be in an ectopic pregnancy?

A

static or slow rising

37
Q

What would HCG levels be in a failing pregnancy?

A

levels fall

38
Q

What would HCG levels be in a viable pregnancy?

A

levels are doubling or >60% rise

39
Q

When do HCG levels fall naturally?

A

weeks 12-14

40
Q

What happens to serum HCG levels every 48hours in a one baby pregnancy?

A

double every 48hours

41
Q

What urinary changes occur during pregnancy?

A

increase GFR and renal plasma flow
increased reabsorption of ions and water
increase in urine formation

42
Q

How do positional changes in pregnancy affect renal function?

A

upright - decreases it
supine position - increases it
lateral position - increases it a lot

43
Q

What is the average maternal weight gain?

A

11kg - can be as much as 30kg though

44
Q

How many extra kcal a day does a mother need?

A

200 kcal a day

45
Q

What extra protein intake does a mother need?

A

30g a day

46
Q

What phase occurs in the 1st-20th week of pregnancy?

A

anabolic phase

  • small nutritional demands of the foetus
  • lower plasma glucose, glycogen stores increase
47
Q

What phase occurs in the 21-40th week of pregnancy?

A 
high metabolic demands of the foetus
accelerated starvation of the mother
maternal insulin resistance
lipolysis
increased transport of nutrients through the placental membrane
48
Q

What hormone stimulates milk production?

A

prolactin

49
Q

What hormones inhibit milk production?

A

oestrogen and progesterone

50
Q

What is the role of oestrogen in terms of lactation?

A

causes growth of the ductile system

51
Q

What is the role of progesterone in terms of lactation?

A

causes development of the lobule-alveolar system

1. Reproduction (50 decks)

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