Physiology of Pregnancy and Fetus Flashcards

1
Q

Acts as the “fetal gut, lung and kidney”

A

Placenta

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2
Q

What does the placenta do for the fetus?

A
  1. Supplies nutrients
  2. Exchanges CO2 and O2
  3. Regulates fluid and disposes of wastes
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3
Q

The placenta synthesizes _____ that affect maternal and fetal metabolism

A

Steroids, proteins and hormones

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4
Q

The placenta has a large surface area for exchange, however the mother and fetal components still remain _____

A

Separate

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5
Q

What is the functional unit of the placenta?

A

Chorionic villi

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6
Q

Chorionic villi ____ to increase surface area and room for exchange of material

A

Branch

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7
Q

What arteries from the maternal side are involved with the placenta?

A

Spiral arteries

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8
Q

Spiral arteries from the mother empty into what?

A

Intervillous space

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9
Q

What drain the intervillous space?

A

Maternal veins

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10
Q

What does slow filling of the intervillous space allow for?

A

Adequate time for exchange of nutrients

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11
Q

What arteries does the fetal blood flow have?

A

2 umbilical arteries

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12
Q

Fetal umbilical arteries carry what type of blood?

A

DEoxygenated

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13
Q

The fetus receives the O2 (oxygenated blood) and nutrients from what?

A

1 Umbilical vein

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14
Q

Fetal capillary network has ______ to allow for slower blood flow and greater exchange

A

Terminal dilations

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15
Q

Describe the partial pressures of oxygen of the mother and fetus

A

Mother’s partial pressures of oxygen are much HIGHER than the fetal partial pressures of oxygen

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16
Q

What does the partial pressure difference of oxygen between the mother and fetus allow for?

A

Diffusion of oxygen into the chorionic villi for the fetus!

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17
Q

Fetal hemoglobin has a slightly different structure than maternal hemoglobin. Why?

A

It binds the limited oxygen with a higher affinity

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18
Q

How is CO2 transferred from the fetus to the mother?

A

Fetal blood has a lower affinity for CO2 than maternal blood, thus it favors the transfer

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19
Q

What are 4 other transfer mechanisms that can also occur at the placenta?

A
  1. Passive diffusion
  2. Facilitated diffusion
  3. Primary and secondary active transport
  4. Receptor mediated endocytosis
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20
Q

What is transferred to the fetus at the placenta via facilitated diffusion?

A

Glucose

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21
Q

What is transferred to the fetus at the placenta via primary and secondary active transport?

A

AA, minerals and vitamins

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22
Q

What is transferred to the fetus at the placenta via receptor mediated endocytosis?

A

Large molecules - antibodies, insulin

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23
Q

hCG

A

Human Chorionic Gonadotropin

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24
Q

What produces hCG?

A

Syncytiotrophoblasts

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25
Q

hCG is structurally related to ____ and can activate its receptors

A

LH

26
Q

Main function of hCG?

A

Binds to LH receptors in the corpus luteum to maintain HIGH levels of PROGESTERONE

27
Q

Maternal serum levels of ____ double daily for up to ____ weeks

A

hCG

10 weeks

28
Q

What is thought to cause morning sickness?

A

hCG

29
Q

If small amounts of hCG enter the fetal circulation, what will be produced?

A

Will bind the LH receptors on leydig cells to produce testosterone

30
Q

hPL

A

Human placental lactogen

31
Q

What produces hPL?

A

Syncytiotrophoblasts

32
Q

When is hPL detected in maternal serum?

A

Week 3

33
Q

What is hPL structurally similar to?

A

GH and Prolactin

34
Q

Main function of hPL?

A

Promotes shift of maternal use of glucose –> FA

Promotes development of mammary glands

35
Q

What may contribute to maternal diabetes during prenancy?

A

hPL

36
Q

High levels of _____ are required for implantation and throughout pregnancy

A

Progesterone

37
Q

Where is progesterone derived from?

A

Corpus luteum

38
Q

Main functions of progesterone

A
  • Increases endometrial gland secretions and adhesion proteins
  • Reduces uterine motility and contractions
  • Induces mammary growth and differentiation
39
Q

Main functions of estrogen

A
  • Induces endometrial growth, LH surge and number of progesterone receptors
  • Induces growth and development of mammary glands
40
Q

What hormone increases the uteroplacental blood flow?

A

Estrogen

41
Q

Which hormones contribute to the development of mammary glands?

A

hPL
Progesterone
Estrogen

42
Q

During pregnancy, which hormones are very high?

A

Progesterones and Estrogens

43
Q

The placenta cannot produce the very high levels of progesterones and estrogens by itself. It required a coordinated effort between?

A

Mother, placenta, fetus

44
Q

What does the mother supply to help produce high levels of progesterones and estrogens?

A

Cholesterol

45
Q

What parts of the fetus help produce high levels of progesterones and estrogens?

A

Fetal adrenal glands and liver

46
Q

What do the fetal adrenal glands and liver produce to help produce the high levels of progesterones and estrogens?

A

Enzymes that the placenta lacks

47
Q

The fetal circulatory system has ____ shunts

A

3

48
Q

Why does the fetal circulatory system have 3 shunts?

A

To bypass the liver and lungs that are not yet functioning properly

49
Q

What are the 3 shunts in the fetal circulatory system?

A
  1. Ductus venosus
  2. Foramen Ovale
  3. Ductus arteriosus
50
Q

Ductus venosus shunt bypasses?

A

Liver

51
Q

Foramen ovale shunt moves blood from where to where?

A

Right atrium to left atrium of heart

52
Q

Ductus arteriosus shunt moves blood from where to where?

A

Pulmonary artery to aorta

right to left

53
Q

What are the right to left fetal shunts?

A

Foramen ovale and ductus arteriosus

54
Q

Which fetal shunts close after birth?

A

Foramen ovale and ductus arteriosus

55
Q

How long after birth does the ductus venosus take to permanently close?

A

1-3 months

56
Q

When the foramen ovale closes, what does it establish?

A

Right and Left circulatory systems

57
Q

Patent Ductus Arteriosus

A

Persistent ductus arteriosus

- oxygenated blood of aorta mixes with deoxygenated blood of pulmonary artery

58
Q

What are the symptoms of patent ductus arteriosus?

A

Heart murmur, increased strain on heart and pulmonary hypertension

59
Q

Patent Foramen Ovale

A

Persistent Foramen Ovale

60
Q

Symptoms of patent foramen ovale?

A

Pulmonary hypertension - coughing, sneezing

61
Q

Which fetal shunt rarely fails to close?

A

Ductus venosus