Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 OBS AND GYNAE > Physiology of Pregnancy and Labour > Flashcards

Physiology of Pregnancy and Labour Flashcards

1
Q

List the cell stages a fertilised ovum goes through before implantation

A

Fertilised ovum
Cleavage (4-cell/8-cell stages)
Morula
Blastocyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

During which days following fertilisation does the blastocyst enter the uterus and attach to the lining of the uterus respectively?

A

Days 3-5

Days 5-8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which surface cells help the blastocyst penetrate and adhere to the endometrium?

A

Trophoblastic cells

Tunnel deeper into endometrum, carving out a hole for the blastocyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the components of a blastocyst and the relative function of each

A

Inner cell mass - becomes embryo and fetus

Trophoblast - accomplishes implantation and develops into fetal portion of placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

By what day following fertilisation does the blastocyst become fully buried in the endometrium?

A

Day 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which tissue is the placenta derived from?

A

Trophoblast and decidual tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is the placental cavity formed?

A

Trophoblastic cells differentiate into syncitotrophoblasts which invade the decidua of the endometrium to form cavities filled with maternal blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does the embryo communicate with the placenta?

A

Placental villi containing foetal capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

There is no direct contact between foetal and maternal blood. True/False?

A

True

Thin membrane in intervillous space acts as an AV shunt, seperating maternal and foetal blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

By which week of pregnancy are the foetal heart and placenta fully functional?

A

5th week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List functions of HCG

A

Stimulates progesterone to prevent involution of corpus luteum
Development of male sex organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Oxygen-saturated blood goes to the foetus via which vessel?

A

Umbilical vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Oxygen-poor blood goes from the foetus to the mother via which vessels?

A

Uterine veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What 3 factors increase the supply of O2 to a foetus?

A

Foetal Hb has increases carrying capacity
Higher Hb concn in foetal blood
Foetal Hb can carry more O2 in low PCO2 (Bohr effect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List some substances that are transferred in placental exchange

A 
Water
Electrolytes (follow water)
Glucose
Fatty acids
Waste products
Drugs (teratogens)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the effect of human chorionic somatomammotropin (HCS)?

A

Decreases insulin sensitivity of mother
Protein tissue formation
Breast development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the main hormonal effects of progesterone ?

A

Development of decidual cells
Decreases uterus contractility
Preparation for lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the main hormonal effects of oestrogen?

A

Increases size of uterus
Breast development
Relaxation of ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What happens to the cardiac output during pregnancy?

A

Increases to cope with demands of uteroplacental circulation (30-50%)
Decreases in last 8 weeks due to uterus compressing vena cava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What happens to blood pressure during pregnancy?

A

Decreases during second trimester as uteroplacental circulation expands and peripheral resistance reduces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens to Hb levels during pregnancy? What is the consequence?

A

Decrease due to dilution of blood

Require iron supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What effect does progesterone have on CO2 levels?

A

Stimulates brain to lower CO2 levels by increasing respiratory rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is renal function affected during pregnancy?

A

GFR and RPF increases

Postural changes affect function - upright position reduces and increased when supine or sleeping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Taking folic acid during pregnancy reduces the risk of what?

A

Neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Taking vitamin B during pregnancy helps what?

A

Make red blood cells (erythropoeisis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Taking vitamin K before birthing prevents what?

A

Intracranial bleeding during labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Towards the end of pregnancy, how does the ratio of oestrogen:progesterone change?

A

Ratio increases - oestrogen promotes contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which hormone secreted from the posterior pituitary helps stimulate contractions in labour?

A

Oxytocin - stimulates uterine contractions and produces prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Give an example of positive feedback from the foetus that increases contractility during labour

A

Cervical stretch due to foetus head

N.B. also increases oxytocin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the 3 stages of labour?

A

1: cervical dilation (8-24hrs)
2: passage through birth canal (0-120mins)
3: expulsion of placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Oestrogen and progesterone inhibit milk production. True/False?

A

True

After birth, levels drop to facilitate lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which hormone stimulates lactation?

A

Prolactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What 2 stimuli cause lactation in the “milk let-down” reflex?

A

Baby crying

Baby suckling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is pre-eclampsia? What is a main clinical sign?

A

Pregnancy-induced hypertension and proteinuria

Oedema in hands and feet due to salt and water retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is eclampsia? List clinical signs

A 
Extreme preclampsia (lethal without treatment)
Vascular spasms, extreme hypertension, chronic seizures, coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

State the average maternal weight gain in pregnancy

A

24lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

State the extra calories per day that should be consumed during pregnancy

A

250-300 extra kcal/day

38
Q

State the two phases of pregnancy and the relative demands of the fetus

A

ANABOLIC PHASE (up to week 20)
Small nutritional demands of fetus
CATABOLIC PHASE (from week 21)
High metabolic demands of fetus

39
Q

What is the effect of the catabolic phase of pregnancy on the mother?

A

Accelerated starvation

40
Q

What is colostrum?

A

First breast milk produced after birth, loaded with immunoglobulins, protective effect for baby

41
Q

What should be expelled from the uterus in normal labour?

A

Foetus
Membranes
Umbilical cord
Placenta

42
Q

What is Ferguson’s reflex in labour?

A

Pressure on the cervix triggers a hormonal pathway that leads to uterine contractions and dilation of cervix

43
Q

There are 3 stages in labour. What does stage 1 comprise of?

A

Latent phase: 3-4 cm cervical dilation

Active phase: 4-10 cm cervical dilation

44
Q

There are 3 stages in labour. What does stage 2 comprise of?

A

Full cervical dilation (10cm) to delivery of baby

45
Q

There are 3 stages in labour. What does stage 3 comprise of?

A

Delivery of baby to expulsion of placenta and membranes (typically 10 minutes)

46
Q

Describe the clinical features of the latent phase of stage 1 of labour

A

Mild irregular intrauterine contractions
Cervix softens and shortens
May last a few days

47
Q

Describe the clinical features of the active phase of stage 1 of labour

A

Contractions become more rhythmic and intense
Cervix achieves full dilation
Slow descent of presenting part of baby

48
Q

When is stage 2 of labour considered prolonged in a nulliparous woman?

A

If it exceeds 3 hours where there is analgesia

If it exceeds 2 hours where there is no analgesia

49
Q

When is stage 2 of labour considered prolonged in a multiparous woman?

A

If it exceeds 2 hours where there is analgesia

If it exceeds 1 hour where there is no analgesia

50
Q

Why are oxytocic drugs recommended for stage 3 of labour?

A

Help contractions

Reduce risk of post-partum haemorrhage

51
Q

What chemical causes cervical softening?

A

Hyaluronic acid

52
Q

What causes cervical ripening during labour?

A

Decrease in collagen fibre alignment and tensile strength

53
Q

What are Braxton Hicks contractions?

A

Tightening of the uterine muscles to aid body to prepare for birth
Not usually felt until 2nd/3rd trimester

54
Q

How long typically are the gaps between “true labour contractions”?

A

5 minutes

55
Q

How do Braxton Hicks contractions differ from true labour contractions?

A

BHC: irregular, do not increase in frequency/intensity, resolve with change in activity
TLC: regular, increasing frequency/intensity, don’t resolve

56
Q

What does it mean if a baby is “born in a caul”?

A

Born with some membrane/amniotic sac still surrounding it

57
Q

Describe the “normal” presentation of a baby as it passes through the pelvic canal

A

Longitudinal lie, cephalic presentation

Occipito-anterior, then occipito-transverse with flexed head

58
Q

What presentations are classified as “abnormal” in a baby’s birth?

A

Transverse/oblique/breech lie

Occipito-posterior engagement

59
Q

There is a relationship between the clinical state of the cervix and the onset of labour. Which 5 parameters are assessed under the Bishops score?

A 
Position
Consistency
Effacement
Dilatation
Station in pelvis/ Level of presenting part
60
Q

List options for analgesia during labour

A 
Paracetamol/ co-codamol
TENS
Entonox
Diamorphine
Epidural anaesthesia
Remifentanyl
Combined spinal/ epidural
61
Q

What would be considered an abnormal amount of blood loss during labour?

A

More than 500ml

Blood loss prior to delivery apart from ‘show’

62
Q

When does placental expulsion occur following delivery?

A

5-10 mins

Considered normal up to 30 mins

63
Q

How long does it take tissues to return to non-pregnant state in puerperium?

A

6 weeks

64
Q

What harmonal change occurs to initiate labour?

A

Change in oestrogen/ progesterone ratio

65
Q

What is the role of progesterone in onset of labour?

A

Keeps uterus settled
Prevents formation of gap junctions
Hinders contractility of myocytes

66
Q

What is the role of oestrogen in onset of labour?

A

Makes uterus contract

Promotes prostaglandin production

67
Q

What is the role of oxytocin in onset of labour?

A

Initiates and sustains uterine contractions

Acts on decidual tissue to promote prostaglandin release

68
Q

What is the role of liquor during labour?

A

Nurtures and protects fetus and facilitates movement

69
Q

List potential timings for membrane rupture

A 
Preterm
Prelabour
1st stage
2nd stage
Born in a caul
70
Q

List the 3 key factors that interplay to determine a smooth labour

A

POWER: uterine contractions via the uterine muscle
PASSAGE: shape of maternal pelvis
PASSENGER: fetal position

71
Q

What is the pacemaker of the uterus?

A

Region of tubal ostia, waves spread in downward direction

72
Q

List the features of normal uterine contractions

A

Frequency: 3-4 in 10 minutes
Duration: 10-45 seconds and adequate resting tone
Intensity: maximum in 2nd stage

73
Q

What is the most suitable shape of maternal pelvis?

A

Gynaecoid:
wide inlet and outlet
narrow ischial spines

74
Q

How is the position of the fetal head determined during labour?

A

Fontanelles can be felt during vaginal examination

75
Q

What can be used to record progress of labour?

A

Partogram

76
Q

List the 7 cardinal movements of labour describing the position of the baby’s head in the pelvis

A
  1. Engagement
  2. Descent
  3. Flexion
  4. Internal rotation
  5. Crowning and extension
  6. Restitution and external rotation
  7. Expulsion
77
Q

When is the fetal head classed as ‘engaged’?

A

When widest diamter of fetal head has passed below the pelvic inlet
3/5 of fetal head entered pelvis, 2/5 abdominal

78
Q

During descent of the fetus, what position is adopted so that the widest part of the head passes through the widest diameter of the pelvis?

A

Occiput-transverse psition

79
Q

How often is a vaginal exam carried out for cervical assessment?

A

4 hourly

80
Q

Describe the change in position of the fetal head during internal rotation in labour?

A

Occiput-transverse to occipito-anterior position as it passes through the pelvis

81
Q

When does extension and crowning occur in labour?

A

Once fetus has reached level of interoitus, bringing base of occiput in contact with symphysis pubis

82
Q

What is meant by restitution during labour?

A

Return of fetal head to correct anatomical position in relation to fetal torso (optimal for position of shoulder)

83
Q

Which part of the fetus undergoes expulsion during labour first?

A

Anterior shoulder

84
Q

What is the purpose of delayed cord clamping? When does it occur?

A

Increase the flow of RBCs to fetal organs and reduce rates of anaemia in the fetus
From cessation of pulsations, up to 3 minutes after expulsion

85
Q

List clinical signs of the third stage of labour

A

Uterus contracts, hardens and rises
Umbilical cord lengthens permanently
A temporary gush of blood
Placenta and membranes appear at introitus

86
Q

List methods for active management of labour

A

Prophylactic administration of syntometerine or oxytocin 10U
Cord clamping and cutting
Controlled cord traction
Bladder emptying

87
Q

What is the most common method of placental separation?

A 
Matthew Duncan (separation at margin)
Shultz (separation from central aspect)
88
Q

List uterine changes that occur in puerperium

A

Uterine involution
Uterine weight loss
Fundal height reduces
Endometrium regenerates

89
Q

What physical and harmonal processes initiate lactation?

A

Placental expulsion

Reduction in oestrogen and progesterone

90
Q

Describe how oestrogen and progesterone inhibit milk production

A

Block release of prolactin from pituitary gland by making mammary gland cells unresponsive to this pituitary harmone

Y3 OBS AND GYNAE (44 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions