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Reproduction > Physiology of Pregnancy and Lactation > Flashcards

Physiology of Pregnancy and Lactation Flashcards

1
Q

At what stage does the embryo implant into the uterus

A

Blastocyst- inner cells become embryo. Outer cell burrow into uterine wall and become placenta

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2
Q

What is the stage before blastocyst

A

Morula

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3
Q

When does the blastocyst attach to the lining of the uterus

A

Day 5-8

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4
Q

What are the surface layer cells of the blastocyst called

A

trophoblast

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5
Q

By what day does the blastocyst become buried in the uterine lining

A

day 12

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6
Q

What is the placenta made from

A

Trophoblast and decidual tissue

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7
Q

When is the placenta and foetal heart functional

A

by week 5 of the pregnancy

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8
Q

How is the placental developed

A

Invasion of trophoblastic cells into the decidua
HCG is secreated which signals to the corpus luteum to continue to secret progesterone - this stimulate decidual cells to concentrated glycogenm proteins and lipids to help placental development

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9
Q

How does fetal, oxygenated blood return to the fetus

A

via the umbilical vein

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10
Q

how does maternal, now oxygen poor blood flow from the intervillous space back to the maternal circulation

A

via the uterine arteries

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11
Q

What is different about fetal Hb

A

increased ability to carry oxygen
higher Hb conc in fetal blood
Fetal Hb can carry more oxygen in low PCO2 than high pCO2

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12
Q

What is the function of HCG

A

prevents involution of the corpus luteum (progesterone production maintained)
effect on testes of mall fetus - helps develop sex organs

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13
Q

What is human chorionic somatomammotropin (HCS)

A

Growth hormone like effects - protein tissue formation
Decreases insulin sensitivity in the mother - more glucose available for the fetus
Involved in breast development and possibly lactation (?)

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14
Q

When is HCS produced

A

from week 5

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15
Q

what is the function of progesterone

A

development of decidual cels
decreases uterus contractility
preparation for lactation

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16
Q

What is the purpose of oestrogens

A

enlargement of uterus
breast development
relaxation of ligaments

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17
Q

what does the estriol level indicate

A

the vitality of the fetus

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18
Q

What conditions can result as a consequence of hormonal changes in pregnancy

A

Hypertension
Diabetes
Hyperthyroidism
Hyperparathyroidism

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19
Q

Why can hypertension and diabetes occur

A

CRH is increased – ACTH increases – aldosterone increases = HYPERTENSION
Increased ACTH – increased cortisol – insulin resistance and oedema = gestational diabetes.

20
Q

Why can hyperthyroidism occyr

A

HCG can causes increase thyroxin

21
Q

Why can hyperparathyroidism occur

A

increased calcium demands

22
Q

how much does the cardiac output increase in pregnancy

A

30-50 percent beginning week 6 and peaking at wk 24

23
Q

Why is the CO increased in pregnancy

A

demands of uteroplacental circulation
increases metabolism
renal circulation
thermoregulation

24
Q

when does the CO decrease in pregnancy and why is this

A

the last 8 weeks - the uterus compresses vena cava

but increases again in labour

25
Q

How are the heart rate and BP affected by pregnancy

A

Hr- increased up to 90/min

BP- drops during second trimester

26
Q

What are the haematological changes in pregnancy

A

Plasma volume increases
Erythropoeiss increased by 1/4
Hv is decreased by dilutsion and this decreases blood viscosity
Iron requirements increase to 6-7mg/day in 2nd half

27
Q

Why do lung changes occur

A

Progesterone increase - progesterone signals the brain to lower CO2 levels
enlarging uterus interferes with lung function
O2 consumption increases

28
Q

How are CO2 levels lowered

A

increased resp rate
tidal and minute volume increases
PCO2 decreases

no change on PO2 or vital capacity

29
Q

What changes occur in the urinary system

A

glomerular filtration rate and renal plasma flow increase up to 30-50 percent
increased reabsorption of ions and water
slight increase in urine formation

30
Q

why is there more reabsorption of ions and water

A

because of increased aldosterone

and increased placental steroids

31
Q

how do postural changes affect renal function

A

upright position - decreased
supine- increased
lateral position during sleep - very increased

32
Q

How much weight does a mother typicaly gain

A

11kgs
5- fetus
6- mother

33
Q

how many extra calories should be ingested a day in pregnancy

A

250-300

30g extra protein

34
Q

When does the fetus have high metabolic demands

A

wks 21-40

35
Q

What special nutritional needs are there in pregnancy

A 
high protein diet
iron supplements 300mg 
B vitamins for erythropoesis
folic acid
vit D3 and calcium supplements
vitamin K before parturition
36
Q

What happens to the oestrogen:progesterone ratio in parturition

A

Oestrogen increases as it increases contractility while progesterone inhibits it

37
Q

What other factors increase contractility

A

Maternal and fetal oxytocin
mechanical stretch of uterine muscle fibres
stretch of the cervix

38
Q

what does prostaglandidn fo

A

control timing of labour

39
Q

What effect does oestrogen and progesterone do in terms of lactation

A

Oestrogen - growth of ductile system
Progesterone- development of lobule alveolar system

Both inhibit milk production so their levels drop suddenly at birth

40
Q

What does prolactin do

A

stimulates milk production

stimulates colostrum

41
Q

describe the milk let down reflex

A

receptors in nipples stimulated- impulses propagates to spinal cord- stimulation of hypothalamic nuclei- oxytocin released- contraction- milk ejected

42
Q

where is oxytocin released from

A

the posterior pituitary gland

43
Q

describe the mothers nutritional status throughout pregnancy

A

wks 1-20 = anabolic

wks 21-40= catabolic ie fetus has high demands, mother experiences accelerated starvation

44
Q

what happens in the anabolic phase

A

normal or increases insulin sensitivity
lower plasmatic glucose level
lipogeneis, glycogen stores
growth of breasts, uterus, weight gain

45
Q

what causes insulin resistance in pregnancy

A

HCS
cortisol
growth hormone

Reproduction (52 decks)

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