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repro > physiology of pregnancy and lactation > Flashcards

physiology of pregnancy and lactation Flashcards

1
Q

fertilised egg develops and differentiates into a

A

blastocyte

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2
Q

transport into uterus on day ?

A

3-5

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3
Q

attaches to lining ofuterus on day?

A

5-8

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4
Q

blastocyst - inner cells develop into embryo, outer cells burrow into uterine wall and become placenta. what does the placenta produce which maintains pregnancy>

A

hormones

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5
Q

blastocyst lined by?

A

trophobalst cells

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6
Q

when blastocyst adheres to the endometrial lining, chords of trophoblastic cells….?

A

begin to penetrate into the endometrium

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7
Q

advancing chords of trophoblastic cells tunnel deeper into the endometrium, carving a hole for the blastocytes

A

when implantation is finished, blastocyst is completely buried in endometrium

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8
Q

completely delved by?

A

day 12

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9
Q

placenta is derived from both …cells and …cells

A

trophoblastic and decidua

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10
Q

trophoblast cells differentiate into multinucleate cells, (syncytiotrophoblasts), which invade decidua and break down capillaries to form cavities filled with maternal blood

A

y

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11
Q

what does the developing embryo do?

A

sends capillaries into the syncytiotrophoblastic projections to form placental villi

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12
Q

placental villi - separate maternal blood and fetal blood by thin layer of tissue. is there exchange?

A

no

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13
Q

when is the placenta functional by?

A

5th week of pregnancy

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14
Q

early nutrition of the embryo?

A

invasion of the trophoblastic cells into the decieua

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15
Q

hcg signals the corpus luteum to continue secreting?

A

progesterone

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16
Q

progesterone stimulates the endometrium to concentrate which substances?

A

glycogen, protens and lipid

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17
Q

as placenta develops, it extends hair like projections into the uterine wall

A

this increases contact area between the uterus and placenta

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18
Q

a thin membrane separates fetal blood from maternal blood. what is the space called between this>

A

intervillous space

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19
Q

the placenta plays the role of?

A

fetal lungs

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20
Q

exchange takes place between maternal (oxygen rich blood) and umbilical cord (arterial and venous blood)

A

y

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21
Q

oxygen rich blood travels to the fetus via the?

A

umbilical vein

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22
Q

maternal oxygen poor blood travels back into the ?

A

uterine veins

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23
Q

deoxygenated blood from fetus..pathway?

A

umbilical arterIES - (maternal) uterine vein

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24
Q

3 factors which facilitate oxygen supply to the fetus?

A

fetal haemoglobin has an increased ability to carry 02, have more haemoglobin, 3 = bohr effect (fetal hb can carry more oxygen in low PC02)

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25
Q

how does water diffuse across placenta?

A

osmosis, exchange increases during pregnancy up to 35th week. (3.5l/day)

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26
Q

how do electrolytes get across?

A

follow water

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27
Q

which electrolytes only go from mother to child?

A

iron and ca

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28
Q

how does glucose cross the placenta?

A

simplified transport (scsp)

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29
Q

free diffusion of?

A

fatty acids

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30
Q

there is an increased demand of glucose for the fetus in?

A

3rd trimester

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31
Q

what effect does HCG have on male testes?

A

development of sex organs

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32
Q

HCS - what week of pregnancy does it start being produced?

A

week 5

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33
Q

it has growth hormone like effects, what tissue does it act on?

A

protein

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34
Q

how does it get more glucose for the fetus?

A

decreases insulin sensitivity in the mother

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35
Q

what is it also involved in the development of?

A

breast development

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36
Q

progesterone - when does is start to rapidly increase?

A

week 10. 10 deci. prep.

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37
Q

what is it involved in?

A

development of decidual cells, preparation for lactation, decreases uterine contractility

38
Q

effect of estradiol on uterus?

A

increased proliferation

39
Q

what hormone is involved in the relaxation of ligaments?

A

oestrogen (east)

40
Q

which hormone acts like thyroid hormones

A

HCG

41
Q

mimics hyperthyroidism

A

y

42
Q

increased calcium demands in pregnancy can lead to?

A

hyperparathyroidism

43
Q

cardiac output in pregnancy?

A

30 - 50% higher(beginning in week 6, peaking week 24)

44
Q

when does it decrease?

A

in the last 8 weeks

45
Q

what happens to the heart rate?

A

increases to 90 per minute to increase cardiac output

46
Q

when does blood pressure drop?

A

2nd semester

47
Q

specifically with twins, what happens to blood pressure and cardiac output?

A

blood pressure drops more, CO increases more

48
Q

what happens to plasma volume>

A

increases proportiaonally with co

49
Q

what happens to hb as a consequence?

A

concentration is reduced, and blood viscosity decreases

50
Q

in the second half of pregnancy, there is a significant increased requirement for what? what supplements are needed>

A

iron

51
Q

wjy are there respiratory changes?

A

partly due to increased progesterone, partly due to pressure of uterus interfering with lung function

52
Q

what does progesterone signal?

A

brain to lower CO2 levels

53
Q

because of these signals to lower co2 levels, what happens to resp rate/tidal volume, pc02, vital capacity and P02

A

all decrease, except P02 and vital capacity remain the same

54
Q

what happens to GFR and plasma renal flow?

A

increases by 30-50%

55
Q

why is there increased reabsorption of ions and water?

A

placental steroids

56
Q

urine formation?

A

slight increase

57
Q

how do postural changes affect renal function?

A

upright position decreases it, supine position increases it, lateral position during sleep increases it more

58
Q

pregnancy induced hypertension and proteinuria?

A

pre eclampsia

59
Q

when is the cut off for gestational hypertension?

A

20 weeks, must be after 20 weeks

60
Q

if woman has hypertension before 20th week, what is diagnosis?

A

pre existing hypertension

61
Q

pre eclampsia more common in women with pre existing hypertension, diabetes, autoimmune diseases, family history, avesity and women with multiple gestation

A

y

62
Q

what is the single biggest risk factor?

A

previous pre eclampsia

63
Q

what is eclampsia>

A

extreme pre ecampsia

64
Q

vascular spasms, extreme hypertension, chronic seizures and coma

A

y

65
Q

treatment of eclampsia?

A

vasodilators and caesarean section

66
Q

average weight gain ?

A

24lbs

67
Q

250-300 extra k/cal/day

A

extra protein intake 30g per day

68
Q

what is the fetal glucose need at the end of pregnancy?

A

`5mg/kg/min

69
Q

glucose need of the mother

A

2.5mg/kg/min

70
Q

when is mothers anabolic phase?

A

1st - 20th week

71
Q

during anabolic phase for mother, anabolic metabolism for mother, and quite small catabolic needs for the baby

A

weeks 21–40 - high metabolic demands of the fetus, accelerated starvation of the mother

72
Q

in the anabolic phase, mothers build ?

A

fat and glycogen

73
Q

in anabolic phase what is insulin sensitivity like?

A

normal/increased

74
Q

thererefore, what is the plasmatic glucose level like?

A

low

75
Q

what happens to glycogen stores?

A

increased (building glycogen)

76
Q

what happens re fat?

A

lipogenesis

77
Q

basically in anabolic phase, you build glycogen and fat

A

y

78
Q

in catabolic phase, you get insulin resistance, what hormones cause this>

A

HCS, cortisol and growth hormone

79
Q

what are some special nutritional needs in pregnancy?

A

high protein diet, iron supplements, b vitamins, folic acid

80
Q

what are b vitamins for?

A

erythropoesis

81
Q

whats folic acid for

A

reduce risk of neural defects

82
Q

what should be given, before partuition, to reduce the risk of intercranial bleed during labour?

A

vitamin K

83
Q

progesterone decreases uterine contractibility

A

ratio of e:p changes at partiution

84
Q

what hormone (from pp gland) increases contraction and contractibility

A

oxytocin

85
Q

what does mechanical stretch of the uterine muscles cause?

A

increased contractibility

86
Q

stretch of _____also stimulates uterine contractions

A

cervix

87
Q

what happens to the frequency of Braxton hicks contractions?

A

increase towards end of pregnancy

88
Q

stretch of the cervix by fetal head increases contractility, this is an example of?

A

positive feedback

89
Q

cervical stretching also causes further release of?

A

oxytocin

90
Q

strong uterine contractions and pain from the birth canal cause neurogenic reflexes from spinal cord that iduce intense abdominal contractions

A

u

91
Q

what does oestrogen do to the uterus which stimulates uterus to contract and placenta to make prostaglandins>

A

induces oxytocin receptors

92
Q

what do prostaglandins do?

A

stimulate more vigorous contractions of the uterus

repro (30 decks)

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