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Repro > Physiology of Pregnancy and Lactation > Flashcards

Physiology of Pregnancy and Lactation Flashcards

1
Q

What does the fertilised ovum do?

A

Progressively divides and differentiates into a blastocyst

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2
Q

Where does the fertilised ovum move to?

A

Site of fertilisation in the upper oviduct (ampulla to the site of implantation in the uterus

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3
Q

What sweeps the ovum into the oviduct?

A

Fimbrae

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4
Q

What happens at day 1?

A

Fertilisation occurs in the ampulla of the fallopian tube

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5
Q

What happens at days 3-5?

A

Transport of blastocyst into the uterus

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6
Q

What happens at days 5-8?

A

Blastocyst attaches to lining of uterus

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7
Q

What happens to the blastocyst?

A

Inner cells develop into embryo

Outer cells burrow into uterine wall and become placenta

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8
Q

What does the placenta do?

A

Produce several hormones to maintain pregnancy

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9
Q

What happens when the blastocyst adheres to the endometrial lining?

A

Cords of trophoblastic cells begin to penetrate the endometrium

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10
Q

What happens by day 12?

A

Implantation is completed and the blastocyte is buried in the uterine lining

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11
Q

What is the placenta derived from?

A

Trophoblast and decidual tissue

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12
Q

What happens to trophoblastic cells (Chorion)?

A

Differentiates into multinucleated cells (Syncytiotrophoblasts) which invade decidua and break down capillaries to form cavities filled with maternal blood

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13
Q

How are placental villi formed?

A

Embryo sends capillaries into the syncytiotrophoblast projections

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14
Q

What does each villus contain?

A

Foetal capillaries separated by maternal blood by a thin layer of tissue

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15
Q

Is there any direct contact between foetal and maternal blood?

A

No

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16
Q

What is functional by week 5 of the pregnancy>

A

Placenta

Foetal heart

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17
Q

What helps with embryo nutrition?

A

Invasion of trophoblastic cells into the decidua

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18
Q

What does Human chorionic gonadotrophin (HCG) do?

A

Signals the corpus luteum to continue secreting progesterone - stimulating decidual cells to concentrate glycogen, proteins and lipids

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19
Q

What acts as an arteriovenous shunt?

A

Circulation within the intervillous space

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20
Q

What does the placenta play the role of?

A

The foetal lungs

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21
Q

What 3 factors facilitate the oxygen supply to the foetus?

A 
Fetal Hb (increased ability to carry O2)
Higher Hb (concentration in fetal blood 50% more than in adults)
Bohr effects (fetal Hb can carry more O2 in low pCO2 than in higher pCO2)
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22
Q

Water diffusion increases until which week?

A

35th (3.5l/day)

23
Q

When is a higher concentration of glucose required?

A

3rd trimester

24
Q

Describe Human Chorionic Somatomammotrophin (HCS)

A

Produced from week 5
Growth hormone effect
Decreases insulin sensitivity in mother
Involved in breast development

25
Q

What does changes in progesterone cause?

A

Development of decidual cells
Decreased uterus contractibility
Preparation for lactation

26
Q

What does changes in estrogens cause?

A

Enlargement of uterus
Breast development
Relaxation of ligaments
Estriol level - indicator of vitality of foetus

27
Q

Cardiac output increases by what until when?

A

Up by 30-50% until last 8 weeks

28
Q

How high is the heart rate to accomodate the increased CO?

A

90/min

29
Q

When does the BP drop?

A

2nd trimester

30
Q

What happens to the CO and BP if the mother is carrying twins?

A

CO increases more

BP drops more

31
Q

What happens to the plasma volume?

A

Increases proportionally with CO (50%)

32
Q

What happens to Hb?

A

Decreases by dilution (Decreases blood viscosity)

33
Q

What respiratory changes happen to lower CO2 levels?

A

Respiratory rate increases
Tidal volume and minute volume increase (50%)
pCO2 decreases slightly
Vital capacity and pO2 don’t change

34
Q

What happens to the Glomerular Filtration Rate and Renal Plasma Flow?

A

Increases up to 30-50%, peaking at 16-24 weeks

35
Q

What are features of pre-aclampsia?

A

Oedema
Hypertension
Proteinuria
GFR and renal plasma flow decreases

36
Q

What happens in eclampsia?

A 
Vascular spasms
Severe hypertension
Chronic seizures
Coma
Death
37
Q

What is the treatment of eclampsia?

A

Vasodilators

Cesarean section

38
Q

How much extra kcal/day should be consumed by the mother?

A

250-300

39
Q

How much extra protein should the mother consume?

A

30g/day

40
Q

Describe the 1st metabolic phase of pregnancy?

A

1st-20th week
Mother’s anabolic phase
Anabolic metabolism of the mother
Quite small nutritional demands of the conceptus

41
Q

Describe the 2nd metabolic phase of pregnancy?

A

21-40th week (esp. last trimester)
high metabolic demands of fetus
Accelerated starvation of mother

42
Q

What happens in the mothers anabolic phase?

A

Normal or increased sensitivity to insulin
Lower plasmatic glucose level
Lipogenesis, glycogen stores increase
Growth of breasts, uterus, weight gain

43
Q

What happens in the catabolic phase?

A

Maternal insulin resistance
Increased transport of nutrients through placental membrane
lipolysis

44
Q

What causes insulin resistance?

A

HCS
Cortisol
Growth hormone

45
Q

What is the purpose of taking folic acid (folate) during pregnancy?

A

Reduces risk of neural tube defects

46
Q

What is the purpose of taking vitamin K and when should it be taken?

A

Prevention of intercranial bleeding during labour

Before parturition

47
Q

What is erythropoesis?

A

making red blood cells

48
Q

What does cervical stretching cause?

A

Oxytocin release

49
Q

What are the 3 stages of labour?

A

1st: Cervical dilation (8-24 hrs)
2nd: Passage through birth canal (few to 30 mins)
3rd: Expulsion of placenta

50
Q

What does estrogen do to the breasts?

A

Growth of ductile system

51
Q

What does prgesterone help develop?

A

Lobule-alveolar system

52
Q

What do estrogen and progesterone inhibit?

A

Milk production

53
Q

What does prolactin stimulate?

A

Milk production

Repro (46 decks)

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