Physiology Of Pregnancy And Lactation

Question 1

What happens on day 1?

Answer 1

Fertilisation in ampulla

Question 2

What happens days 3-5?

Answer 2

Transport of blastocyst into uterus

Question 3

What happens days 5-8?

Answer 3

Blastocyst attaches to lining of uterus

Question 4

In blastocyst, inner cells become what?

Answer 4

Embryo

Question 5

In blastocyst, outer cells become what?

Answer 5

Placenta

Question 6

By when is the blastocyst implanted?

Answer 6

Day 12

Question 7

What is placenta derived from?

Answer 7

Trophoblast and decidual tissue

Question 8

What does the placenta work as?

Answer 8

A physiological arteriovenous shunt

Question 9

Adaptations to supply foetus with oxygen?

Answer 9

HbF have increased ability to carry oxygen
Higher Hb conc in fetal blood
Bohr effect - HbF can carry more O2 in low pCO2

Question 10

What are drugs called that cross the placental barrier?

Answer 10

Teratogens

Question 11

Give examples of teratogens

Answer 11

Thalidomide
Carbamazepine 
Tetracycline
Alcohol
Nicotine
Heroin
Cocaine
Caffeine

Question 12

Effect of HCG during pregnancy?

Answer 12

Prevents involution of corpus Luteum

Question 13

Effect of HCS during pregnancy?

Answer 13

Growth hormone like effects
Decreases insulin sensitivity in mother - more glucose for foetus
Involved In Breast development

Question 14

Effect of progesterone in pregnancy?

Answer 14

Development of decidual cells
Decreases uterus contractility
Prep for lactation

Question 15

Effect of oestrogens during pregnancy?

Answer 15

Enlargement of uterus
Breast development
Relaxation of ligaments
Estriol level is indicator of vitality of fetus

Question 16

What is placenta derived from?

Answer 16

Trophoblast and decidual tissues

Question 17

Does CO increase or decrease in pregnancy?

Answer 17

Increases 30-50% from week 6
Decreases in last 8 weeks
Increases 30% in labour

Question 18

Does BP increase or decrease in pregnancy?

Answer 18

Decreases during second trimester

Question 19

Haem changes during preganancy?

Answer 19

Plasma volume increases
Erythopoiesis increases
Hb decreases by dilution
Iron requirements increase

Question 20

Adaptions to lower CO2 levels during preganancy?

Answer 20

Increase RR
Increase tidal and minute volume
Decrease pCO2

Question 21

How does GFR and renal plasma flow change during preganancy?

Answer 21

Increase

Question 22

Most significant risk factor for PET?

Answer 22

Having had pre-eclampsia previously

Question 23

Why do you get oedema in PET?

Answer 23

Kidney function declines -> salt and water retention -> oedema formation

Question 24

What is pre eclampsia?

Answer 24

Pregnancy induced hypertension and proteinuria

Question 25

What is eclampsia?

Answer 25

Extreme pre -eclampsia

Question 26

What happens in eclampsia?

Answer 26

Vascular spasms Extreme hypertension Chronic seizures Coma

Question 27

Treatment of eclampsia?

Answer 27

Vasodilators and Caesarean section

Question 28

Average weight gain during pregnancy?

Answer 28

24lbs

Question 29

How many extra calories are needed during pregnancy?

Answer 29

250-309

Question 30

Oestrogens role in lactation?

Answer 30

Growth of ductile system

Question 31

Progesterone a role in lactation ?

Answer 31

Development of lobule-alveolar system

Question 32

Oestrogen and progesterone effect on milk production?

Answer 32

They both inhibit milk production

Question 33

Prolactins effect on lactation?

Answer 33

Stimulates milk production

Question 34

Properties of colostrum?

Answer 34

Low volume | No fat

Question 35

What is the milk let down reflex?

Answer 35

``` Receptors in nipples stimulated Impulses propagated to spinal cord Stimulation of hypothalamic nuclei Oxytocin release Milk ejected ```