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Repro and Sexual Health > Physiology of Pregnancy and Lactation > Flashcards

Physiology of Pregnancy and Lactation Flashcards

1
Q

what cells invade into the endometrium to allow implantation?

A

trophoblast cells

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2
Q

day 1 of fertilization?

A

fertilization occurs in the ampulla of fallopian tube

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3
Q

day 3-5 of fertilization?

A

transport of blastocyst into the uterus

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4
Q

day 5-8?

A

blastocyst attaches to lining of uterus

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5
Q

what does blastocyst develop into?

A

inner cells = embryo

outer cells = burrow into uterine wall and become placenta

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6
Q

what does placenta do?

A

//

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7
Q

impnataion>

A

..

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8
Q

…..

A

..

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9
Q

..

A

..

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10
Q

..

A

..

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11
Q

..

A

..

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12
Q

placenta is derived form what tissue?

A

trophoblast and decidual tissue

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13
Q

how does placenta develop?

A 
trophoblast cells (chorion) differentiate into multinucleate cells (syncytiotrophoblasts) which invade decidua and break down capillaries to form cavities filled with maternal blood
.......
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14
Q

HCG released by trophoblast signals the corpus luteum to continue secreting which hormone?

A

progesterone

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15
Q

where does early nutrition of the embryo come from?

A

trophoblast (invasion into the decidua)

…

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16
Q

laetr nutrition>

A

…

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17
Q

how does the placenta act as a atriovenous shunt?

A

,,

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18
Q

key role of placenta?

A

oxygen transport (foetal lungs) and CO2 removal

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19
Q

how does foetal respiration occur?

A

takes place between maternal blood and the umbilical blood (arterial/venous mix, O2 poor)
oxygen diffuses from maternal into fetal circulation
CO2 follows a reverse gradient

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20
Q

the suply of oxygen tot the foetus is facilitated by the increased ability of fetal haemoglobin to carry oxygen, the conc of fetal ???ms;MDOWQFNGUW

A

DNDVB

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21
Q

3 factors which facilitate the supply of oxygen to fetus?

A 
fetal Hb (increased ability to carry O2)
higher Hb (50% more than in adults)
bohr effect
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22
Q

water transport in fetus?

A

diffuses into placenta along its osmotic gradient

exchange increases during pregnancy up to the 35th week

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23
Q

electrolyte transport in fetus?

A

follows water (iron and Ca2+ only go from mother to child)

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24
Q

glucose transport?

A

fetus main source of energy

passes placenta via simplified transport (high glucose needed in 3rd trimester)

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25
Q

fatty acid transport?

A

free diffusion

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26
Q

waste products transport?

A

diffusion based on concentration gradient

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27
Q

drugs which can cross the placenta?

A

//

28
Q

HCG changes in pregnancy?

A

peaks at weeks 8-12
preventa degeneration of corpus luteum
has effect on testes of male fetus (development of sex organs)

29
Q

HPL/HCS changes in pregnancy?

A

produced from week 5
GH like effects (protein tissue formation)
dcreases ……….

30
Q

progesterone function in pregnancy?

A

developemnt of decidual cells
decreases uterus contractility
preparation for laction
breast development

31
Q

function of oestrogen in pregnancy?

A

enlargement of uterus
breast development
relaxation of ligaments

32
Q

how should HCG levels increase in pregnancy?

A

double every 48 hours in early pregnancy

33
Q

uses of measuring HCG?

A

monitor changes in levels to help diagnose

  • ectopic pregnancy (static or slow rising)
  • failing pregnancy (falling)
  • ongoing viable pregnancy (doubling or >60% rise)
34
Q

side effects of HCG?

A

nausea
vomiting
(effect peak at 8-10 weeks when levels peak)

35
Q

when can high levels of HCG occur?

A

multiple pregnancy

molar pregnancy

36
Q

..

A

..

37
Q

other hormonal changes in pregnancy?

A

placenta produces CRH > ACTH released in mother > aldosterone and cortisol preoduced > ….
……
………

38
Q

how much does cardiac output increase in pregnancy?

A 
around 40%
(can be 30-50%)
- due to demands of uteroplacental circulation (placental circulation, metabolism, skin thermoregulation, renal circulation etc)
- begins at week 6 and peaks at 24 weeks
- then decreases in last 8 weeks
39
Q

normal CO related changes in pregnancy?

A

ECG changes
functional murmurs
changed heart sounds

40
Q

HR changes in pregnancy?

A

increases up to 90 to increase CO

41
Q

BP changes in pregnancy?

A 
////
drops in 2nd trimester
42
Q

haematological changes in pregnancy?

A

Plasma volume increases proportionally with CO (50%)
erythropoeisis (RBCs) increase (25%)
therefore Hb is decreased by dilution (which decreases blood viscosity)
iron requirements increase (…….)
…..

43
Q

resp changes in pregnancy?

A

lung function changes occur partly due to progesterone increases and partly because the enlarging uterus interferes with lung function
- progesterone signals the brain to ////
.
….

44
Q

urinary system changes?

A

…
GFR and RPF increases
increased reabsorption of ions and water (due to placental steroids and aldosterone)
slight increase in urine formation

45
Q

how do postural changes affect renal function in pregnancy?

A

//

46
Q

what is pre-eclampsia?

A

pregnancy induced hypertension and proteinuria

47
Q

features of pre-eclampsia?

A

..

48
Q

most significant risk for pre-eclampsia?

A

previous episode of pre-eclampsia

49
Q

what causes pre-eclampsia?

A

possibly

  • extensive secretion of placental hormones
  • immune response to fetus
  • insufficient …..
50
Q

…

A

..

51
Q

average maternal weight gain in pregnancy?

A

11kg

52
Q

what is weight gain made up of?

A 
fetus (3.5kg)
extra-embryonic fluid/tissues (2kg)
uterus (1kg)
breasts (1kg)
....
.
.
.

.

53
Q

extra food intake in pregnancy?

A

extra 200kcal per day
extra 30kg protein per day
at end of pregnancy - fetal glucose need 5mg/kg/min (Mother 2.5mg/kg/min)

54
Q

2 phases of pregnancy in terms of metabolism?

A

//////

55
Q

describe mothers anabolic phase?

A

normal/increased insulin sensitivity
lower plasmatic glucose level
lipogenesis,glycogen stores increase
growth of breasts, uterus and weight gain

56
Q

…

A

..

57
Q

special nutritional needs in pregnancy?

A 
folic acid (reduced neural tube defects)
Vit D supplements
high protein diet, higher energy intake
iron supplemets
B vitamins (erythropoeisis)
58
Q

how does the uterus change at time of birth?

A

becomes more exciteable towards end of pregnancy
estrogen:proegsterone ratio changes which increases excitability (progesterone inhibits contractility which oestrogen does the opposite)
oxytocin (from maternal posterior pituitary) increases contractions and excitability
fetal hormones (oxytocin, adrenal gland, prostaglandins and …) ……
…
.
.

59
Q

describe the onset of labour

A

//

60
Q

initiation of labour? (feedback systems)

A

//

61
Q

third stage of labour is defined as what?

A

delivery of placenta

62
Q

2nd stage?

A

passage through birth canal (few mins to 120 mins)

63
Q

stage 1?

A

cervical dilation (8-24 hours)

64
Q

what hormones are required for milk release from breast?

A

oestrogen = growth of ductile system
progesterone = development of lobule-alveolar system
(both inhibit milk production, sudden drop in Oe and P after birth)
prolactin = milk production (steady risk in levels week - birth, induces ….
…..

65
Q

feedback system in breastfeeding?

A

//

Repro and Sexual Health (63 decks)

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