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Reproduction and sexual health > Physiology of pregnancy and lactation > Flashcards

Physiology of pregnancy and lactation Flashcards

1
Q

What happens in day of conception

A

Fertilisation of the egg by sperm in the ampulla of the uterine tube

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2
Q

during which days does the blastocyst transport into the uterus

A

3-5

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3
Q

During which days does the blastocyst attach to the endometrium

A

5-8

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4
Q

In the blastocyst, the inner cell mass becomes the embryo/placenta
and the outer cells become the embryo/placenta

A

inner cell mass becomes embryo

outer cells become placenta

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5
Q

What are trophoblasts

A

Cells that line the blastocyst

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6
Q

What is decidual tissue

A

specialised tissue of the endometrium formed during the secretory phase that has embryo receptive properties

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7
Q

At which day is the blastocyst completely embedded in the endometrium

A

day 12

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8
Q

which tissues is the placenta derived from

A

trophoblasts and decidual tissue

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9
Q

What are syncytiotrophoblasts and what do they do

A

They are multinucleate cells derived from trophoblasts

They invade the decidua and break down capillaries to form cavities of maternal blood

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10
Q

How are placental villi formed

A

they are projections from the embryo sent into the syncytiotrophoblasts

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11
Q

There is direct contact between maternal and foetal blood circulations, true or false

A

FALSE, there is no direct contact, they are separated by a thin layer of tissue

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12
Q

By which week of pregnancy should the placenta and foetal heart be functional

A

Week 5

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13
Q

What provides early nutrition to the embryo

A

Trophoblasts

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14
Q

What does hCG signal to the corpus luteum to secrete

A

Progesterone

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15
Q

What influence does progesterone have on decidual cells

A

Causes decidual cells to secrete glycogen, proteins and lipids

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16
Q

Foetal oxygen rich blood goes to foetus via umbilical vein/artery
Maternal oxygen poor blood flows back through ?

A

foetal oxygen rich blood - umbilical vein

maternal oxygen poor blood - uterine veins

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17
Q

What are the 3 factors that facilitate oxygen supply to the foetus

A
  1. Foetal Hb - can carry more oxygen
  2. Higher Hb concentration - 50% more than adults
  3. Bohr effect - can carry more O2 when there is low CO2 rather than high CO2 levels
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18
Q

In which direction do Fe and Ca move, mother to child or child to mother

A

Mother to child only

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19
Q

List some teratogens that can cross the placenta

A 
Thalidomide 
Phenytoin 
Na valproate 
ACEI/ARBs 
Carbamazepine 
Coumarins 
Tetracyclines 
Opioids 
Cocaine 
Alcohol 
Nicotine 
Heroin 
Caffeine
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20
Q

what weeks does hCG peak

A

8-12 (~10)

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21
Q

What is another name for Human Chorionic Somatomammotrophin (HCS)

A

Human placental lactogen (HPL)

22
Q

When is HPL produced

A

Week 5 of pregnancy and gradually increases

23
Q

What are the functions of HPL

A

Growth hormone like effects - builds protein
Reduces insulin sensitivity
Breast development

24
Q

What are the functions of progesterone

A

Development of decidual cells
Decreases uterine contractility
Preparation for lactation

25
Q

Which hormones increase and decrease uterine contractility

A

Progesterone decreases

Oestrogen increases

26
Q

What are the functions of oestrogen

A

Enlargement of uterus
Increase uterine contractility
Relax ligaments

27
Q

What happens to serum hCG every 48 hours

A

Levels double

28
Q

Why is it useful to monitor hCG levels

A 
ectopic pregnancy 
miscarriage 
ongoing viable pregnancy 
multiple pregnancy 
molar pregnancy
29
Q

What are the cardiovascular adaptation that occur to the mother in pregnancy

A

Increased cardiac output to meet demands or uteroplacental circulation
subtle ECG changes - right axis deviation
functional murmurs
heart sounds

30
Q

What haematological changes occur in the mother in pregnancy

A

Increased plasma volume
Erythropoesis
Decreased Hb concentration from dilution (^PV)
Iron supplementation may be needed

31
Q

What respiratory adaptations occur in the mother in pregnancy

A

O2 consumption increases
PCO2 decreases
RR + TV increase
Due to increasing progesterone levels and enlarging uterus

32
Q

What renal adaptations occur in the mother in pregnancy

A

increased plasma renal flow and increased GFR

increased reabsorption of ions and water

33
Q

what is pre eclampsia

A

pregnancy induced hypertension and proteinuria after 20 weeks gestation

34
Q

What is eclampsia

A

Extreme pre eclampsia, lethal without treatment

35
Q

What is the normal average weight gain for a woman in pregnancy

A

11 kg

  • foetus 3.5kg
  • extra embryonic fluid/tissue 2kg
  • uterus 1kg
  • breasts 1kg
  • body fluid 2kg
  • fat 1kg
36
Q

What are the 2 phases in pregnancy in relation to metabolism

A

phase 1 = mother’s anabolic/building phase during 1-20wk

phase 2 = accelerated starvation/mothers catabolic phase 21-40wk, foetus has high metabolic demands

37
Q

What hormones cause insulin resistance in pregnancy

A

HPL, cortisol, growth hormone

38
Q

What are the recommendations for folic acid supplementation

A

400ug normally
5mg if obese, NTD history, AED,
taken 3 months pre and post conception

39
Q

What supplements are required

A 
Vitamin D 
Iron 
Calcium 
Vitamin B 
Protein
40
Q

What happens to the oestrogen:progesterone ration during parturition

A

Oestrogen levels rise

Progesterone levels fall

41
Q

What does oxytocin do during delivery and where does it come from

A

Comes from posterior pituitary

increases contractility and excitability of uterus

42
Q

List factors which increase uterine contractility

A 
Oestrogen 
Oxytocin 
Mechanical stretching of uterus by foetus 
Cervical stretching 
Foetal hormones
43
Q

What are Braxton Hicks contractions

A

Tightenings, painless
Not proper contractions
Happen more towards end of pregnancy

44
Q

What happens in positive feedback during delivery

A

foetal head stretched cervix
which releases more oxytocin, prostaglandins which in turn cause uterine contractions which causes cervical stretch
cycle repeats

45
Q

What are the stages of labour

A

1st stage = cervical dilatation
2nd stage = delivery of baby through birth canal
3rd stage = expulsion and delivery of the placenta

46
Q

What effect does oestrogen have on lactation

A

causes growth of ductile system

inhibits milk production

47
Q

What effect does progesterone have on lactation

A

development of lobular-alveolar system

inhibits milk production

48
Q

What happens to oestrogen and progesterone levels at birth

A

Their levels decrease

49
Q

Which hormones are needed for milk production

A

Prolactin (anterior pituitary)

Oxytocin (posterior pituitary)

50
Q

What is the milk let down reflex

A

Mechanoreceptors in nipple stimulated by suckling
impulses go to spinal cord
hypothalamus is stimulated
oxytocin released from posterior pituitary
milk ejected

Reproduction and sexual health (46 decks)

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