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3 Reproduction and Sexual Health > Physiology of Pregnancy and Puerpium Lactation > Flashcards

Physiology of Pregnancy and Puerpium Lactation Flashcards

1
Q

the fertilised ovum divides and differentiates into what structure?

A

a blastocyst

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2
Q

what is the name of the egg from its journey from the site of fertilisation to the endometrium?

A

blastocyst

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3
Q

how many days does it take for the blastocyst to ENTER the uterus?

A

3-5 days

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4
Q

how many days does it take for the blastocyst to IMPLANT in the uterus?

A

5-8 days

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5
Q

what do the inner cells of a blastocyst form?

A

embryo

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6
Q

what do the outer cells of a blastocyst form?

A

placenta

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7
Q

name the cells of the blastocyst that invade the endometrial cavity

A

trophoblast cells (surface layer of the blastocyst)

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8
Q

what signifies the end of implantation?

A

when the blastocyst is completely buried in the endometrium

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9
Q

how many days after fertilisation is the end of implantation?

A

day 12

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10
Q

the placenta is derived from what 2 types of tissue?

A

trophoblast

decidual tissue

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11
Q

another word for trophoblast cells?

A

chorion

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12
Q

how are placental blood vessels formed?

A
  1. trophoblast cells invade decidua and breaks down capillaries to form cavities for maternal blood
  2. embryo creates blood vessels which insert into the cavities to form villi
    N.B foetal capillaries and maternal blood are separated by a thin layer to prevent cross contamination
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13
Q

in what week of pregnancy are the placenta and foetal heart functional?

A

week 5

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14
Q

what does HCG do?

A

signals the corpus luteum to continue secreting progesterone

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15
Q

what effect does progesterone have on decidual cells?

A

stimulates them to concentrate glycogen, protein and lipids

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16
Q

why does the placenta contain villi?

A

increases contact area between uterus and placenta

allows more nutrients and waste to be exchanged

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17
Q

the thin membrane separating mums blood from babys in the placenta is located in what space?

A

intervillous space

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18
Q

what makes up umbilical blood? how oxygenated is it?

A

mix of arterial and venous blood

poorly oxygenated

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19
Q

how oxygenated is mums blood in the placenta?

A

oxygen rich

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20
Q

describe the transport of oxygen within the placenta?

A

O2 diffuses from M to B’s circulation

CO2 diffuses from B to M’s circulation

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21
Q

what vessel transports oxygen rich blood to the foetus?

A

umbilical vein (because it’s LEAVING the placenta)

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22
Q

what vessel transports maternal oxygen poor blood?

A

uterine veins

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23
Q

what 3 factors facilitate oxygen transport to the foetus?

A

foetal Hb
higher Hb concentration in fetal blood
Bohr effect

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24
Q

what is the bohr effect?

A

fetal Hb can carry more oxygen in low pCO2 than high pCO2

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25
Q

PO2 is higher in mum/baby

PCO2 is higher in mum/baby

A

mum

baby

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26
Q

a fetus has a __% higher Hb concentration than an adult; why is this?

A

50

to give them an increased ability to carry O2

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27
Q

what 2 electrolytes can only go from mother to child?

A

iron

Ca

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28
Q

what substance is the fetus’ main source of energy?

A

glucose

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29
Q

exchange of water increases during pregnancy T or F

A

T

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30
Q

what substances diffuse freely across the placenta?

A

fatty acids

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31
Q

glucose crosses the placenta via what process?

A

simplified transport

32
Q

HCG peaks at how many weeks gestation?

A

10

33
Q

human chorionic somatomammotropin is produced from around week _ of pregnancy

A

5

34
Q

what does HCS do?

A

GH-like effects eg on protein tissue
decreases insulin sensitivity
breast development

35
Q

why are pregnant women more insulin resistant?

A

to provide more glucose for the foetus

36
Q

what does progesterone do?

A

develops decidual cells
decreases uterine contractility
preps for lactation

37
Q

what does oestrogen do?

A

enlarges uterus
breast development
relaxes ligaments

38
Q

what pituitary hormone is also synthesised by the placenta? what does it stimulate release of?

A

CRH

ACTH

39
Q

effect of increased CRH in pregnancy?

A

excess cortisol can cause insulin resistance -> GDM

excess aldosterone can cause HT

40
Q

main consequence of excess HCG production? why is this?

A

hyperthyroid

can mimic TSH

41
Q

what effect can pregnancy have on the parathyroid gland and why?

A

hyperparathyroidism

increased Ca demands

42
Q

cardiac output increases/decreases in pregnancy, why is this?

A

increases

increased demands from the uteroplacental/renal circulation and inc metabolism

43
Q

CO increases by __%

A

30-50

44
Q

at what gestation does CO peak?

A

24

45
Q

its normal to have ECG changes and heart sounds in pregnancy T or F

A

T

46
Q

a HR of up to _ BPM is normal in pregnancy

A

90

47
Q

when does BP drop in pregnancy and why?

A

2nd trimester

uteroplacental circulation expands and TPR decreases

48
Q

when pregnant with twins CO ___ and BP ____ more

A

increases

decreases

49
Q

___ increases proportionally with CO

A

PV

50
Q

how much iron is needed in the second half of pregnancy per day?

A

6-7mg a day

51
Q

what effect does progesterone have on the lungs?

A

instructs the brain to lower CO2 levels to increase O2 consumption (needed by fetus, placenta and mother)

52
Q

GFR decreases in pregnancy T or F

A

F, increases as does renal plasma flow

53
Q

what happens to reabsorption of ions in the kidneys in pregnancy?

A

increases

54
Q

3 main features of pre-eclampsia?

A

pregnancy induced hypertension
proteinuria
oedema

55
Q

what happens to the kidneys in pre-eclampsia?

A

renal blood flow and GFR decrease

get salt and water retention = oedema

56
Q

biggest risk for pre-eclampsia?

A

previous pre-eclampsia

57
Q

presentation of eclampsia?

A

SEVERE

vascular spasms, extreme hypertension, chronic seizures, coma

58
Q

Tx of eclampsia?

A

vasodilators

CS

59
Q

average weight gain of the mother in lbs

A

24lbs

60
Q

how much extra protein should be ingested by mum?

A

30g per day

61
Q

at what trimester is mum’s metabolism at its most anabolic? why is this?

A

1st and some of 2nd
need to store energy and glucose for the foetus
growing breasts/uterus/weight

62
Q

at what trimester is the mother most insulin resistant?

A

3rd trimester

63
Q

what effect does progesterone have on uterine contractility?

A

inhibits it

64
Q

what produces oxytocin?

A

POSTERIOR pituitary gland

65
Q

what does oxytocin do?

A

increases uterine excitability by:

  1. stimulating uterus to contract
  2. stimulating placenta to make prostaglandins (stimulates more contractions)
66
Q

describe the positive feedback mechanism of labour?

A

stretching of structures eg the cervix by the fetal head:
increases contractility by increasing oxytocin release
increases abdo contractions caused by reaction to pain

67
Q

what hormone stimulates oxytocin receptors on the uterus?

A

oestrogen

68
Q

name the 1st stage of labour and how long it lasts

A

cervical dilatation

8-24hrs

69
Q

name the 2nd stage of labour and how long it lasts

A

passage through birth canal

few mins to 2 hours

70
Q

name the 3rd stage of labour

A

expulsion of the placenta

71
Q

describe the role of oestrogen in lactation?

A

growth of the ductile system

72
Q

what hormone develops the lobule alveolar system

A

progesterone

73
Q

oestrogen and progesterone inhibit/promote milk production

A

inhibit

there is a drop after birth which increases lactation

74
Q

what 2 hormones need to be increased for milk to be produced?

A

oxytocin

prolactin

75
Q

steroids are given to premature babies

A

30

protects the brain

3 Reproduction and Sexual Health (51 decks)

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