Physiology of Pregnancy, Partuition, Lactation Flashcards
Prostaglandinds and labor
- role?
- synthesis stimulated by what?
- what specific compounds can help induce labor?
- uterine stretch stimulates?
Characteristics of endometrium during implantation
- thickness, vascularization?
- capture of embryonic hCG important why?
Initiation of lactation:
- coordination between what: levels of proactin vs levels of estrogen/progesterone
- suckling?
Placenta can’t manufacture adequate what?
because it lacks which enzymes, which are necessary for estone/estradiol/estriol (3)
-how does the mother placental fetal unit overcome this (2 ways)
Progesterone:
- What is source and purpose of high progesterone during pregnancy?
- what regulates the levels of progesterone?
Placenta is major lifeline b/n mom and fetus. How?
acts as fetal gut supplying nutrients
fetal lung exchanging o2 co2
fetal kidney regulating fluid volumes and disposing of waste metabolites
endocrine gland synthesizes steroids and proteins tht affect both maternal and fetal metabolism
Estrogen:
- Produced by?
- DHEAs released from fetal zone are converted by what into what?
- estriol?
- functions of estrogen?
precursor of estriol is coming from fetus, so you can use estriol levels to see if fetus is healthy
Preterm labor:
- definition
- risk factors?
Fetus does not synthesize estrogens without assistance due to lack of?
- what do these enzymes do?
- why is it important that the fetus cant synthesize estrogens on its own?
Estrogen affect on partuition:
- affect on uterine contractility
- stimulates synthesis of what receptors?
Fetal movements can elicit smooth muscle contraction
-how is that known?
Mechanisms thought to be responsible for preeclampsia:
- trophoblast role?
- release of what placental factors cause hypertension and renal natriuresis
Maternal levels of progesterone, estrogens, during pregnancy?
-progesterone needs to be high because?
Fetal hormones and the uterus:
- fetal pituitary
- fetal adrenals
- fetal placental membranes
HCG:
- first hormone produced by what
- composed of what?
- binds to what type of receptor?
- primary action?, what does that prevent
Progesterone synthesis by the syncytiotrophoblast:
-early on in pregnancy does fetus have ability to take pregnenolone to progesterone via 3B-HSD?
no, not till late pregnancy
3 major structures of the mature placenta
- what is the functional unit of the placenta, why?
- where do spiral arteries from the mother drain?
umbilican veins have high o2 content.
Why might MAP decrease during mid pregnancy despite increase in plasma volume?
Progesterone stimulates what type of nutrition important during the first trimester?
-what does progesterone prevent?
Positive feedback once labor is initiated:
- uterine contractions stimulate what?
- uterine activity stretches what? what does this cause?
Principal factors affecting maternal blood flow:
-what happens during uterine contractions?
Obstructed labor/ labor dystocia:
- what is happening?
- causes?
- complications?
Preeclampsia:
- occurs after which week?
- characterized by what?
- cause?
- placenta characterization of woman with preeclampsia associated with what?
Phases of Delivery:
-Dilation/effacement- what is effacement, how is it measured, contraction time, average duration of phase
Descent/expulsion phase: size of cervix, duration of phase
Expulsion of placenta: what contracts, average duration
Placenta makes variety of hormones during pregnancy
-where are the peaks for HCG, progesterone, HPL, Estradiol
early progesterone from the corpus luteum, syncytiotrophoblast of placenta takes over eventually
estriol is most important during pregnancy, estradiol for non pregnant
Five major routes of milk secretion
- Secretory pathway
- what milk proteins are synthesized in er and sorted in golgi
- enzyme in lumen of golgi
- vesicle contents into where?
Relaxin
- produced by what three things?
- role during pregnancy?
- increased during labor for what reason?
Lipid pathway of milk components
- fats come from where?
- lipid droplets move to which membrane
- secretion of milk lipids
Four effects of suckling on hormone release
Progesterone and the window of activity
- what days
- how?
How are high estrogen and progesterone levels acheived in pregnancy?
- corpus luteum
- what happens at 8 weeks gestation?
Immunology:
-breast milk immunological contents
Fetus avoids high levels of hormones by its lack of?
placenta serves as a sink for what, which helps prevent masculization of female fetuses?
how does fetus reduce biological activity of intermediates
-what things are sulfated
Lactation:
During pregnancy how is it that PRL is so high but no lactation occurs.
what is colostrum and when does it develop?
Ruptured uterus:
- Spontaneous/traumatic
- risk factors
- signs symptoms
Contractions during pregnancy, onset of labor, during labor:
- most of pregnancy uterus undergoes periodic episodes of weak/slow contractions called?
- become very strong when? and are called labor contractions when what starts to happen?
- positive feedback of stretch?
what are the stages of labor? what physiological changes are associated?
Transceullular endocytosis/exocytosis components of milk:
maternal immunoglobulins?
how are they taken up?
Movement of products across the placenta:
- urea/creatinine, how
- lipid soluble steroids, how
- glucose, how
- aa, how
- vitamins/mineral how
LDL, antibodies, immunoglobulin G, how?
glut 1 for glucose
Maternal-placental-fetal unit
- what does fetus not have
- what does placenta not have
-
-fetus lacks 3b hsd, aromatase, cant produce estrogens. however it provides an important precursor for estriol (16 a OH DHEA-S), placenta lacks 17a hydoroxylase 17,20 desmolase
Lactation:
- fundamental secretory unit?
- lobules empty into what?, which expands into?
- each alveolus contains what type of cells?
Maternal response to pregnancy:
- progesterone affect on alveolar ventilation?
- progesterone affect on GI? (gastric empty time, sphincter tone, motility, dietary needs)
Hormones affecting the mammary gland during pregnancy/ breast feeding
Just before ovulation, the ovary is in the late follicular phase and makes high levels of what?
- estrogen promotes growth of what? induces expression of what>
- ultimately, estrogen induces?
Human Placental Lactogen
- produced in?
- similar to?
- how does it affect insulin?
- protein anabolic/lipolytic function
Mechanisms of ensuring adequate fetal oxygenation
- Fetal Hb vs adult
- CO of fetus
- Hb concentration late in preg
Fetal HPA axis:
- what produces CRH
- rapid release stimulates fetal production of what?
- what is positive feedback mechanism that occurs
- how does CRH affect uterus
Estrogen increases Oxytocin receptors in myometrial and what other tissue?
- what does oxytocin do?
- ferguson reflex
- does oxytocin initiate uterine contractions?
Prolonged labor:
- definition
- types
- main causes
Prolactin:
- actions on mammary glands?
- high levels of prolactin can cause?
- feedback system?
Gases moving across the placenta:
-diffusion of O2 from maternal blood into chorionic villi leads to what?
Oxytocin and lactation:
- what kind of effect on breast tissue?
- suckling feedback?
Paracellular pathway of milk components:
-which cells and fluids go through paracellular route
Two important functions of the amniotic fluid
serves as mechanical buffer, fetus excretes waste through it
Endocrine function of the placenta:
-syncytiotrophoblasts do what?
HCG is working analogous to LH.
Maternal blood flow:
- blood flows in what manner through spiral arteries towards the chorionic plate?
- maternal blood is traped in which space
- how does maternal blood drain, where does it go?
- **capillaries?
Fetal Station:
refers to what?
- what is presenting part?
- 0 station?
- presenting part numerical system (-) vs (+)
Cardiac output of mom and fetus during pregnancy
- when does BV start to increase, expand rapidly, and plateau?
- what percent increase
- what is mainly responsible for increase?
Transcellular salt and water transport mechanism of milk components:
-what generates osmotic gradient
Oxytocin affect on decidual cells
- role during second stage of labor
- role after the fetus has been expelled?
- why is this important
Partuition:
- why might uterus be “quiet” throughout pregnancy?
- timing after fertilization vs last menstrual period?
- obstetric definition of labor
