Physiology of the Placenta and Pregnancy

Question 1

Special group of cells within the hollow, fluid-filled blastocyst

Answer 1

inner cell mass

Question 2

Cells that form the outer surface of the blastocyst

Answer 2

trophoblast cells

Question 3

What day does the trophoblast invade the endometrium and implantation occur?

Answer 3

day 7

Question 4

mononucleated cells that form the inner layer of trophoblast (Langhans cell layer)

Answer 4

cytotrophoblast

Question 5

outer multinucleated zone of trophoblast without distinct cell boundaries: This forms chorionic villi and the two umbilical arteries and the single umbilical vein

Answer 5

Syncytiotrophoblast

Question 6

What are the metabolic functions of the placenta?

Answer 6

glycogen and cholesterol synthesis. removal of lactate and other waste products

Question 7

one of the primary endocrine mediators of parturition and possibly also of fetal development

Answer 7

Placental corticotropin-releasing hormone (CRH)

Question 8

replaces pituitary GH during pregnancy

Answer 8

Insulin-like human placental GH (hPGH)

Question 9

hormone that maintains a non-contractile uterus, anti-inflammatory and immunosuppressive

Answer 9

progesterone

Question 10

steroid hormones that play a crucial role in regulating organ development and fetal maturation

Answer 10

glucocorticoids

Question 11

hormone that is responsible for enlargement of the uterus, breasts, external genitalia as well as relaxation of the pelvic ligaments

Answer 11

estrogen

Question 12

Normal opthalmic changes with pregnancy

Answer 12

cornea thickens and intraocular pressure decreases

Question 13

choroidal vascular insufficiency caused by toxemia of pregnancy can lead to what ocular emergency?

Answer 13

secondary retinal detachments

Question 14

Dental change associated with pregnancy due to hormonal changes softening the tissues in the mouth contributing to bleeding or inflammation.

Answer 14

gingivitis

Question 15

a hyperplastic lesion in the mouth composed mainly of capillary vessels and endothelial proliferation. referred to as “pregnancy tumor.”

Answer 15

Epulis

Question 16

Result of decreased esophageal sphincter tone during pregnancy

Answer 16

GERD

Question 17

Timeframe for morning sickness (nausea gravidarum)

Answer 17

first month to 16 weeks

Question 18

caused by rapidly rising serum levels of hormones such as HCG and estrogen

Answer 18

Hyperemesis gravidarum

Question 19

Sex hormone that reduces ureteral tone and peristalsis predisposing pregnant women to UTIs and pyelonephritis

Answer 19

progesterone

Question 20

What must be a part of management for any pregnant woman with pyelonephritis?

Answer 20

admission to the hospital

Question 21

Changes to urinary bladder in pregnancy

Answer 21

progesterone relaxes muscular wall, edema/hypermia of mucosa, and decreased capacity due to enlarged uterus

Question 22

What is the increase in renal blood flow and glomerular filtration by mid trimester and plasma volume?

Answer 22

40-50%

Question 23

What happens to Cr, BUN, and uric acid levels during pregnancy?

Answer 23

Cr drops 0.4-0.5 mg/dL. Decreased BUN and uric acid

Question 24

Responsible for respiratory alkalosis that is compensated for by renal excretion of bicarb

Answer 24

hyperventilation

Question 25

common in normal pregnant women and perhaps is beneficial as the decrease in viscosity may help with perfusion

Answer 25

anemia

Question 26

T/F The amount of iron absorbed from diet plus stored iron is insufficient to meet the requirements of pregnancy

Answer 26

true

Question 27

When you should a woman begin taking a multivitamin with folic acid and oral iron supplements?

Answer 27

6 months before conception

Question 28

Change in blood pressure associated with pregnancy?

Answer 28

systolic BP decreases 10 mmHg and diastolic decreases 15 mmHg

Question 29

Interferes with absorption of iron so supplements that contain this should be taken at different time

Answer 29

magnesium

Question 30

Normal cardiovascular changes in pregnancy include all of the following EXCEPT: muscle mass of heart increase, heart shifts to left, apical pulse moves to 4th intercostal space, softer heart sounds, and wie split S1 and S2 by 3rd trimester

Answer 30

heart sounds become louder not softer

Question 31

can occur in women in the second half of pregnancy due to compression of the aorta and inferior vena cava by the gravid uterus. results in a decrease in cardiac output with effects ranging from transient asymptomatic hypotension to cardiovascular collapse.

Answer 31

Supine Hypotensive Syndrome

Question 32

Occur during pregnancy due to increases in clotting factors, decreases in protein S and inhibition of fibrinolysis

Answer 32

hypercoagulable state

Question 33

Effect of estrogen on upper respiratory tract

Answer 33

increased phagocytic activity leading to nasal congestion

Question 34

Hormone that stimulates respiratory drive, increases minute ventilation w/out change in resp. rate.

Answer 34

progesterone

Question 35

Average weight gain during pregnancy

Answer 35

20-40lb

Question 36

Why are pregnant women less sensitive to the action of ADH?

Answer 36

clearance is increased from week 10-mid pregnancy due to vasopressinase produced by the placenta

Question 37

Effect of maternal hyperglycemia and DM on the developing embryo

Answer 37

birth defects

Question 38

Molecules that the placenta is impermeable to

Answer 38

large lipids

Question 39

Provide maternal fuel

Answer 39

high triglycerides

Question 40

Normal finding in many pregnant women due to increased water retention

Answer 40

edema

Question 41

most common pregnancy related dermatosis

Answer 41

Pruritic Urticarial Papules and Plaques

Question 42

triggered by rapid decline in progesterone and elevated levels of prolactin, cortisol, and insulin

Answer 42

milk production after delivery

Question 43

Levels of most cytokines are depressed during this period which is important to sustain fetus

Answer 43

initial 20 wks

Question 44

A layer of fibrin between the boundary zone of compact endometrium and the cytotrophoblastic shell in the placenta. Allows separation of placenta after delivery

Answer 44

Nitabuch's layer