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Nutr 337 > Placenta Metabolism > Flashcards

Placenta Metabolism Flashcards

1
Q

fastest growth of the placenta?

A

first half of pregnency (before the fetal growth spurt)

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2
Q

forms the fetal surface of the placenta

A

the chorionic plate

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3
Q

cytotrophoblasts

A

cells from the placenta that connect the mother and the fetus ( these cells attach to the uterus, and eventually evolve into tumor-like cells that invade the mothers uterus to establish blood flow to the fetus )

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4
Q

fetal and maternal placenta are anchored together by which type of cell

A

cytotrophoblasts

forming the cytotrophoblastic shell and anchoring villi

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5
Q

maternal blood is driven into the ________ spaces in funnel- shaped spurts

A

intervillous

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6
Q

major functioning unit of the placenta

A

the chorionic villus

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7
Q

IUGR infants have microscopically ___ _____ of the villi

A

less branching ( the branching creates more surface area and allows for more exchange of nutrients and wastes)

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8
Q

placenta functions

A 
metabolism 
transport
endocrine
hormone catabolism
nutrient storage
protection from xenobiotics
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9
Q

placenta metabolism

A

synth of compounds the fetus needs ( glycogen, lactate, CH )

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10
Q

how much glucose and oxygen dos the actual placenta use

A

50% oxygen and 65% glucose

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11
Q

the umbilical ____ carries oxygenated blood to the fetus

A

vein

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12
Q

what are the mechanism of transport of the placenta similar too?

A

similar to the intestine (active, facilitated, passive)

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13
Q

Passive Diffusion

A 
O2, Co2
FA
steroids
electrolytes
Fat sol vitamins
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14
Q

facilitated diffusion

A

sugar and long chain PUFA

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15
Q

active transport

A

amino acids and cations

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16
Q

solvent drag

A

electrolytes

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17
Q

what does maternal malnutrition lead to in pregnancy

A

reduced blood volume
inadequate cardiac output
decreased placenta blood flow
smaller placenta size–> reduced nutrient transfer–> fetal growth retardation

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18
Q

when does fetal weight more than double

A

3rd trimester ( last 10 weeks)

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19
Q

does placenta weight increase in the last 10 weeks ?

A

not as dramatically as fetus ( about 50%), it grew a lot before to prepare for the growth spurt. however the blood flow increases to compensate

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20
Q

last 4 weeks of gestation

A

progressive decline in amount of nutrients transferred/unit fetal body mass/ unit time

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21
Q

the decline in nutrient transferred in the last 4 weeks is partially responsible for what?

A

deceleration in fetal growth rate

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22
Q

FFA transport

A

partially passive but bc fetus replies on energy from fat and brain development so have facilitated diffusion with transporters (PUFA)

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23
Q

there is ____ transport of fat sol vitamin

A

poor

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24
Q

sugar transport

A

carrier-mediated facilitated diffusion - partially protective to hyperglycaemia bc max rate

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25
Q

hyperglycaemia in the mother

A

not in fetus bc protective mechanism with max rate in transporters

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26
Q

fetal size is proportional to ______ size

A

placenta

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27
Q

iron def on placenta and fetal status

A

iron def= low blood volume expansion= decreased cardiac output = decreased placental blood flow–> decreased growth

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28
Q

what would cause decreased uterine blood flow?

A

hypotension, renal disease and placenta infarction ( caused by and obstruction to the blood flow to placenta)

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29
Q

key nutrient for optimal placental development

A 
essentail FA
( blood flow and optimal function is closely related to eicosanoids, from essential FA's)
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30
Q

low concentrations of linoleum acid, arachidonic acid, DHA, were associated with

A

low birth weight

short gestation and small head circumference

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31
Q

EFA deficiencies cause

A

defect in placental integrity and function

  • needed for vasodilation and contractions
  • growth
  • brain
32
Q

explain the biomagnification of DHA in the human fetus

A

the fetal Brian gets the most

  • increasing order from maternal RBC to fetal cord blood to fetal liver to the brain
  • this is bc of a sensitive transfer from the maternal circulation
33
Q

DHA

A

better cognitive function in offspring

34
Q

brain is structurally?

A

a lipid rich organ

  • -> 50-60% of structural matter is lipid
  • using high amounts of DHA and arachidonic acid
35
Q

Endocrine functions of the placenta ( what 4 does it release?)

A

hCG
HCS
progesterone
estrogen

36
Q

hCG

A

maintains the corpus lute to secrete estrogen and progesterone

37
Q

HCS (human chorionic somatotrophin- or placenta lactogen )

A

produced in late gestation and influences fat and carb metabolism
- may be responsible for insulin resistance and carbohydrate intolerance observed in pregnancy

38
Q

progesterone larghi reduced by the ______ up until 10 weeks

A

corpus lutem

39
Q

after 10 weeks what takes over secreting progesterone

A

placenta

40
Q

what may be responsible for insulin resistance and carbohydrate intolerance observed in pregnancy

A

HCS ( placental lactogen)

41
Q

progesterone

A

suppresses contractility in the uterus smooth muscles to prevent early birth
- at the end of pregnancy with high levels of estrogen this is suppressed

42
Q

when is estrogen maximally secreted

A

end of pregnancy

43
Q

what does estrogen stimulate

A

myometrium growtth ( inner middle part of the uterus which contains lots of smooth muscles), antagonists myometrial- suppression by progesterone, and stimulates mammary gland development

44
Q

which hormones does the placenta metabolize (catabolize) into there inactive forms so that high levels don’t harm the fetus?

A

glucocorticoids (cortisol),
insulin,
thyroxin

45
Q

what happens to the hormones that are normally metabolized by placenta if the placenta doesn’t develop properly

A

harm to fetus

- example excess insulin may lead to excess fetal growth

46
Q

HCS breaks down what energy source for fuel

A

fat ( late in pregnancy )

47
Q

when do the majority of major physiological adaptations occur during pregnency

A

first half

48
Q

major physiological adaptations during pregnency

A

kidney - GFR increase and tubular reabsorption goes down –> more excretion of waste
stomach - heartburn, less histamine and pepsin
hemodilution
slower digestion- better absorption
lungs- increase ventilation
heart- increased cardiac output
altered plasma lipid and glucose profiles

49
Q

altered plasma lipid levels

A

increase in TG and CH –> want to conserve glucose

50
Q

altered plasma glucose levels

A

in third trimester fetus needs go way up, maternal blood glucose fall, however increase lipolysis and mild ketosis

51
Q

decreased muscle breakdown + increased placental uptake of alanine

A

low alanine availability–> so impaired hepatic gluconeogenesis
–> less alanine bc less muscle breakdown and more placenta uptakes of alanine

52
Q

anabolic phase

A

early ( first half of pregnency)
- increased storage of fat, CHO and protein

  • CHO stored as glycogen or converted to fat due to sharp rise in insulin
  • fats= converted to TG for fat stores
  • want to store more rather than use for energy ( so less lipolysis)
  • increase in maternal protein synthesis, particularly in the placenta and RBC
53
Q

anabolic stage CHO

A

CHO stored as glycogen or converted to fat due to sharp rise in insulin

54
Q

anabolic stage - fats

A

converted to TG for fat stores

- want to store more rather than use for energy ( so less lipolysis)

55
Q

anabolic stage- protein

A

increase in maternal protein synthesis, particularly in the placenta and RBC

56
Q

catabolic phase

A

fat mobilized to conserve glucose for the fetus

- increase in ketones and blood CH

57
Q

post-pran-di-al

A

during or relating to the period after dinner or lunch

58
Q

what happens to postprandial insulin levels in the catabolic stage?

A

insulin levels are blunted by estrogen, progesterone and placental lactogen –> which cause catabolism of maternal fat and glycogen and protein
- results in insulin resistance in the mother

59
Q

does the placenta rely on insulin for glucose uptake

A

no

60
Q

why do we want high catabolism in the second half of pregnancy?

A

what to break down fat, so that we can conserve glucose for the fetus

61
Q

blunted insuring response means?

A

increase in glucose (hyperglycaemia) so that more glucose will reach the placenta

62
Q

what % body fat should woman have before pregnancy?

A

22%

63
Q

average weight gain of ___%

A

12% , of which 40% = fetal, placenta and amniotic fluid

64
Q

if BMI >29, limit weight gain to ?

A

6kg

65
Q

adolescent mothers need to gain?

A

more weight

aim for 12.5-18kg

66
Q

twins

A

35-45lb regardless of pregnency weight

67
Q

20-27 BMI weight gain should be

A

11.5-16 kg (25-35 lb)

68
Q

patterns of weight gain

A

3-4lb for the first 10 weeks pregnenncy

then 1lb per week thereafter

69
Q

gaining over ___ /week raises concerns as it is probably due to edema

A

1 kg

70
Q

obligatory wt gain

A

fetus, placenta, increase blood volume, breast enlargement, enlarged uterine

71
Q

40% of energy needed for pregnency is deposited in the 1st ____ weeks

A

20 - in subcutaneous fat ( lower body - thighs)

72
Q

why does hematocrit decrease

A

hemodilution, more increase in volume than Hb

73
Q

fetal weight shows a ___ curve

A

S

- very little weight gain at the start, rapid weight gain, then tapers off right at the end

74
Q

preterm birth

A

before 37 weeks

75
Q

IUGR

A

intra-uterine growth retardation

- below 2 SD in weight for gestational age, or below 10%, or below 2500 g

Nutr 337 (10 decks)

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