Pregnancy

Question 1

What physiological changes occur in pregnancy

Answer 1

Nutrient metabolism, maternal physiology and anatomy

Question 2

Why do these physiological changes need to occur

Answer 2

Fetal growth and development, maintain maternal homeostasis and prepare for lactation

Question 3

What impacts nutrient metabolism in the mother

Answer 3

Placental hormone secretion

Question 4

What processes are involved in nutrient adjustment during pregnancy

Answer 4

Nutrient accretion in new tissue, nutrient deposition in maternal stores, nutrient redistribution among tissues and increased metabolic rate/turnover of nutrients

Question 5

What 2 processes facilitate the nutrient adjustment during pregnancy

Answer 5

Increased nutrient absorption in the intestine and decreased nutrient excretion in the intestine and/or kidney

Question 6

What drives nutrient adjustment

Answer 6

Hormones, placental transport (e.g. active transport of insulin), fetal demands and maternal nutrient supply

Question 7

What is metabolic programming

Answer 7

The metabolic adaptation of the foetus to maximise adulthood (reproduction age) survival based on experience in the womb, even at the expense of later life conditions

Question 8

What is the function of the corpus luteum

Answer 8

Produces hormones to maintain the pregnancy and influence metabolism

Question 9

What is they key hormone produced by the corpus luteum

Answer 9

Human chorionic Gonadotrophin (hCG)

Question 10

How does hCG concentration change during pregnancy

Answer 10

Rapid rise just days after implantation, peaks at 13weeks and then decreases

Question 11

What is the ‘first’ endocrine gland that supports early pregnancy

Answer 11

The corpus luteum

Question 12

What hormone is produced in correlation with increasing placental mass

Answer 12

Human placental lactogen (hPL)

Question 13

What is the function of hPL

Answer 13

Impacts carbohydrate and lipid metabolism

Question 14

Which hormones increase progressively throughout pregnancy

Answer 14

Oestrogens and progesterone

Question 15

What are the functions of oestrogens during pregnancy

Answer 15

Impacts mother, fetus and placenta by increasing level of binding hormones (increase in total hormone concentrations)

Question 16

What initially produces progesterone

Answer 16

The corpus luteum

Question 17

What produces progesterone in later pregnancy

Answer 17

The placenta

Question 18

What is the function of progesterone

Answer 18

Relaxes smooth muscle e.g. GI tract, urinary tract

Question 19

What are the changes in fat metabolism during pregnancy

Answer 19

Increase in TG, phospholipids, glycerol, fatty acids and cholesterol

Question 20

Explain how vitamin and mineral number increases but concentration decreases during pregnancy

Answer 20

Increase in plasma volume by 800mL

Question 21

Which serum nutrient concentration decreases

Answer 21

Albumin

Question 22

Why does BMR increase during pregnancy

Answer 22

Complex changes in protein metabolism in both fetus and mother (growth of placenta and fetus)

Question 23

How is the increased energy demand met by the mother

Answer 23

• changes in physical activity
• increased food consumption
• reduction in lipid synthesis and maternal fat storage in last trimester

Question 24

What are the two types of cells formed by placental trophoblasts

Answer 24

Synctiotrophoblasts and extravillous trophoblast

Question 25

What are the two main types of vascular remodelling during pregnancy

Answer 25

Main uterine arteries create vasodilators reserve and terminal spiral arteries direct blood to placenta

Question 26

What are syncytiotrophoblast cells

Answer 26

Multivillous, epithelial membranous structure that secretes hormones and growth factors (IGF, EGF etc.)

Question 27

What are extravillous trophoblast cells

Answer 27

Cells that invade uterine wall into lumen of endometrial blood vessels and invades interstitial tissue surrounding endometrial blood vessels

Question 28

What are the adaptations to the mother cardiovascular physiology

Answer 28

Increased HR, SV and blood volume, decreased vascular resistance and anti-coagulant changes

Question 29

What are the changes to the mothers respiratory physiology

Answer 29

Changes to thoracic wall and ribcage expansion during pregnancy so decreased total lung capacity, tidal volume increases and functional residual capacity decreases

Question 30

How does progesterone impact the respiratory physiology during pregnancy

Answer 30

Increases o2 consumption/ binding to haemoglobin

Question 31

What are the gastrointestinal changes during pregnancy

Answer 31

Relaxation of oesophagus, displacement of stomach, slower and heavier digestion and cravings

Question 32

What are the microbiomic and immune changes during pregnancy

Answer 32

Types of micro bacteria in gut changes during pregnancy and the types of WBC in the body change

Question 33

What are the changes in insulin sensitivity throughout pregnancy to promote fetal growth

Answer 33

Increased insulin sensitivity in early pregnancy and decreased insulin sensitivity in late pregnancy