Pregnancy

Question 0

Maternal hormones

Answer 0

Prolactin
Relaxin
Oxytocin

Question 1

Placental hormones during pregnancy

Answer 1

Estrogens
Progesterone
hPL
hCG

Question 2

Role of estrogens

Answer 2

3 types
Produced by corpus luteum for 4-5wks
Taken over by placenta
- Increase protein synthesis in myometrium (hyperplasia and hyper trophy)
- increase blood flow to uterus (vasodilation)
- increase water in connective tissue
- initiates mammary duct and alveolar development
- increases prolactin secretion by pituitary gland
- initiation and maintainence of labour

Question 3

Progesterone during pregnancy

Answer 3

Produced by corpus luteum for 6-8 weeks under influence of hCG

• stimulates secretion of glycogen by endometrial glands
• decreases excitability of myometrium cells
• relaxes smooth muscle
• suppresses maternal immune response and prolactin

Question 4

Human placental lactogen (hPL)

Answer 4

Promotes maternal insulin resistance and mammary growth
Mobilises fatty acids
Accelerates AA transfer to foetus
Inhibits prolactin

Question 5

hCG

Answer 5

Prevents degeneration of corpus luteum
Stimulates corpus luteum to secrete progesterone and estrogen and foetal testosterone
Stimulates placental progesterone production
Suppresses maternal immune response and cervical ripening

Question 6

Prolactin

Answer 6

Pituitary gland
Promotes mammary growth
Stimulates alveoli to produce colostrum/milk

Question 7

Oxytocin

Answer 7

Hypothalamus
Involved in initiation of labour
Stimulates release of milk from alveolar/ducts

Question 8

Pregnancy changes to CV system

Answer 8

• Increased blood volume > increases SV > increased CO
• hyper coagulability
• Decreased TPR = BP remains stable

Question 9

Respiratory system changes

Answer 9

• Ribs flare as diaphragm is pushed up
• increased tidal volume + ventilation because of increased BMR
• increased levels of oxygen
• decreased levels of CO2: inc ventilation and inc CO2 sensitivity

Question 10

Renal system changes

Answer 10

• Inc renal blood flow and GFR
• increased re absorption of H2O and electrolytes
• increased excretion of urea, creatinin, calcium, glucose and protein
• relaxation of tract
• increased micturition

Question 11

Metabolic changes in early pregnancy

Answer 11

Increased insulin and peripheral use of glucose - inc glycogenesis
Increased fat storage (lypogenesis)
Increased protein synthesis and nitrogen retention (plasma AA levels reduced)

Question 12

Metabolic changes in late pregnancy

Answer 12

Increased insulin BUT insulin resistance 
- inc blood glucose transfer to foetus 
- inc glycogenesis
Increased fat breakdown (lypolysis)
Decreased nitrogen Excretion