Pregnancy

Question 1

what is the chorionic membrane made up of

Answer 1

cytotrophoblast and syncytitrophoblast

Question 2

which part of the trophoblast allows for implantation

Answer 2

syncytiotrophoblast as this contains specialised receptors to allow for initial contact and to enter the endometrium

Question 3

when and where does implantation occur

Answer 3

day 6 on the superior, posterior uterine wall

Question 4

what is an ectopic pregnancy

Answer 4

where implantation occurs anywhere other than the uterine body

Question 5

where do ectopic pregnancies most commonly occur

Answer 5

Fallopian tubes

Question 6

what is placenta praevia

Answer 6

where implantation occurs over the internal os

Question 7

how many umbilical arteries are there and what do they carry

Answer 7

2 carrying deoxygenated blood from the foetus to the placenta

Question 8

how many umbilical veins are there and what do they carry

Answer 8

1 carrying oxygenated blood from the placenta to the foetus

Question 9

what is the decidua

Answer 9

the modified endometrium which controls the invasion of the embryo into the endometrium

Question 10

what is the decidua like in pre-eclampsia

Answer 10

sub-optimal therefore doesn’t allow full implantation of the embryo

Question 11

what cardiovascular changes are seen in a pregnant woman

Answer 11

varicose veins and oedema - due to increased IVC pressure from compression
bp may decrease slightly
hypertrophy of heart, heart murmur

Question 12

what may cause a decrease in bp in pregnancy

Answer 12

progesterone causing vasodilation

Question 13

what happens to calcium metabolism during pregnancy

Answer 13

placenta produces DHCC which increases calcium absorption to pass to the foetus to help bone development

Question 14

what steroid hormones are produced by the placenta

Answer 14

oestrogen and progesterone

Question 15

when does the placenta start producing steers hormones

Answer 15

about 11 weeks

Question 16

how does inhibin prevent a further pregnancy

Answer 16

inhibits FSH so follicle maturation can’t occur

Question 17

what affects does progesterone have

Answer 17

vasodilator

increases appetite

Question 18

why is an increase in appetite advantageous in pregnancy

Answer 18

to increase fat stores to supply foetus when its more metabolically active and for use of fatty acids for respiration for the mother

Question 19

what protein hormones does the placenta produce

Answer 19

hCG
hCS
hCT
hCC

Question 20

what does hCG do

Answer 20

supports corpus leutum until placenta takes over hormone production

Question 21

where is hCG produced

Answer 21

syncytiotrophoblast

Question 22

what does hCS stand for

Answer 22

human chorionic somatomammotrophin

Question 23

what does hCS do

Answer 23

decreases the mothers sensitivity to insulin so there is more glucose circulating in her blood so more glucose to diffuse across the placenta

Question 24

what structures in the placenta allow for maximising exchange

Answer 24

villi in the cotyledons

Question 25

what are cotyledons

Answer 25

areas where both maternal tissue and fatal villi are found and so where exchange occurs

Question 26

what happens to the placenta membrane as the foetus grows

Answer 26

it gets thinner - decreasing the diffusion gradient

Question 27

what do the cytotrophoblast do

Answer 27

develop into the syncytiotrophoblast is there are holes/gaps in this layer

Question 28

how is passive immunity achieved through the placenta

Answer 28

IgG can diffuse through the placenta to supply the foetus

Question 29

what is teratogenesis

Answer 29

when normal development of the fetus is altered

Question 30

what are teratogens

Answer 30

agents which influence/alter normal development of the fetus

Question 31

give some examples of teratogens

Answer 31

alcohol, thalidomide, warfarin, ACE inhibitors, smoking

Question 32

when is the most sensitive period for the effect of teratogens

Answer 32

embryonic period (2-8 weeks)

Question 33

what is a molar pregnancy

Answer 33

where there is overgrowth of the trophoblast and so implantation can go all the way through the uterus and it can spread into the blood

Question 34

what is choriocarcinoma

Answer 34

malignancy of the chorionic membrane

Question 35

what does gestational diabetes cause

Answer 35

an increase in glucose in the child

Question 36

what effects will the child have due to gestational diabetes

Answer 36

larger hyperplasia of B cells in pancreas sue to increase in insulin production increase in glycogen stores in the liver reparatory distress syndrome

Question 37

why can babies born to mothers which gestational diabetes have respiratory distress syndrome

Answer 37

as they have a premature birth so didn't have enough time to produce surfactant

Question 38

why are babies born to mothers with gestational diabetes hypoglycaemic at birth

Answer 38

as they suddenly have their glucose supply dropped and it takes times for their feedback mechanisms to fix this as hey haven't been needed before

Question 39

what is physiological anaemia in pregnancy

Answer 39

where there is an increase in plasma volume but not RBC mass and so there is a decrease in the haematocrit

Question 40

why does the plasma vol of blood increase but RBC mass does not in pregnancy

Answer 40

as the nutrients the baby needs are in the plasma where as they don't have a big required for oxygen

Question 41

what affects can the baby have if the mother has severe anaemia

Answer 41

underdeveloped, still birth, growth retardation

Question 42

what causes pre-eclampsia

Answer 42

the embryo does not implant into the endometrium fully and so the needs to the foetus can't be met - therefore the mother increases blood flow to the placenta to try and combat this

Question 43

what signs/symptoms will a women with pre-eclampsia have

Answer 43

protein in the urine high blood pressure decrease in kidney and liver function oedema (pitting)

Question 44

what is eclampsia

Answer 44

life threatening seizures

Question 45

what changes occur in the reflexes of a mother with pre-eclampsia

Answer 45

the increased blood flow causes more activity of the reflexes

Question 46

what eye changes will occur in pre-eclampsia

Answer 46

double vision, blurry, blindness - due to ischamia to the back of the eyes