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Histology and Physiology Reproduction System > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

day 14 of ovarian cycle =

A

ovulation (after LH surge)

after which… the uterine endometrium differentiates into functional tissue (secretory phase)

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2
Q

where does fertilization

A

ampulla of the fallopian tube

usually about one day after ovulation

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3
Q

when does implantation of blastocyst (60 cells) occur during uterine cycle

A

secretory phase of uterine cycle (day 21-24), about 6-7 after ovulation

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4
Q

blastocyst –> trophoblast

A

as the blastocyst differentiates, the trophoblast is formed by the outer cell layers that attach to the endometrium

tissue eventually becomes part of the placenta

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5
Q

2 layers of trophoblast and their function

A

differentiates into 2 layers…

  1. inner cytotrophoblast = produces cells that can become part of the syncytiotrophoblast
    - retains its ability to undergo mitosis, so it can continue to produce new cells
  2. outer syncytiotrophoblast
    - cannot undergo mitosis
    - consists of multinucleated cells produced by fusion of cells produced in the cytotrophoblast
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6
Q

Which layer of trophoblast sends finger like projections into epithelial layer of the uterus

A

the syncytiotrophoblast

invades the stromal layer of the endometrium

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7
Q

hCG

A

released by syncytiotrophoblast

functions similar to LH in that it rescues the corpus luteum

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8
Q

Decidual reaction

A

estrogen and progesterone produced by the corpus luteum induces the decidual reaction, in which….

the stromal cells of the uterine endometirum hypertrophy

stromal cells are not cigar shaped like they usually are, but are instead much larger

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9
Q

importance of the decidua

A

nutrient source for the embryo until the placental blood vessels develop to allow nutrient exchange between mother and fetus

in addition…

once implantation has occured, it provides a barrier to prevent the embryo from invading the uterine wall too much

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10
Q

endocrine function of decidua

A

Relaxin = functions to inhibit uterine contraction early in pregnancy and to soften the cervix before birth
(+) by hCG and occurs in the decidua, corpus luteum, and placenta

Prolactin = functions to decrease the mother’s immune response to the fetus

  • –> effect on mammary gland is inhibited by high esterogen and progesterone during pregenancy…then when these levels drop after birth, prolactin is effective in stimulating lactation
  • **produces small amounts of prolactin compared to maternal pituitary

Prostaglandins = produced late in pregnancy to cause contraction of the uterus and softening of the cervix

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11
Q

myometrium during pregnancy (general)

A

undergoes both hyperplasia and hypertrophy

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12
Q

placenta function (general)

A

a temporary endocrine organ

develops during pregnancy

produces and releases steroid and protein hormones designed to support pregnancy

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13
Q

regulations of placental hormones

A

are NOT regulated by maternal or fetal mechanisms

truly an independently functional endocrine organ

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14
Q

placenta develops by what?

A

develops by the invasion of the syncytiotrophoblast into the endometrium

where it comes into contact with maternal blood vessels

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15
Q

how are secondary villi formed

A

the extraembryonic mesoderm and cytotrophoblast grow into the syncytiotrophoblast

forming the secondary villi

**note: secondary villi do not contain blood vessels

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16
Q

after the secondary villi forms…

the cytotrophoblast grows past what…

A

grows past the syncytiotrophoblast

creating a cytotrophoblast shell around the entire embyro

tertiary villi develop that contain vessels of fetal circulation from the umbilical cord

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17
Q

difference between secondary and tertiary villi

A

tertiary have blood vessels

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18
Q

maternal portion of the placenta

A

decidua basalis, made from decidual cells…

contributes to the basal plate and the placental septa

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19
Q

fetal portion of the placenta

A

chorion

contributes the following components

  • cytotrophoblast
  • syncytiotrophoblast
  • extraembryonic mesoderm
  • fetal endothelial cells
  • chorionic plate
  • chorionic vili (both free and anchoring villi - anchored to maternal side)
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20
Q

placental barrier from maternal to fetal side

A

consists of…

syncytiotrophoblasts
cytotrophoblasts
connective tissue (extraembryonic mesoderm)
fetal endothelial cells

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21
Q

what substances CAN cross the placenta

A

any molecule less than 600 Daltons can freely diffuse

gases and nutrients (glucose, amino acids, and some proteins)

transferrin (carry iron to fetus)

steroid hormones

CO2 and other fetal waste material

maternal antibodies, mostly in the form of IgG: function to provide passive immunity to the baby

alcohol, some drugs, and some viruses

22
Q

where does placenta break off after birth

A

at the level of the decidua basalis

leaving the basal layer of the endometrium in place

23
Q

parallels between the HPA axis and the relationship between syncytiotrophoblast and cytotrophoblast

A

cytotrophoblasts are analogous to the hypothalamus

syncytiotrophoblast are analogous to the anterior pituitary gland

24
Q

hormones produced by the cytotrophoblast

A

IGF-1 and IGF-2 –> function to increase proliferation and differentiation

GnRH, CRH, TRH, and somatostatin –> act on the syncytiotrophoblast

25
Q

hormones produced by the syncytiotrophoblast

A

hCG

human chorionic ACTH

human placental GH

human chorionic thyrotropin (similar actions to TSH)

progesterone

estrogens

human chorionic somatomammotropin (hCS), aka human placental lactogen (hPL)

inhibin A

26
Q

actions of progesterone produced by the syncytiotrophoblasts

A

decreases the mother’s immune response to the fetus

produces precursor substances that fetal adrenal glands can use to produce needed hormones

inhibits uterine contractions

causes mammary gland development

**produced in placenta from maternal cholesterol

27
Q

what can progesterone NOT be converted to within the placenta

A

cannot be converted to androgens in the placenta, because the needed enzymes for those reactions are not present

28
Q

actions of estrogens produced by the syncytiotrophoblastss

A

= estriol, estradiol, and estrone

function to increase uterine SmM growth and mammary gland development

made using precursors by the fetal adrenal gland

29
Q

major estrogen produced during pregnancy

A

estriol

30
Q

actions of hCS (or hPL) produced by syncytiotrophoblasts

A

shunts nutrients preferentially to the fetus

31
Q

actions of inhibin A produced by syncytiotrophoblasts

A

functions to decrease maternal FSH

since you don’t need to stimulate follicle developement during pregnancy

32
Q

hCG progression in pregnancy

A

levels rise shortly after pregnancy occurs

remains at a high level throughout pregnancy

33
Q

progesterone progression in pregnancy

A

initially produced by the corpus luteum - which is being maintained by hCG

around the end of the 1st trimester, the placenta takes over progesterone production and levels rise significantly

34
Q

estrogens progression in pregnancy

A

rise significantly during pregnancy…throughout whole time

35
Q

hCS progression during pregnancy

A

increases throughout pregnancy

36
Q

prolactin progression during pregnancy

A

increases throughout pregnancy (mostly by maternal pituitary gland)

high progesterone and estrogen inhibit prolactin effects on the mammary gland until birth

37
Q

measuring fetal and placental health

A

estriol –> useful assay to determine fetal health

placental production of estriol is dependent on the precursors produced in the fetus

hCG = a hormone produced by the syncytiotrophoblasts of the placenta - used to determine placental health

38
Q

why are progesterone levels not the best way to determine placental or fetal health

A

it is also produced in small amounts by the corpus luteum of pregnancy (even after the 1st trimeseter)

39
Q

steroid contraceptives (the pill)

mechanism

A

function to inhibit the development of ovarian follicles and thus inhibit ovulation

presence of progesterone in these pills provides negative feedback on the hypothalamus –> reducing the pulse frequency of GnRH

also (-) FSH and LH release from anterior pituitary gland –> preventing follicles from developing

with no follicular development –> no large increase in estrogen –> no LH surge –> no ovulation

also increase viscosity of cervical mucosa

estrogen included in many of these pills stabilize the endometrium and prevents breakthrough bleeding - in addition to a role in inhibiting the development of ovarian follicles

40
Q

types of steroid contraceptives

A

combination estrogen-progestin
= constant concentrations over 21 day period followed by 7 day rest

phasic estrogen-progestin
= varying concentrations throughout the 21 day period and 7 days of placebo

progestin only = contant progesterone dose daily

41
Q

intrauterine contraceptive devices

A

prevent blastocyst implantation by altering the endometrial lining

some release progesterone, modifying the endometrial lining

42
Q

barrier methods

condoms, foam, and diaphragms

A

prevent fertilization by either interfering with the acess of sperm to the uterine cavity or destroying sperm in the vaginal cavity

43
Q

sterilization

A

surgically disrupt the continuity of the fallopian tubes

impairing access of the fertilized ovum to the uterine cavity and implantation

44
Q

abortive contraception

A

antiprogestin mifespristone produces an increase in prostaglandin F2-alpha synthesis

leading to expulsion of the embyro

45
Q

rhythm contraception

A

relies on changes in mucus thickness and body temperature throughout the mesntrual cycle

indicating a ‘safe’ period for intercourse

46
Q

fertility drugs (general)

A

stimulate the development of ovarian follicles and ovulation

prepare the endometrium for implantation of a blastocyst

47
Q

progesterone fertility drug

A

used when serum progesterone is low

48
Q

estrogen partial antagonists (Clomiphene)

A

stimulates GnRH

49
Q

gonadotropins (hMG) fertility drugs

A

literally made from LH and FSH extracted from the urine of post-menopausal women (because they have high levels)

50
Q

GnRH agonists

fertility drugs

A

allow control LH and FSH release, thus controlling the timing of ovulation

51
Q

GnRH antagonists fertility drugs

A

prevent LH and FSH release - thus controlling the timing of ovulation

52
Q

bromocriptine (dopamine agonist)

fertility drugs

A

decreases prolactin from the anterior pituitary

thus reducing the inhibitory effect high prolacitn levels have on estrogen

also decreases the inhibition of ovulation caused by high prolactin levels

Histology and Physiology Reproduction System (12 decks)

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