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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
hormones produced by the syncytiotrophoblast
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
actions of progesterone produced by the syncytiotrophoblasts
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
what can progesterone NOT be converted to within the placenta
cannot be converted to androgens in the placenta, because the needed enzymes for those reactions are not present
28
actions of estrogens produced by the syncytiotrophoblastss
= estriol, estradiol, and estrone function to increase uterine SmM growth and mammary gland development made using precursors by the fetal adrenal gland
29
major estrogen produced during pregnancy
estriol
30
actions of hCS (or hPL) produced by syncytiotrophoblasts
shunts nutrients preferentially to the fetus
31
actions of inhibin A produced by syncytiotrophoblasts
functions to decrease maternal FSH since you don't need to stimulate follicle developement during pregnancy
32
hCG progression in pregnancy
levels rise shortly after pregnancy occurs remains at a high level throughout pregnancy
33
progesterone progression in pregnancy
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
estrogens progression in pregnancy
rise significantly during pregnancy...throughout whole time
35
hCS progression during pregnancy
increases throughout pregnancy
36
prolactin progression during pregnancy
increases throughout pregnancy (mostly by maternal pituitary gland) high progesterone and estrogen inhibit prolactin effects on the mammary gland until birth
37
measuring fetal and placental health
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
why are progesterone levels not the best way to determine placental or fetal health
it is also produced in small amounts by the corpus luteum of pregnancy (even after the 1st trimeseter)
39
steroid contraceptives (the pill) mechanism
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
types of steroid contraceptives
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
intrauterine contraceptive devices
prevent blastocyst implantation by altering the endometrial lining some release progesterone, modifying the endometrial lining
42
barrier methods condoms, foam, and diaphragms
prevent fertilization by either interfering with the acess of sperm to the uterine cavity or destroying sperm in the vaginal cavity
43
sterilization
surgically disrupt the continuity of the fallopian tubes impairing access of the fertilized ovum to the uterine cavity and implantation
44
abortive contraception
antiprogestin mifespristone produces an increase in prostaglandin F2-alpha synthesis leading to expulsion of the embyro
45
rhythm contraception
relies on changes in mucus thickness and body temperature throughout the mesntrual cycle indicating a 'safe' period for intercourse
46
fertility drugs (general)
stimulate the development of ovarian follicles and ovulation prepare the endometrium for implantation of a blastocyst
47
progesterone fertility drug
used when serum progesterone is low
48
estrogen partial antagonists (Clomiphene)
stimulates GnRH
49
gonadotropins (hMG) fertility drugs
literally made from LH and FSH extracted from the urine of post-menopausal women (because they have high levels)
50
GnRH agonists fertility drugs
allow control LH and FSH release, thus controlling the timing of ovulation
51
GnRH antagonists fertility drugs
prevent LH and FSH release - thus controlling the timing of ovulation
52
bromocriptine (dopamine agonist) fertility drugs
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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