pregnancy Flashcards
how are Nutritional Status and Pre-pregnancy Weight an Important influence on pregnancy outcome :
Pre-pregnancy Weight:
- Underweightwomen(BMI<18.5kg/m2)
- ↑ risk to deliver low-birth-weight infant (LBW)
- Overweightwomen(BMI>25kg/m2)
- ↑ prevalence of obesity
- ↑riskofhealthcomplicationsforbaby&mother
Nutritional status
• Maternalvitaminstatus→maindeterminantofstatusin
neonates.
factor affecting Infant Birthweight
• Low-birth weight (LBW): higher risk of serious health complications, including neonatal mortality.
Pre-term birth < 37 Weeks → caused by early birth; correction is often possible (catch up growth)
Small for Gestational Age (SGA) > 37 wks caused by poor nutrition during pregnancy
• Higher risk of permanent damage and/or serious health problems
• Largeforgestationalage(LGA)
Often caused by obesity or diabetes of the mother during a pregnancy
Associated with increased risk of type 2-diabetes and other healthproblems later in life (e.g. ↑ risk of obesity)
what is the Placenta
A dynamic organ consisting of maternal blood and fetal blood circulating side by side, but separated by a membrane.
functions of the placenta
Functions of the Placenta
A dynamic organ consisting of maternal blood and fetal blood circulating side by side, but separated by a membrane.
Main functions:
- nutrient exchange, respiration & excretion between mother and fetus.
- Endocrine function: production of hormones for regulation of fetal growth and development.
- Signalling of maternal metabolic changes, i.e. utilization of nutrients
- Promotes the supply of nutrients → fetus
- Passive immunity-Some antibodies (Ig G) pass through the placenta
what does the umbilical vein do?
delivers o2 and nutrients to the baby
what does the umbilical artery do
removes co2 and wasteproducts from the baby
what are the following:
SynT
VCTB
iCTB
AV
FV
SynT : syncytiotrophoblast, SynT:
VCTB: villi cytotrophoblasts
iCTB: invasive cytotrophoblasts
AV: anchoring villi
FV: (floating villi )part of fetal (vascular) endothelium, FV
nutrients must cross 2 membranes what are they
1. SynT : syncytiotrophoblast, SynT:
1 barrier, consists of 2 plasma membranes
OUT: microvillous membrane (MVM), in contact with maternal blood pools
IN: basal plasma membrane (BM), oriented toward the fetal circulation.
2. fetal capillary epithelium
how are fats delivered?
Extracellular lipases release fatty acids from maternal lipoproteins
FATPs (fatty acid transport proteins) → integral membrane proteins, different types, e.g. role of cellular uptake of LCPUFAs
FABPs fatty-acid binding proteins → in cytosol of placenta;
guide FAs to sites within the cell for:
- esterification,
- β-oxidation or
- transfer to fetus
how are AA delivered?
Amino Acids
levels of AA fetus are higher AA mother (active transport)
2 main types: accumulative transporters and exchangers; present at
MVM and BM (but more at MVM)
- selective transfer of AAs,
- Metabolism of AAs to other AAs; and also foetal synthesis
what are GLUTs
Glucose transporters
what in summary are the placental requirements for a good outcome?
A well-developed placenta=
- good Weight, good available surface area
- transfer of essential macronutrients: Glucose, AA, FFAs and cholesterol
- Nutrient Transporters → correct Number, density, distribution
- good Blood flow (utero- and feto)
what happens to maternal blood haemoglobin during pregnancy
Blood Volume Expansion, Dilution Effects
A greater increase in plasma volume compared with red-blood cells
→ Dilution of plasma proteins and hemoglobin
↓ concentrations of water- soluble vitamins
FIGURE:
Increased total hemoglobin but becasue of blood plasma increase
Reduced hemoglobin concentration Iron deficiency Anaemia <11 g/dl
↓ blood viscosity → Improved nutrient exchange at the placenta
