Pregnancy

Question 1

At what stage can a fetus survive?

Answer 1

26 weeks without ICU, 22 with ICU.

Question 2

What risks are associated with the first trimester?

Answer 2

Miscarriage (1/3 of all pregnancies), Vulnerable to teratogens (worst in first but can occur in all trimesters). Physical development abnormalities including spina bifida and cleft pallet.

Question 3

What difines the three trimesters?

Answer 3

Maternal experience. eg 1st has morning sickness and altered emotions and appetite.

Question 4

What is the viability limit?

Answer 4

24 weeks

Question 5

what maternal changes occur in the second trimester?

Answer 5

Increased weight (baby goes from 50g–>1000g)
Increased blood volume
Increased blood clotting
Decreased blood pressure
Altered fluid balance and urinary frequency

Question 6

Which systems develope in the fetus mainly in the third trimester?

Answer 6

Brain
Immune
Lungs
Digestion

Question 7

What is the general rule for babies leaving NICU

Answer 7

When the baby has reached the age that would have been full term

Question 8

Define term

Answer 8

37-41 weeks after the first day of the mothers last period.

Question 9

What does the term conceptus include in its meaning

Answer 9

Everything that came from the zygote, eg embryo and placenta

Question 10

Which stage of pregnancy poses the greatest risk to the mother?

Answer 10

Third trimester.

Question 11

During what stages of pregnancy are the mothers immune system, hormone levels, emotions, appetite and brain function altered

Answer 11

From the first trimester onwards.

Question 12

What is the name for severe morning sickness?

Answer 12

Hyperemesis gravidarum

Question 13

What pattern do hCG levels follow during pregnancy?

Answer 13

Rise rapidly and reach a peak at 9 week and the rapidly decline once the placenta takes over hormonal control.

Question 14

Draw the graph of maternal endocrinology

Answer 14

google

Question 15

What is the function of the placenta

Answer 15

(BE SIC)
Biosythesis
Exchange (of nutrients and waste)
Separation (of maternal and fetal systems)
Immunoregulation (whole pregnancy)
Connection (anchors pregnancy in place)

Question 16

Describe the fetal side of the placenta.

Answer 16

Disk shaped, has the umbilical cord, Maternal blood vessels carrying nutrients to the fetus insert near the centre. Thin fetal membrane surrounds the disk.

Question 17

During what time period does the cytotrophoblast shell cover the conceptus?

Answer 17

From week 4 (post fertilisation) to 10 weeks gestation

Question 18

What is the name given to the units of tissue on the maternal side of the placenta?

Answer 18

Cotyledon

Question 19

What is the maternal decidua and how is it related to miscarriage

Answer 19

It is the maternal tissue in between the cotyledons. Failure of the placenta to fully attach the the maternal decidua can result in miscarriage due to the increased pressure caused by cytotrophblast shell break down and spiral arteries taking over causing the placenta to fully detach.

Question 20

Describe the stages of placental development.

Answer 20

Implantation of conceptus in endometrial epithelium
Trophoblast–> cytotrophoblasts (inner) and synctiotrophoblasts (outer)
Villi develop from ctb and anchoring by stb into endometrium
contact with maternal tissue. Lacunae in stb
hypertrophy of decidual glands
Villi go from primary-> secondary->teriary then invade the spiral arteries and remodel
Spiral arteries have cytotrophoblast plug breakdown.

Question 21

What is the role of decidula glands in pregnancy

Answer 21

Histotrophic nutrition for the first trimester

Question 22

Describe the remodelling of spiral arteries

Answer 22

Invasion of cytotrophoblasts
loss of smooth muscle means the arteries can no longer vasoconstrict.
Cytotrophoblastic shell breaks down gradually due to exposure to fetal and maternal blood.

Question 23

In what was is the placenta like the lungs?

Answer 23

Arterial system carries deoxygenated blood and the venus system carries oxygenated.

Question 24

What is the difference between a miscarriage and a still birth?

Answer 24

A misscarriage occurs <24 weeks so the baby was not viable
A still birth occurs >24 weeks. A baby born with no signs of life. It is often associated with labour and can happen at any gestational age

Question 25

What can indicate a risk of still brith.

Answer 25

Abnormal doppler scan or reduced/ no fetal movement.