Pregnancy Flashcards
What hormone is used to detect pregnancy in a home pregnancy test?
hCG
What cells make hCG?
syncytiotrophoblasts
At what week do you have a early pregnancy assessment and dating ultrasound?
6wks
What is confirmed during an early pregancny assessment and dating ultrasound?
Location, # of embryos, heart beat, length of embryo.
What is visible in an early pregnancy assessment and dating ultrasound?
Yolk sac and embryo (5mm)
When is the first trimester screening for pregnancy?
12 weeks
What is tested/can be tested during the First trimester screening of preganancy?
ßhCG
PAPP-A (Pregnancy associated plasma protein A - growth promoting hormone in the placenta)
Fetal heart beat, size, nuchal translucency
Amniocentesis
Chorionic Villus Sampling (CVS) - CV tissue drawn through suction (vagina) or needle
Non-invasive prenatal testing (NIPT): measures cell free fetal DNA in mothers blood.
What are some chromosomal disorders which can be diagnosed at 12 weeks gestation?
Down syndrome
Turner syndrome
Edward syndrome
Patau syndrome
Which chromosome is abnormal in Down syndrome?
Trisomy 21: 47 chromosomes in each cell.
Which chromosome is abnormal in Turner syndrome?
Monosomy X: 45 chromosomes in each cell - missing a sex chromosome
Which chromosome is abnormal in Edward syndrome:
Trisomy 18: extra 18 Chromosome`
Which chromosome is abnormal in Patau syndrome?
Trisomy 13: extra 13 chromosome
What week of the gestation is the fetal anaotmy scan conducted?
20 Wks
What is determined at the fetal anatomy scan?
Heart beat, size, placenta position, volume of amniotic fluid, reviewing basic anatomy structures and blood floow.
Neural tube defects, heart and kidney problems, cleft lip.
Gender
How many preganacies in Austalia are unplanned?
50%`
What is considered a Low birth weight?
<2.5 kg
*Premature
What weight is considered small for gestational age?
<2.5kg full term
What are some risks associated with small for gestational age babies?
Problems with blood glucosecontrol, temperature regulation, growth and development
What is considered normal birth weight?
2.5- 4 kg
What is considered high birth weight?
<4kg
What are some risks associated with high birth weight babies?
Gestational diabees
delivery problems, obesity and diabetes.
When is there maximum amniotic fluid in the amniotic sac during gestation?
Wk 34
What are 4 factors that affect growth patterns of a fetus other than foetal genome?
Nutrition
Smoking and drug abuse
Matrnal size
Psychological factors
During what weeks is the maximum growth rate of a fetus?
30-36 wks
What is the counted as the beginning of the first trimester?
Counted from date of last menstrual period
What weeks of a pregnancy are considered the first trimester?
First 13 weeks
When is the embryonic period and what size is the foetus at the end of it?
Up to week 8 - 22mm long
When is the foetal period of gestation?
Week 9-38
When do most spontaneous abortions occur?
First trimester
What are the 2 layers of the bilaminar disc?
Epiblast and Hypoblast
What forms the amnion?
Formed from ectoderm, the upper part of the epiblast, dorsal layer of the embryonic disc
What is the amnion and its function?
Embryonic membrane that surround the embryo and is filled with amniotic fluid.
- Fluid from maternal blood
- Shock absorber
- Temperature regulator
- Prevents adhesion
What is the yolk sac formed from?
Formed from the endoderm plus trophoblasts, hypoblasts lower layer of embryonic disc.
What is the yolk sac the site of?
Early blood and blood vessel formation.
What forms the allantois?
Caudal end of the yolk sac, outpocketing of the hindgut (originaly yolk sac) plus mesodermal body stalk.
What is the allantois?
Structural base for umbilical cord - embryonic vessels of the placenta.
What is the chorion made from?
Outermost membrane, derived from trophoblast cells after implantation.
What is the chorion?
The embryonic part of the placenta.
What does the chorion secrete?
hCG
What forms the placenta?
Formed from trophoblastic chorion and allantois plus maternal endometrium.
Is there direct blood contact between other and fetus?
No
Oxygenated blood is taken to fetus heart via _____
One ubilical vein
Blood is returned to placenta from fetus via the ___
Two umbilical arteries
What has formed from the ectoderm at the end of the embryonic phase of gestation?
dermis, cartilages, bones, mesenchyme of urogenital organs
What has formed from the mesoderm at the end of the embryonic period of gestation?
epithelium of digestive, urogenital and respiratory systems, glandular parts of digestive tract
What weeks of gestation are considered the ‘seconds trimester’
13-24 weeks
What is transferred to the fetus in the last month of gestation?
Fat, iron and calcium
Changes and accomplishments of fetus at 8 weeks
Head as large as rest of body. All brain regions present. Urinary & GI tract development. All body systems – rudimentary form. Limbs present.
Changes and accomplishments of the fetus at 9-12 weeks
Body elongation. Brain continues to enlarge. Retina present. Liver prominent (secretes bile). External genitalia
Changes and accomplishents to the fetus at 13 - 16 weeks
Kidney structure. Blinking. Sucking motions. GI glands develop. Distinct bones and joints.
Changes and accomplishemnt of the fetus at 17–20 weeks
Vernix. Lanugo. Quickening/movement. Limbs reach final proportions
Changes and accomplishents of the fetus at 21-30 weeks
Eyes open. Myelination of spinal cord. Nails present. Bone marrow producing red blood cells. Testes reach scrotum.
Changes and accomplishments of the fetus at 30-40 weeks
Lungs functional. Lay down subcutaneous fat. Skin changes from red & wrinked, to smooth.
How much weight gain should a mother have in the 1st trimester?
0.9-1.8kg
How much weight gain should a mother have during the second and third trimester
0.5kg weekly
How much weight should a mother gain over an entire pregnancy?
11.5-16kg
If a mother is in a ‘low’ bmi category (<18.5) what are the increased risks?
Preterm delivery
LBW
If a mother is in a high or obese BMI category(25-29.9, >30), what are the associated risks?
Preterm delivery
High blood pressure
Gestational diabetes
Preeclampsia
Prolonged labour
Unplanned caesarean delivery
What are the uterine changes during pregnancy?
- myometrial growth
- hypertrophy of existing smooth muscle cells (50-500µm long)
- development of new muscle cells
- formation of collagen and extracellular matrix
- endometrial proliferation and angiogenesis
- fluid formation
What are the main discomforts of pregnancy during the 1st trimester?
Morning sickness.
Lifestyle changes, breast changes, urinary frequency, vaginal discharge and tiredness
What are the main discomforts of pregnancy during the 2nd trimester?
Most comfortable pregnancy period stretch marks, colostrum production, heartburn, indigestion, constipation, backache, increased urine production, increased tidal volume
What are the discomforts of pregnancy during the 3rd trimester?
A time of marked baby growth – expansion of mother’s abdomen, lordosis, relaxed pelvic ligaments (relaxin), charged emotion, anticipation and anxiety, “Braxton Hicks” contraction (false labour), haemorrhoids, lower limb oedema, water/blood content increase <40%, CO increase <40%.
How does hCG maintain the corpus luteum?
It prevents luteolysis
WHen is hCG no longer required during gestation?
After week 8
What kind of molecule if hCG?
Glycoprotein
When may an at home pregnancy test give a false negative in terms of hCG?
Before week 6 and after week 16
What is the main source of estrogen and progesterone at the beginning of pregnancy?
The corpus luteum
When is progesterone and oestrogen initially secreted by the placenta, and predominantly secreted by the placenta?
Initially at weeks 2-3, predominantly after weeks 4-5
When are ovaries no longer required for pregnancy?
Week 6
What are the functions of progesterone during pregnancy?
calms uterine smooth muscles
increases secretion of endometrial glands
induce breast development
tranquillises foetus (anaesthetic)
Placenta (trophoblasts) produces ____ and ___ from maternal cholesterol but not ____.
Foetal adrenals use placental steroids to make _____.
In turn, placenta converts foetal _____to ____, mainly ____.
Placenta (trophoblasts) produces pregnenolone and progesterone from maternal cholesterol but not acetate
Foetal adrenals use placental steroids to make androgen
In turn, placenta converts foetal androgen to oestrogen, mainly oestriol
What type of hormone is prolactin?
Pleiotrophic
What % homology does prolacti have with GH or placental lactogen?
40%
When does prolactin secretion peak during gestation?
week 25
What are the actions of prolacting in pregnancy?
promotes breast development
remains high in breast feeding mothers
promotes differentiation of glandular epithelium at the time of implantation
What is the alternative nam for Human placental lactogen (hPL)?
Human chorionic somatomammotrophin (hCS)
When is human placental lactogen initially secreted during preganancy and what secretes it?
Secreted from chorion, by the end of 1st trimester to replace hCG
When is the peak hPL secreted duing gestation?
Birth, levels continuously rise after week 6
What are the functions of human placental lactogen?
Preparatory action on mammary glands
Promotes foetal growth by stimulating aa uptake, DNA synthesis and IGF-1 production.
Insulin resistance in mother, glucose sparing by mother, she will utilise fat and protein more, leaving glucose for baby.
What is Human Chorionic thyrotropin and what is its function?
hCT is a glycoprotein from the placenta that is similar to TSH.
It increases maternal metabolism, increases parathyroid hormone and provides positive calcium balance for foetal bone development.
Why are closely spaced births dangerous?
Mothers need time to recover iron stores. Recover from birth trauma. Uterus needs to shrink and recover. Sleep. Mental Health.
What are the energy needs of a pregnant woman in the first trimester?
Balanced and adequate diet
What are the energy needs of a pregnant woman in the 2nd and 3rd trimester?
1400–1900 kJ/day
By how much does a pregnancy woman need to increase RDI of Vitamin B during pregnancy?
30%
By how much does a pregnancy woman need to increase RDI of Vitamin B6 during pregnancy?
45%
By how much does a pregnancy woman need to increase RDI of Folate during pregnancy?
50%
What does adequate intake of iodine prevent during pregnancy?
Prevents maternal goitre.
What are some important minerals needed for healthy bebe?
Zinc, selenium, Calcium, Iron, Iodine
What % of birth defects are genetic?
15-25%
What percent of birth defects are environmental?
10%
