Pregnancy and Lactation

Question 1

What is Polycystic ovary syndrome (PCOS)?

Answer 1

Endocrine disorder caused by elevated levels of androgens

Question 2

What are some symptoms of PCOS?

Answer 2

Polycystic ovaries
acne
hirsutism
associated with type 11 diabetes and obesity

Question 3

What are two medications for PCOS?

Answer 3

IVF
Oral contraceptives

Question 4

What is preimplantation diagnostic (PID)?

Answer 4

Removal of one embryonic cell
Diagnosis of genetic defects by methods of molecular biology

Question 5

What are some pros and cons of PID?

Answer 5

cons - design baby, eugenics
Pros - healthy embryos, fewer abortions

Question 6

When does implantation occur?

Answer 6

Day 7

Question 7

What happens to the trophoblast?

Answer 7

Become either syncytiotrophoblast (invade endometrium) or cytotrophoblast (stay surrounding the blasteocoel)

Question 8

What is the mass origin of the epiblast and inner cell?

Answer 8

Hypoblast

Question 9

What is the placenta?

Answer 9

Fetomaternal organ

Question 10

What are the 2 components of the placenta?

Answer 10

Fetal part - develops from chorionic sac
Maternal part - derived from the endometrium

Question 11

What are the 5 functions of the placenta?

Answer 11

Protection
Nutrition
Respiration
Excretion
Hormone production

Question 12

What is the amnion?

Answer 12

Fetal membrane that surrounds the fetus - mechanical protection

Question 13

What is the chorion?

Answer 13

Fetal membrane that is smooth and villous (discoid placenta)

Question 14

What are 2 other fetal membranes?

Answer 14

Yolk sac
Allantois - drains fetal urinary bladder

Question 15

What is diagnostic amniocentesis?

Answer 15

Sampling of amniotic fluid by needle insertion through abdominal wall and uterus
week 12

Question 16

What is chronic villus sampling?

Answer 16

Biopsy of chorionic villi in week 7

Question 17

What is the role of human chorionic gonadotropin (HCG)?

Answer 17

Persistence of the C.I (progesterone secretion)
Prevents menstruations
development of decidual cells
production of testosterone in fetal testes

Question 18

What and when is HCG synthesised?

Answer 18

Syncytial trophoblast cells from day 9 with peak during 10-12

Question 19

What is the role of estrogen?

Answer 19

Enlargement of uterus and breast ducts, external genitalia
relaxation of pelvic ligaments

Question 20

What is estrogen synthesised by?

Answer 20

Syncytial trophoblast cells from androgenic steriod compounds
peak at end of pregnancy

Question 21

What is the effect of progesterone?

Answer 21

Increase secretion and uterus before implantation
development of decidual cells
decreased contractility of pregnant uterus

Question 22

When does luteolysis lead to abortion?

Answer 22

Between week 7 and 12

Question 23

What is the effect of placental lactogen?

Answer 23

Development of breast
decreased insulin sensitivity/utilization of glucose in mother - more for fetus
release of FA in mother
promotion of fetal growth

Question 24

What does placental lactogen secretion start?

Answer 24

From 5th week onwards

Question 25

What is the effect of Relaxin?

Answer 25

Decreases uterine muscle contractility Relaxation of ligaments of symphysis pubis facilitates birth

Question 26

What is relaxin synthesised by?

Answer 26

Placenta and Corpus luteum

Question 27

What 2 events happen before paturition?

Answer 27

fetus, placenta and fetal membranes are expelled labor - sequence of uterine contractions (dilation of cervix)

Question 28

What is parturition induced by?

Answer 28

Hormonal cascade: fetal hypothalamus - CRH fetal pituitary gland - ACTH adrenal cortex - cortisol stimulates estrogen production in placenta release of prostaglandins - unterine contractions, sensitizing cells for oxytocin maternal pituitary gland - oxytocin

Question 29

What are the 5 stages of labor?

Answer 29

Dilation of cervix Expulsion Placental seperation Retained/adherent placenta

Question 30

When does breast development start?

Answer 30

During puberty by estrogen

Question 31

What occurs to the breast during pregnancy?

Answer 31

Final differentiation of duct system growth of breasts due to increase of stroma and adipose tissue

Question 32

What 6 hormones are involved with the growth of the ductal system?

Answer 32

Estrogen GH Prolactin adrenal glucocorticoids insulin

Question 33

What hormone is involved with the development of the lobulealveolar system?

Answer 33

Progesterone

Question 34

What hormone promotes the secretion of milk?

Answer 34

prolactin (anterior pituitary gland)

Question 35

What causes a 10-20 fold surge in prolactin secretion?

Answer 35

Suckling

Question 36

What is the first milk secretion called?

Answer 36

Colostrum

Question 37

What 4 hormones support milk secretion?

Answer 37

GH Cortisol PTH insulin

Question 38

What is milk flow in the ductal system induced by?

Answer 38

Contraction of myoepithelial cells in alveoli

Question 39

What hormone causes contraction of the myoepithelial cells?

Answer 39

Oxytocin

Question 40

What is menopause?

Answer 40

Cessation of ovary function (ripening and release of oocytes + estrogen release) 12 months with no bleeding

Question 41

What happens to hormone levels during menopause?

Answer 41

Low AMH High FSH

Question 42

What are menopause symptoms?

Answer 42

Hot flushes night sweats vaginal dryness incontinences osteoporosis depression

Question 43

What is treatment for menopause?

Answer 43

Hormone replacement plant estrogen herbal drugs