Pregnancy and Lactation Flashcards
What is Polycystic ovary syndrome (PCOS)?
Endocrine disorder caused by elevated levels of androgens
What are some symptoms of PCOS?
Polycystic ovaries
acne
hirsutism
associated with type 11 diabetes and obesity
What are two medications for PCOS?
IVF
Oral contraceptives
What is preimplantation diagnostic (PID)?
Removal of one embryonic cell
Diagnosis of genetic defects by methods of molecular biology
What are some pros and cons of PID?
cons - design baby, eugenics
Pros - healthy embryos, fewer abortions
When does implantation occur?
Day 7
What happens to the trophoblast?
Become either syncytiotrophoblast (invade endometrium) or cytotrophoblast (stay surrounding the blasteocoel)
What is the mass origin of the epiblast and inner cell?
Hypoblast
What is the placenta?
Fetomaternal organ
What are the 2 components of the placenta?
Fetal part - develops from chorionic sac
Maternal part - derived from the endometrium
What are the 5 functions of the placenta?
Protection
Nutrition
Respiration
Excretion
Hormone production
What is the amnion?
Fetal membrane that surrounds the fetus - mechanical protection
What is the chorion?
Fetal membrane that is smooth and villous (discoid placenta)
What are 2 other fetal membranes?
Yolk sac
Allantois - drains fetal urinary bladder
What is diagnostic amniocentesis?
Sampling of amniotic fluid by needle insertion through abdominal wall and uterus
week 12
What is chronic villus sampling?
Biopsy of chorionic villi in week 7
What is the role of human chorionic gonadotropin (HCG)?
Persistence of the C.I (progesterone secretion)
Prevents menstruations
development of decidual cells
production of testosterone in fetal testes
What and when is HCG synthesised?
Syncytial trophoblast cells from day 9 with peak during 10-12
What is the role of estrogen?
Enlargement of uterus and breast ducts, external genitalia
relaxation of pelvic ligaments
What is estrogen synthesised by?
Syncytial trophoblast cells from androgenic steriod compounds
peak at end of pregnancy
What is the effect of progesterone?
Increase secretion and uterus before implantation
development of decidual cells
decreased contractility of pregnant uterus
When does luteolysis lead to abortion?
Between week 7 and 12
What is the effect of placental lactogen?
Development of breast
decreased insulin sensitivity/utilization of glucose in mother - more for fetus
release of FA in mother
promotion of fetal growth
What does placental lactogen secretion start?
From 5th week onwards
What is the effect of Relaxin?
Decreases uterine muscle contractility
Relaxation of ligaments of symphysis pubis
facilitates birth
What is relaxin synthesised by?
Placenta and Corpus luteum
What 2 events happen before paturition?
fetus, placenta and fetal membranes are expelled
labor - sequence of uterine contractions (dilation of cervix)
What is parturition induced by?
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
What are the 5 stages of labor?
Dilation of cervix
Expulsion
Placental seperation
Retained/adherent placenta
When does breast development start?
During puberty by estrogen
What occurs to the breast during pregnancy?
Final differentiation of duct system
growth of breasts due to increase of stroma and adipose tissue
What 6 hormones are involved with the growth of the ductal system?
Estrogen
GH
Prolactin
adrenal glucocorticoids
insulin
What hormone is involved with the development of the lobulealveolar system?
Progesterone
What hormone promotes the secretion of milk?
prolactin (anterior pituitary gland)
What causes a 10-20 fold surge in prolactin secretion?
Suckling
What is the first milk secretion called?
Colostrum
What 4 hormones support milk secretion?
GH
Cortisol
PTH
insulin
What is milk flow in the ductal system induced by?
Contraction of myoepithelial cells in alveoli
What hormone causes contraction of the myoepithelial cells?
Oxytocin
What is menopause?
Cessation of ovary function (ripening and release of oocytes + estrogen release)
12 months with no bleeding
What happens to hormone levels during menopause?
Low AMH
High FSH
What are menopause symptoms?
Hot flushes
night sweats
vaginal dryness
incontinences
osteoporosis
depression
What is treatment for menopause?
Hormone replacement
plant estrogen
herbal drugs
