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Endocrine/Repro > Pregnancy Diagnosis and Maintenance > Flashcards

Pregnancy Diagnosis and Maintenance Flashcards

1
Q

what is a MUST for pregnancy maintenance in all species?

A

maintaining appropriate concentrations of progesterone! (must be greater than 2ng/mL)

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2
Q

list progesterone’s 4 roles in pregnancy

A
  1. stimulates endometrial gland production of histiotroph
  2. prevents uterine contractions
  3. keeps cervix closed
  4. immunomodulatory
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3
Q

describe how progesterone stimulates endometrial gland function (3)

A
  1. in response endometrial glands produce uterine milk (histiotroph)
  2. histiotroph is extracellular material derived from endometrium and uterine glands that accumulates in the space between maternal and fetal tissues
  3. absorption by phagocytosis by the trophectoderm of the blastocyst and later by the trophoblast of the placenta or endoderm of yolk sac provides histiotrophic nutrition to the embryo and later on the fetus
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4
Q

describe how progesterone prevents uterine contractions

A

maintains quiescence to prevent premature labor

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5
Q

describe how progesterone maintains the cervix “closed”

A
  1. prevents relaxation, maintains tone
  2. increases secretions to “plug” the cervix
  3. prevents ascending infection of the uterus and placenta
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6
Q

what is the initial source of progesterone in ALL species?

A

the corpus luteum

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7
Q

in what species is the CL the ONLY source of progesterone throughout pregnancy?

A

goat, pig, dog

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8
Q

in what species does the placenta take over progesterone production AND the CL regresses?

A

horse, sheep

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9
Q

describe the sources of progesterone during bovine pregnancy

A

the CL is maintained throughout gestation, but the placenta does take over progesterone production halfway through pregnancy

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10
Q

describe the relationship between progesterone and prolactin in dogs (5)

A
  1. CLs are the only source of progesterone BUT
  2. the progesterone profile is similar between non-pregnant dogs in diestrus and pregnant dogs BUT
  3. CLs need luteotrophic support of prolactin after 30 days post-ovulation (prolactin is both luteotrophic AND lactogenic! SO
  4. progesterone CANNOT be used to diagnose pregnancy is dogs AND
  5. treatment with dopamine agonists (dopamine inhibits prolactin) after day 30 of dog pregnancy can cause pregnancy termination
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11
Q

can serum progesterone levels be used for anything in dogs?

A

yes! can be used to predict parturition and fetal readiness for birth in the dog

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12
Q

how is abortion accomplished in sheep and cows? (2)

A
  1. treatment with PGF2a until day 150 (cows) or day 50 (sheep) results in pregnancy termination by lysing CL
  2. afterwards, dexamethasone is used to decrease placental progesterone production
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13
Q

describe equine sources of progesterone and progestagens (6); what does this mean in terms of maintenance of pregnancy?

A
  1. embryonic cells invade the endometrium and form endometrial cups
  2. cups secrete eCG, which has LH activity (will stimulate follicles to either ovulate or just straight up luteinize)
  3. eCG induces formation of supplementary CLs that support progesterone production
  4. cholesterol from maternal circulation enters fetal adrenal glands and is converted to pregnelone, which is converted to progesterone in fetal adrenals and then in the placenta is converted to 5a pregnane
  5. 5a pregnane is a progestagen, which is a steroid hormone that binds to progesterone receptors and functions similar to progesterone
  6. after day 120, progestagens produced by the feto-placental unit replace ovarian progesterone to maintain pregnancy

this means that both a live foal and a functional placenta are needed for progestagen production and maintenance of pregnancy! total progestagen concentration indicates feto-placental wellbeing and you will rarely see mummified foals

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14
Q

describe relative concentrations of estrogen and progesterone throughout pregnancy (4)

A
  1. progesterone remains elevated throughout pregnancy
  2. BUT progesterone must decrease to allow parturition to begin so
  3. progesterone decreases sharply prior to parturition in most species along with
  4. a simultaneous increase in total estrogens
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15
Q

describe the role of estrogen during pregnancy; generally and then 5 specific functions for the overall goals (2)

A

generally: estrogens play a role in uterine remodeling via

  1. endometrial cell multiplication
  2. hypertrophy of myometrium
  3. deposition of myometrial glycogen
  4. vascularization of the uterus
  5. uterine metabolism to cope with the growth requirements of the fetus

all to cope with the increasing growth requirement of the fetus and and playing a role in preparation for parturition

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16
Q

describe how estrogen is produced during pregnancy

A

both from follicles and feto-placental unit

17
Q

describe estrogen levels in the mare during the pregnancy (2)

A
  1. mares produce a shit ton of and many different types of estrogen throughout pregnancy
  2. estrogen is high throughout pregnancy, and increases even more around 5 months when she starts ramping up production so may see estrus behavior around this time
18
Q

what indicates feto-placental well being in ALL species?

A

total estrogen concentrations

19
Q

describe relaxin (4)

A
  1. relaxes connective tissue of the cervix, pubic symphysis, and birth canal
  2. allows dilation and passage of the fetus at parturition
  3. effects are potentiated by previous exposure to estrogens
  4. levels increase early to mid-pregnancy and spike right before parturition
20
Q

what are the 5 goals of a pregnancy exam?

A
  1. diagnose early pregnancy
  2. determine embryo/fetal number: important for early preg in horses (if twins pinch one off), to determine nutrition requirements for small ruminants, and to be able determine when dogs are done whelping
  3. assess viability, growth, and wellbeing
  4. determine stage of gestation
  5. identify at-risk neonates pre-partum
21
Q

what are the 2 categories of pregnancy evaluation techniques? list 3 methods for each kind

A

direct methods: identification of the embryo or fetus itself; includes
1. rectal (mare, cow), or transabdominal (dog, cat) palpation
2. rectal or abdominal ultrasound
3. abdominal radiographs

indirect methods: detection of the products of conceptus; includes:
1. teasing/non-return to estrus
2. progesterone
3. hormones: eCG, estrone sulfate, relaxin, pregnancy-specific protein B

22
Q

describe rectal palpation to detect pregnancy in mares and cows generally and then 5 specific, then include 2 advantages and 4 disadvantages

A

generally looking for changes in uterus due to hormones and conceptus growth, including:
1. thinning of the uterine wall
2. one horn filling with fluid (but could also be pyometra)
3. expansion of the gravid uterine horn first
4. expansion of non-gravid horn later
5. fetal parts

advantages:
1. economical and accurate after 35-40 days
2. fetal viability assessed by movements

disadvantages:
1. early diagnosis not possible
2. fetal stress not assessed
3. fetal number not assessed
4. iatrogenic/embryonic fetal death: esp in early pregnancy in cattle

23
Q

describe rectal palpation “landmarks” for fetal detection in mares and cows (3)

A
  1. fluid filled bulge: earliest diagnosis, 35-40 days
  2. fetus first palpable/placentomes in ruminant: 60-90 days (placentomes day 75)
  3. feel baby close to birth canal: in last month of gestation
24
Q

describe what can be felt on transabdominal palpation of dogs and cats for pregnancy detection (3)

A
  1. embryonic vesicles: 30-35d in dogs and 21-35d in cats
  2. vesicles become confluent and difficult to palpate past 35d
  3. mineralized fetuses are palpable at 45d (dogs) and 58d (cats)
25
Q

describe ultrasonography as pregnancy detection (6)

A
  1. the gold standard!!
  2. earliest accurate diagnosis
  3. can detect twins
  4. can assess viability, growth, and well-being
  5. can determine fetal age and sex
  6. perform transrectally in large animals until 60d, then transabdominal after that; only transabdominal in small animals
26
Q

when is the earliest that ultrasound can detect pregnancy in mare, cattle and pigs, dogs and cats, and small ruminants

A

mares: 14 days
cattle and pigs: 20 days
dogs and cats: also 20 days but could have embryonic loss up to 30d so usually wait until then to ultrasound
small ruminants: transrectal at 20-25d of gestation, right inguinal 45-90d of gestation (can detect embryos, fetus, placentomes, and count numbers)

27
Q

what can be detected via transabdominal ultrasound in horses and cows? (4)

A
  1. placental health
  2. fetal fluid echogenicity
  3. fetal heart rate
  4. fetal activity and tone: active versus flaccid, flexing/extending limbs, head nods, suckling, lip movements, nostril flaring, tail movements
28
Q

describe the use of abdominal radiographs as pregnancy detection (5) and include 2 disadvantages

A
  1. used in small animals, small ruminants, and pocket pets
  2. detected mineralized fetuses (>45d dogs, >38d cats, >65d small ruminants)
  3. method of choice for puppy/kitten counts
  4. determines gestational age
  5. detect feto-maternal disproportion

disadvantages:
1. early diagnosis not possible
2. fetal stress not assessed

29
Q

describe teasing/non-return to estrus as pregnancy detection in horses (4)

A
  1. indicates absence/presence of progesterone
  2. if in estrus by 21-24d after ovulation/estrus = not pregnant
  3. if not in estrus by 21-24d = pregnant OR persistent CL, silent heat, ovarian cysts
  4. MUST know day of ovulation/heat!!
30
Q

describe blood/milk progesterone as pregnancy detection (5)

A
  1. indicates presence/absence or progesterone (for cattle)
  2. if less than 1ng/mL = not pregnant
  3. if more than 1ng/mL = pregnant OR persistent CL, ovarian cysts
  4. MUST know day of ovulation/heat
  5. CANNOT use in dogs!!
31
Q

describe serum or urine estrone sulfate as pregnancy detection (5), including advantages (3) and disadvantages (2)

A
  1. indicates presence/absence of VIABLE fetus
  2. reflects feto-placental well being
  3. detected in mares past 150d and in cws past 120d
  4. advantages: small or fractious females, 99% accurate, and assesses fetal viability
  5. disadvantages: late diagnosis and does not assess fetal number
32
Q

describe eCG as pregnancy detection (4) including an advantage and 2 disadvantages

A
  1. in mares only! indicated presence/absence of endometrial cups
  2. 40-120d after ovulation
  3. advantage: small or fractious females
  4. disadvantages: MUST know day of ovulation, can have false positive after pregnancy loss
33
Q

is there one single hormone that can be used to detect pregnancy in horses?

A

nope! they have such a complex hormonal profile during gestation it is not possible to use 1 hormone to assess

34
Q

describe pregnancy-specific protein B as pregnancy detection (3)

A
  1. in ruminants! binucleate trophoblast cells migrate from trophoblast to endometrium at implantation and produce somatotropin and PSPB
  2. PSPB mediates cell adhesion, immune tolerance, and angiogenesis
  3. can be used to detected pregnancy once placenta starts to develop (after 28d)
35
Q

describe relaxin as pregnancy detection (2)

A
  1. can be used in dogs after 28d of gestation
  2. but persists post-abortion so can have a false positive with pregnancy loss

Endocrine/Repro (31 decks)

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