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Y3 Reproductive > Pregnancy Physiology > Flashcards

Pregnancy Physiology Flashcards

1
Q

When in the menstrual cycle are you fertile?

A

When ovulating + few days before day11-15

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2
Q

How long can an ovum live in the female genital tract?

A

17-24hr

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3
Q

How long can sperm live in the female genital tract?

A

5 days

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4
Q

What changes happens to cervical mucus pre-fertilisation?

A

Thins (for sperm passage)

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5
Q

When an ovum (secondary oocyte) is released from the ovary, how does it travel to the uterus?

A

Ciliated epithelium propel the ovum down the uterus tubes

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6
Q

Where is the commonest site of fertilisation?

A

Uterine tube ampulla

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7
Q

Sperm touching the ____ triggers a ____ reaction

A

Sperm touching the ZONA PELLUCIDA triggers a ACROSOME reaction

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8
Q

Acrosomal digestive enzymes allow _____ of the sperm

A

penetration

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9
Q

After the sperm penetrates the zona pellucida, the ____ fuse and the egg becomes a ______

A

After the sperm penetrates the zona pellucida, the NUCLEI fuse and the egg becomes a ZYGOTE

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10
Q

Is a zygote diploid or haploid?

A

Diploid

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11
Q

On what days post fertilisation does the zygote migrate to uterine cavity?

A

3 - 5

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12
Q

As the zygote migrates to the uterine cavity, what does it become?

A

Morula > blasocyst

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13
Q

What are the main parts of a blastocyst?

A

Inner cell mass

Outer trophoblasts

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14
Q

What does the inner cell mass of the blastocyst give rise to?

A

Fetus

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15
Q

What do the outer trophoblast cells of the blastocyst give rise to?

A

Placenta

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16
Q

On what day post fertilisation does implantation occur?

A

5 - 8

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17
Q

In implantation, the trophoblast cells penetrate the _______, and the ______ degenerates. By day ______ the blastocyst is completely buried in endometrium

A

In implantation, the trophoblast cells penetrate the ENDOMETRIUM DECIDUA, and the ZONA PELLUCIDA degenerates. By day 12 the blastocyst is completely buried in endometrium

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18
Q

What process describes changes to the endometrium in preparation for and during pregnancy?

A

Decidualisation

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19
Q

What is chromosomal sex?

A

22 homologous pairs + XX or XY

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20
Q

What determines male development?

A

Presence of sex determining region on Y chromosome

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21
Q

What is the function of the SRY gene - sex determining region on Y chromosome?

A

Stimulates bipotential gonad to differentiate to testis

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22
Q

In early male development, what do the testis secrete that causing male genital tract development?

A

Testosterone and Mullerian inhibiting factor (aka AMH)

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23
Q

The male reproductive tract is a differentiated form of which primitive tract?

A

Wolffian duct

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24
Q

In early female development, what does the bipotential gonad give rise to?

A

Becomes ovaries (in absence of testosterone)

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25
Q

The female reproductive tract is a differentiated form of which primitive tract?

A

Mullerian duct

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26
Q

At what week gestation does male / female differentiation occur?

A

9wk

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27
Q

At what week gestation can you recognise sex on US?

A

16wk

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28
Q

From what week gestation is the placenta functional?

A

5

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29
Q

What is the function of the intervillous space in the placenta?

A

Separates mother’s/fetal blood

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30
Q

Carbamazepine, tetracyclines, heroin, and nicotine are all ____

A

teratogens

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31
Q

What hormone do syncytiotrophoblasts of the placenta secrete?

A

HCG

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32
Q

What is the function of HCG in pregnancy?

A

Signals corpus luteum to secrete progesterone to maintain the endometrium

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33
Q

Do fetal or adult blood have a higher Hb concentration?

A

Fetal

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34
Q

Fetal Hb has an ____ ability to carry O2

A

increased

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35
Q

HCG increases levels until __ weeks gestation, from then on its levels fall

A

10

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36
Q

What hormone is being described “responsible for protein formation, deceasing insulin sensitivity and breast development”

A

HCS

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37
Q

What hormone is being described “responsible for decidua development,

A

Progesterone

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38
Q

What hormone is being described “enlarges uterus, breast development, relaxes ligaments”

A

Estrogens

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39
Q

What hormone is being described “indicates fetus vitality”

A

Estriol

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40
Q

What hormone is being described “gradual increasing levels from 5wk gestation”

A

HCS

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41
Q

What hormone is being described “released from placenta, increases ACTH, aldosterone and cortisol levels”

A

Corticotropin releasing hormone

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42
Q

The placenta is the sole source of nutrition to the fetus from what week onwards?

A

Week 6

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43
Q

What effect does pregnancy have on cardiac output ?

A

Increases from 6 weeks (by 30-50%)

Falls in last 8 weeks

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44
Q

Pregnancy can cause physiological murmurs and changes in heart sounds. T or F

A

True

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45
Q

What is average mother’s HR in pregnancy?

A

90

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46
Q

What effect does pregnancy have on blood pressure?

A

Falls 1st trimester

Raises 3rd trimester

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47
Q

What effect does pregnancy have on respiratory rate?

A

None

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48
Q

What effect does pregnancy have on arterial pH?

A

Raised

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49
Q

What effect does pregnancy have on O2 consumption?

A

Raised (by 20%)

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50
Q

What effect does pregnancy have on plasma volume?

A

Raised

51
Q

What effect does pregnancy have on haemoglobin concentration?

A

Lowered (by dilution)

52
Q

What effect does pregnancy have on Fe requirement?

A

Raised (in 2nd half)

53
Q

What effect does pregnancy have on vasculature?

A

Vasodilation

54
Q

What effect does pregnancy have on GFR?

A

Raised

55
Q

What effect does pregnancy have on urine volume?

A

Raised

56
Q

How much weight should a mother put on in pregnancy?

A

11kg (5kg are fetus)

57
Q

What effect does pregnancy have on BMR?

A

Increased

58
Q

What are the changes to calorie and protein requirement in pregnancy?

A

Protein requirement increased

Require extra 250-300 calories/day in late pregnancy

59
Q

Does breast growth mainly occur in weeks 1-20 or 21-40?

A

1-20

60
Q

Does lipogenesis mainly occur in weeks 1-20 or 21-40?

A

1-20

lipolysis at 21-40wk

61
Q

Does insulin resistance mainly occur in weeks 1-20 or 21-40?

A

21-40

62
Q

What hormones are responsible for insulin resistance in pregnancy?

A

HCS, cortisol, GH

63
Q

When is term?

A

37-42wk

64
Q

What percentage of births happen at term?

A

90%

65
Q

“The process of the fetus, membanes, umbilical cord and placenta being expelled from the fetus” is the definition of what?

A

Labour

66
Q

What are the ‘false’ contractions of the 3rd trimester called?

A

Braxton Hicks

67
Q

What are risk factors for Braxton Hicks contractions?

A

2nd+ kid

68
Q

Braxton Hicks contractions are painful and irregular. T or F

A

F

Painless, irregular

69
Q

What is the bloody show?

A

Expulsion of mucus blood plug on cervix

70
Q

What is the waters breaking?

A

amniotic sac rupture

71
Q

When does membrane rupture occur?

A

Pre labour
During labour
Very rarely after labour

72
Q

What effect does estrogen have on contractions?

A

Increases

73
Q

What effect does progesterone have on contractions?

A

Inhibits

74
Q

What effect does estrogen have on prostaglandins?

A

Increases

75
Q

What are the 2 parts of stage 1 or labour?

A

Latent and active

76
Q

Which one can last for days, latent or active stage 1 of labour?

A

Latent phase

77
Q

How dilated is the cervix is latent phase of stage 1 labour?

A

3-4cm

78
Q

How dilated is the cervix is active phase of stage 1 labour?

A

4-10cm

79
Q

How many cm is a fully dilated cervix?

A

10cm

80
Q

Describe contractions in latent phase of stage 1 of labour

A

mild irregular

81
Q

Describe contractions in active phase of stage 1 of labour

A

regular, strong

increased need for analgesia

82
Q

Describe the cervix in latent phase of stage 1 of labour

A

Shortens and softens

83
Q

What effect do prostaglandins have on contractions?

A

Increase

84
Q

Where do prostaglandins in labour come from?

A

Placenta

85
Q

What effect do the prostaglandins from the placenta have on oxytocin?

A

+ve feedback

86
Q

How should cervix dilation progress in the active phase of stage 1 of labour?

A

1-2cm/hr

87
Q

How many contractions (freq) are ideal

A

normal 3-4/ 10min

88
Q

What is station?

A

cm from ischial spine

89
Q

Contractions promote ______ softening

A

cervix

90
Q

What is stage 2 of labour?

A

Delivery of baby

91
Q

How long is prolonged stage 2 of labour in nulliparous women?

A

Longer than 2 hours

92
Q

How long is prolonged stage 2 of labour in women with regional anaesthesia?

A

Add on 1 hour

93
Q

How long is prolonged stage 2 of labour in multiparous women?

A

Longer than 1 hour

94
Q

What is stage 3 of labour?

A

Expulsion of placenta

95
Q

How long does stage 3 of labour take on average? How long is considered normal?

A

10 min

<30 min

96
Q

What is the active Mx of stage 3 labour?

A

IV/IJ syncotocinon

Controlled cord traction

97
Q

What is the purpose of controlled cord traction in the active Mx of stage 3 labour

A

Decreases PPH risk

98
Q

If stage 3 labour takes longer than 1hr, what should you do?

A

Remove under GA

99
Q

After placenta expulsion, what step should you take that promotes blood flow to the fetus?

A

Delayed cord clamping

100
Q

How long should delayed cord clamping occur?

A

Less than 3 minutes (normally 30-60 seconds)

101
Q

How long after delivery should skin: skin contact occur for? And what is its purpose?

A

1 hour

Increases breastfeeding and baby’s temp

102
Q

What position should the fetus be in at the pelvic inlet?

A

Occipitotransverse

103
Q

What position should the fetus be in at the pelvic outlet?

A

Occipitoanterior

104
Q

These are the cardinal movements of the fetus. Put them in order

  • Internal rotation
  • Expulsion
  • Extension
  • External rotation
  • Engagement
  • Flexion
  • Descent
A
  • Engagement
  • Descent
  • Flexion (head)
  • Internal rotation
  • Extension (crown)
  • External rotation
  • Expulsion (shoulder)
105
Q

After expulsion of the head, should the anterior or posterior come out next?

A

Anterior shoulder

106
Q

How long is the puerperium period?

A

6 weeks

107
Q

What is lochia?

A

Blood, mucus and endometrial discharge

108
Q

How long post delivery does lochia occur?

A

14 days

109
Q

After pregnancy, does the uterus regress to its pre-pregnancy size and location?

A

Not fully

110
Q

In the postpartum period, diuresis is [physiological/ pathological]

A

physiological

111
Q

What is the appearance of rubra discharge, and how long does it last?

A

Fresh red

Day 3-4

112
Q

What is the appearance of serosa discharge, and how long does it last?

A

Brown-red, watery

Day 4-14

113
Q

What is the appearance of alba discharge, and how long does it last?

A

Yellow

Day 10-20

114
Q

What hormone is responsible for growth of the breast ductile system

A

Estrogen

115
Q

What hormone is responsible for breast lobule-alveolar system development?

A

Progesterone

116
Q

What effect do estrogen and progesterone have on lactation?

A

Inhibit

117
Q

From what week gestation is prolactin produced?

A

Week 5

Steady increasing levels till birth

118
Q

What is the name of the 1st breast secretion?

A

Colostrum

119
Q

What hormone is responsible for colostrum production?

A

Prolactin

120
Q

When does colostrum expulsion occur?

A

Day 1-7 after birth

double check this

121
Q

Colostrum is rich in _____, has a ____ volume and ____ fat

A

Colostrum is rich in IMMUNOGLOBULINS, has a SMALL volume and NO fat

122
Q

What hormone is responsible for the milk let down reflex

A

Oxytocin

123
Q

When is the 1st, 2nd and 3rd trimester complete?

A

1st complete 13wk
2nd complete 28wk
3rd complete 40wk

Y3 Reproductive (28 decks)

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