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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
The female reproductive tract is a differentiated form of which primitive tract?
Mullerian duct
26
At what week gestation does male / female differentiation occur?
9wk
27
At what week gestation can you recognise sex on US?
16wk
28
From what week gestation is the placenta functional?
5
29
What is the function of the intervillous space in the placenta?
Separates mother’s/fetal blood
30
Carbamazepine, tetracyclines, heroin, and nicotine are all ____
teratogens
31
What hormone do syncytiotrophoblasts of the placenta secrete?
HCG
32
What is the function of HCG in pregnancy?
Signals corpus luteum to secrete progesterone to maintain the endometrium
33
Do fetal or adult blood have a higher Hb concentration?
Fetal
34
Fetal Hb has an ____ ability to carry O2
increased
35
HCG increases levels until __ weeks gestation, from then on its levels fall
10
36
What hormone is being described "responsible for protein formation, deceasing insulin sensitivity and breast development"
HCS
37
What hormone is being described "responsible for decidua development,
Progesterone
38
What hormone is being described "enlarges uterus, breast development, relaxes ligaments"
Estrogens
39
What hormone is being described "indicates fetus vitality"
Estriol
40
What hormone is being described "gradual increasing levels from 5wk gestation"
HCS
41
What hormone is being described "released from placenta, increases ACTH, aldosterone and cortisol levels"
Corticotropin releasing hormone
42
The placenta is the sole source of nutrition to the fetus from what week onwards?
Week 6
43
What effect does pregnancy have on cardiac output ?
Increases from 6 weeks (by 30-50%) | Falls in last 8 weeks
44
Pregnancy can cause physiological murmurs and changes in heart sounds. T or F
True
45
What is average mother's HR in pregnancy?
90
46
What effect does pregnancy have on blood pressure?
Falls 1st trimester | Raises 3rd trimester
47
What effect does pregnancy have on respiratory rate?
None
48
What effect does pregnancy have on arterial pH?
Raised
49
What effect does pregnancy have on O2 consumption?
Raised (by 20%)
50
What effect does pregnancy have on plasma volume?
Raised
51
What effect does pregnancy have on haemoglobin concentration?
Lowered (by dilution)
52
What effect does pregnancy have on Fe requirement?
Raised (in 2nd half)
53
What effect does pregnancy have on vasculature?
Vasodilation
54
What effect does pregnancy have on GFR?
Raised
55
What effect does pregnancy have on urine volume?
Raised
56
How much weight should a mother put on in pregnancy?
11kg (5kg are fetus)
57
What effect does pregnancy have on BMR?
Increased
58
What are the changes to calorie and protein requirement in pregnancy?
Protein requirement increased | Require extra 250-300 calories/day in late pregnancy
59
Does breast growth mainly occur in weeks 1-20 or 21-40?
1-20
60
Does lipogenesis mainly occur in weeks 1-20 or 21-40?
1-20 | lipolysis at 21-40wk
61
Does insulin resistance mainly occur in weeks 1-20 or 21-40?
21-40
62
What hormones are responsible for insulin resistance in pregnancy?
HCS, cortisol, GH
63
When is term?
37-42wk
64
What percentage of births happen at term?
90%
65
"The process of the fetus, membanes, umbilical cord and placenta being expelled from the fetus" is the definition of what?
Labour
66
What are the 'false' contractions of the 3rd trimester called?
Braxton Hicks
67
What are risk factors for Braxton Hicks contractions?
2nd+ kid
68
Braxton Hicks contractions are painful and irregular. T or F
F | Painless, irregular
69
What is the bloody show?
Expulsion of mucus blood plug on cervix
70
What is the waters breaking?
amniotic sac rupture
71
When does membrane rupture occur?
Pre labour During labour Very rarely after labour
72
What effect does estrogen have on contractions?
Increases
73
What effect does progesterone have on contractions?
Inhibits
74
What effect does estrogen have on prostaglandins?
Increases
75
What are the 2 parts of stage 1 or labour?
Latent and active
76
Which one can last for days, latent or active stage 1 of labour?
Latent phase
77
How dilated is the cervix is latent phase of stage 1 labour?
3-4cm
78
How dilated is the cervix is active phase of stage 1 labour?
4-10cm
79
How many cm is a fully dilated cervix?
10cm
80
Describe contractions in latent phase of stage 1 of labour
mild irregular
81
Describe contractions in active phase of stage 1 of labour
regular, strong | increased need for analgesia
82
Describe the cervix in latent phase of stage 1 of labour
Shortens and softens
83
What effect do prostaglandins have on contractions?
Increase
84
Where do prostaglandins in labour come from?
Placenta
85
What effect do the prostaglandins from the placenta have on oxytocin?
+ve feedback
86
How should cervix dilation progress in the active phase of stage 1 of labour?
1-2cm/hr
87
How many contractions (freq) are ideal
normal 3-4/ 10min
88
What is station?
cm from ischial spine
89
Contractions promote ______ softening
cervix
90
What is stage 2 of labour?
Delivery of baby
91
How long is prolonged stage 2 of labour in nulliparous women?
Longer than 2 hours
92
How long is prolonged stage 2 of labour in women with regional anaesthesia?
Add on 1 hour
93
How long is prolonged stage 2 of labour in multiparous women?
Longer than 1 hour
94
What is stage 3 of labour?
Expulsion of placenta
95
How long does stage 3 of labour take on average? How long is considered normal?
10 min | <30 min
96
What is the active Mx of stage 3 labour?
IV/IJ syncotocinon | Controlled cord traction
97
What is the purpose of controlled cord traction in the active Mx of stage 3 labour
Decreases PPH risk
98
If stage 3 labour takes longer than 1hr, what should you do?
Remove under GA
99
After placenta expulsion, what step should you take that promotes blood flow to the fetus?
Delayed cord clamping
100
How long should delayed cord clamping occur?
Less than 3 minutes (normally 30-60 seconds)
101
How long after delivery should skin: skin contact occur for? And what is its purpose?
1 hour | Increases breastfeeding and baby's temp
102
What position should the fetus be in at the pelvic inlet?
Occipitotransverse
103
What position should the fetus be in at the pelvic outlet?
Occipitoanterior
104
These are the cardinal movements of the fetus. Put them in order - Internal rotation - Expulsion - Extension - External rotation - Engagement - Flexion - Descent
- Engagement - Descent - Flexion (head) - Internal rotation - Extension (crown) - External rotation - Expulsion (shoulder)
105
After expulsion of the head, should the anterior or posterior come out next?
Anterior shoulder
106
How long is the puerperium period?
6 weeks
107
What is lochia?
Blood, mucus and endometrial discharge
108
How long post delivery does lochia occur?
14 days
109
After pregnancy, does the uterus regress to its pre-pregnancy size and location?
Not fully
110
In the postpartum period, diuresis is [physiological/ pathological]
physiological
111
What is the appearance of rubra discharge, and how long does it last?
Fresh red | Day 3-4
112
What is the appearance of serosa discharge, and how long does it last?
Brown-red, watery | Day 4-14
113
What is the appearance of alba discharge, and how long does it last?
Yellow | Day 10-20
114
What hormone is responsible for growth of the breast ductile system
Estrogen
115
What hormone is responsible for breast lobule-alveolar system development?
Progesterone
116
What effect do estrogen and progesterone have on lactation?
Inhibit
117
From what week gestation is prolactin produced?
Week 5 | Steady increasing levels till birth
118
What is the name of the 1st breast secretion?
Colostrum
119
What hormone is responsible for colostrum production?
Prolactin
120
When does colostrum expulsion occur?
Day 1-7 after birth | double check this
121
Colostrum is rich in _____, has a ____ volume and ____ fat
Colostrum is rich in IMMUNOGLOBULINS, has a SMALL volume and NO fat
122
What hormone is responsible for the milk let down reflex
Oxytocin
123
When is the 1st, 2nd and 3rd trimester complete?
1st complete 13wk 2nd complete 28wk 3rd complete 40wk

Y3 Reproductive (28 decks)

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