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3rd Block > Real Pregnancy And Childbirth > Flashcards

Real Pregnancy And Childbirth Flashcards

1
Q

What is the OVERALL effect of human chorionic gonadotropin?

A

Rescues corpus luteum from degeneration until 3rd or 4th month of pregnancy

Corpus luteum secretes progesterone and estrogens which have the following effects

  1. Maintain endometrium of uterus during pregnancy
  2. Help prepare mammary glands for lactation
  3. Prepare mother’s body for birth of baby
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2
Q

What is the purpose of the corpus luteum secreting estrogens and progesterone?

A
  • Maintain endometrium of uterus during pregnancy
  • help prepare mammary glands for lactation
  • prepare mother’s body for birth of baby
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3
Q

What is the purpose of the corpus luteum and placenta secreting relaxin?

A
  • Increases flexibility of pubic symphysis

- Helps dilate uterine cervix during labor

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4
Q

What is the purpose of the placenta secreting human chorionic somatomammotropin(hCS) ?

A
  • Helps prepare mammary glands for lactation
  • Enhances growth by increasing protein synthesis
  • Decreases glucose use and increases fatty acid use for ATP production
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5
Q

What is the purpose of Corticotropin releasing hormone being released from the placenta?

A
  • establishes the timing of birth

- increases concentration of cortisol

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6
Q

What is female infertility?

A

The inability of a woman to conceive and occurs in about 10% of all women of reproductive age in the U.S.

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7
Q

What is male infertility?

A

The inability of sperm to fertilize a secondary oocyte, thus doesn’t imply erectile dysfunction(impotence)

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8
Q

What may cause female infertility?

A

Ovarian disease

Obstruction of uterine tubes

Inadequate body fat

Conditions where the uterus is not adequately prepared to receive a fertilized ovum

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9
Q

What may cause male infertility?

A
  • over exposure to X rays and ionizing radiation
  • infections
  • toxins
  • malnutrition
  • higher than normal scrotal temperatures (optimal temperature for sperm production is 35 degrees Celsius and 95 degrees Fahrenheit)
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10
Q

What are the requirements of male fertility?

A
  • production of adequate quantities of viable, normal sperm by the testes
  • unobstructed transport of sperm through the ducts
  • satisfactory deposition in the vagina
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11
Q

Explain the process of in vitro fertilization

A
  • occurs in a dish
  • mother-to-be is given FSH shortly after menstruation, producing several secondary oocytes(superovulation)
  • after several follicles have reached appropriate size, secondary oocytes are aspirated from the stimulated follicles and transferred to a solution containing spermatozoa where fertilization occurs
  • when the zygote reaches the 8-cell or 16 cell stage, it is implanted in the uterus
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12
Q

What is intracytoplasmic sperm injection (ICSI)

A

An alternative to IVF, sperm or even a spermatic is suctioned from the testes into a pipette and then injecting it into the oocyte’s cytoplasm

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13
Q

Name some assisted reproductive techniques aside from IVF and ICSI

A

Embryo transfer and Gamete intrafallopian transfer (GIFT)

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14
Q

What is an ectopic pregnancy?

A

Development of an embryo or fetus outside of the uterine cavity

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15
Q

Why does an ectopic pregnancy usually occur?

A

Due to the movement of a fertilized ovum through the uterine tube is impaired by scarring due to a prior tubal infection, decreased movement of the uterine tube smooth muscle, or abnormal tubal a anatomy

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16
Q

Where is the mist common suite of an ectopic pregnancy?

A

In the uterine tube

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17
Q

Aside from the uterine tube, what are common sites of an ectopic pregnancy?

A

In the ovary, abdominal cavity or uterine cervix

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18
Q

What are the risk factors of an ectopic pregnancy?

A

Smoking

Scars due to pelvic inflammatory disease

Previous uterine tube surgery

Previous ectopic pregnancy

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19
Q

What are the signs and symptoms of an ectopic pregnancy?

A

One or two missed menstrual cycles followed by bleeding

Acute abdominal and pelvic pain

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20
Q

What can happen if an ectopic pregnancy goes on untreated?

A

Developing embryo can rupture the uterine tube

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21
Q

How can ectopic pregnancy be treated?

A

Surgery

Use of cance drug- methotrexate which stops embryonic cells from dividing

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22
Q

What do early pregnancy tests use to detect a pregnancy?

A

Detect tiny amounts of human chorionic gonadotropin (hCG) in the urine that begins to be excreted about 8 days after fertilization

Chemicals in kits provide a color change if a reaction occurs between hCG in urine and hCG antibodies in test kit

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23
Q

How early can early pregnancy tests detect a pregnancy?

A

As early as 14 days after fertillization

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24
Q

Compare pharmacy pregnancy test kits with those in hospitals

A

Several of the test kits in pharmacy are as accurate as test kits in hospitals

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25
Q

What is placentation?

A

Process of forming a placenta

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26
Q

Why is the placenta unique?

A

It forms from both the mother and the fetus

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27
Q

Describe the placenta at the beginning of the twelfth week

A

Placenta has 2 distinct parts:
The fetal portion formed from the chorionic villi of the chorion

The maternal portion formed from the decidua basalis of the endometrium

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28
Q

The actual connection between the placenta and embryo and later the fetus is through the _______ ____ which develops from the __________ ______

A

Umbilical cord

Connecting stalk

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29
Q

What are the functions of the placenta?

A
  • Allows oxygen and nutrients to diffuse from maternal blood into fetal blood while carbon dioxide and wastes diffuses from fetal blood into maternal blood
  • placenta stores nutrients carbohydrates, proteins, calcium and iron which are released into fetal circulation
  • provides a protective barrier as microorganisms cannot pass through it
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30
Q

Summary the first week of development in order

A
  1. Fertilization(occurs within uterine tube 12-24 hours after ovulation)
  2. Cleavage(first cleavage completed about 30 hours after fertillization)
  3. Morula formation (3-4 days after fertilization)
  4. Blastocyst formation( 4.5 - 5 days after fertillization)
  5. Implantation occurs about 6 days after fertillization
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31
Q

What is the clear layer that surrounds the entire umbilical cord ?

A

Amnion

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32
Q

What is Wharton’s jelly?

A

Supporting mucous connective tissue which is derived from the allontois

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33
Q

What is the afterbirth?

A

Placenta that detaches from the uterus after birth

This is when the umbilical cord is tied off and severed

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34
Q

What happens to the small portion of the umbilical cord remaining on the baby?

A

It wither and falls off usually within 12-15 days of birth

35
Q

How is the umbilicus/navel formed?

A

The area where the umbilical cord was attached becomes covered by a thin layer of skin and scar tissue forms

36
Q

Describe the maternal respiratory system during pregnancy

A

Tidal volume- 30%-40% increase

Expiratory reserve volume -40% decrease

Functional residual capacity- 25% decrease

Minute ventilation- 40% increase

Bronchial tree airway resistance 30%- 40% decrease

Total body oxygen consumption- 10%-20% increase

37
Q

What are the physiological changes of the maternal digestive system?

A

Increased appetite

Decreased GIT motility

38
Q

What are physiological changes of the maternal urinary system in pregnancy?

A

Increased frequency and urgency of urination

Stress incontinence

Renal plasma flow increase by 35 %

Glomerular filtration increases by 40%

Increased renal filtering capacity, which allows faster elimination of the extra wastes produced by the fetus

39
Q

What are the physiological changes in the mother in pregnancy?

A

Stroke volume increases: 30%

Heart rate: increases 10%-15%

Cardiac output: 20% -30%

Blood volume: increases 30%-50%

Inferior vena cava compressions reduces veinous return and lower limb edema

Renal artery compression may cause renal hypertension

40
Q

What happens to maternal skin during pregnancy?

A
  • increased pigmentation around the eyes and cheekbones in a mask like pattern(chloasma), in the Arellano of the breasts, and in the lineal a of the lower abdomen(Linea nigra)
  • Striae(stretch marks) over the abdomen can occur as the uter enlarges, and hair loss increases
41
Q

What happens to maternal reproductive system in pregnancy?

A
  • edema and increased vascularized of vulva
  • increased pliability and vascular of the vagina
  • the uterus increases from non pregnant mass of 60-80g to 900-1200g at term because of hyperplasia of muscle fibers in the myometrium in early pregnancy and hypertrophy of muscle fibers during the second and third trimester
42
Q

What are teratogens?

A

Any agent or influence that causes developmental defects in the embryo

43
Q

Describe the classes of teratogens

A

Chemicals- alcohol, defoliants, industrial chemicals

Microorganisms- Hepatitus B and C viruses, rubella, measles virus

Prescription and recreational drugs - some. Hormones, antibiotics, anticoagulants

44
Q

Name and describe the uses of the most popular prenatal diagnostic test

A

Fetal ultrasonography- used to determine more accurate fetal age when the date is unclear

Also used to confirm pregnancy

Evaluate fetal viability and growth

Determine fetal position

Identify fetal-maternal abnormalities

Serve as and adjunct to special procedures such as amniocentesis

45
Q

When is amniocentesis usually done?

A

14-18 weeks of gestation

46
Q

What is amniocentesis?

A

Involves withdrawing of some amniotic fluid and analyzing fetal cells and dissolved substances

47
Q

What are the purposes of amnioticentesis?

A

Used to determine the survivability of the fetus

Test for the presence of genetic disorders( like muscular dystrophies, suckle cell disease, hemophilia)

48
Q

When is amniocentesis performed?

A

Only when high risk of genetic defects is suspected because there is a 0.5% chance of spontaneous abortion after the procedure

49
Q

What is chorionic villi sampling?

A

A sample of the chorionic villi is obtained and prepared for chromosomal analysis

50
Q

Why can chorionic villi sampling detect some of the same defects as amniocentesis?

A

Chorionic cells and fetal cells contain the same genome

51
Q

What are the advantages does CVS offer over amniocentesis?

A

CVS can be performed as early as 8 weeks gestation

Test results are available in only a few days (permits and earlier decision on whether to continue the pregnancy)

52
Q

Why may it be safer to perform amniocentesis rather than CVS?

A

CVS is slightly riskier than amniocentesis after the procedure, there is a 1%-2% chance of spontaneous abortion.

53
Q

In hormonal interplay during labor where are the following hormones CRH, ACTH, DHEA secreted from in the fetus/placenta?

A

CRH: produced by the placenta

ACTH: produced by the fetal antuitary gland

Dehydroepiandrosterone secreted by the fetal adrenal cortex

54
Q

What happens to DHEA in the placenta?

A

DHEA is converted to estrogens in placenta

55
Q

What are the effects of DHEA being converted to estrogens in the placenta?

A

Oxytocin is released from the posterior pituitary gland from the mother and which then leads to increased uterine contraction

Cortisol is produced in the fetal adrenal cortex prostaglandin releases from placenta which causes cervical softening

56
Q

What is labor called and define it

A

Labor is called purtrusiin

Labor is the process by which the fetus is expelled from the uterus through the vagina(birth)

57
Q

In which births is the breech position most common?

A

In premature births

58
Q

What may result in dystocia/difficult labour?

A

May be due to abnormal position(presentation), birth canal may be if I’m adequate size for vaginal delivery.

59
Q

What is a Caesarian section?

A

If a fetal or maternal distress presents prevents a vaginal birth the baby may be delivered surgically through an abdominal incision

A low horizontal cut is made through the abdominal wall and lower portion of the uterus through which the baby and placenta are removed

60
Q

What is prematurity one pregnancy?

A

A baby that weighs less than 2500g(5.5 pounds) at birth

61
Q

What are risk factors for prematurity?

A

Poor prenatal care

Drug abuse

Mothers age below 16 or above 35

History of a previous premature delivery

62
Q

What is the problem presented by prematurity?

A

Premature infants are not able to carry out certain critical functions and thus needs medical intervention

63
Q

What is the major problem after delivery of an infant under 36 weeks gestation?

A

Respiratory distress syndrome RDS of the newborn due to insufficient surfactant

Can be eased by use of artificial surfactant and a ventilator that delivers oxygen until the lungs can operate on their own

64
Q

Why in lactation is milk production occurring even when prolactin is secreted?

A

Progesterone inhibits the effects of oxytocin

65
Q

Why is there milk production after birth?

A

After delivery, estrogens and progesterone decline and can no longer inhibit the effects of of prolactin

66
Q

What is the principle stimulus of prolactin?

A

The sucking action of the infant

67
Q

Explain the hormonal secretion of lactation(milk ejection reflex)

A
  1. Touch sensations of the suckling of the baby
  2. Nerve impulses sent from nipples to hypothalamus posterior pituitary to release oxytocin
  3. Increased oxytocin in blood causes contraction of myoepithelial cells in mammary glands
  4. Milk ejection
68
Q

Oxytocin causes release of milk into the mammary ducts vis the ______ __________ _____

A

Milk ejection reflex

69
Q

What is the primary benefit of breastfeeding?

A

Primary benefit : it is nutritional: human milk is sterile solution that contains amounts of fatty acids, lactose, amino acids, minerals etc. and water that are vital for a baby’s growth, digestion and brain development

70
Q

What are other major benefits of breastfeeding?

A

Beneficial cells- several types of white blood cells that help boost the baby’s immunity are present

Beneficial molecules- maternal IgA antibodies in breast milk offers protection against her baby is exposed to

Decreased independence of diseases later in life- breast provides children with slight reduction of risk of lymphoma, heart dusease, allergies, respiratory and gastrointestinal infections, ear infections, diarrhea, diabetes and meningitis

Miscellaneous benefits-breast feeding supports optimal infant growth, enhances intellectual and neurological development, fosters mother-fetal relationship

71
Q

Compare cow milk to human milk

A

The fats and iron in breast milk are more easily absorbed

The proteins in breast milk are more easily metabolized

The lower sodium content is more suited for an infants need

72
Q

Why do premature infants need breast milk even more?

A

Milk produced is adapted for the infants needs, has a higher protein content than milk of mothers full term infants

73
Q

How does breastfeeding help uterus return to normal size?

A

Breastfeeding helps stimulates the release of oxytocin

This promotes expulsion of the placenta(afterbirth) and helps the uterus return to its normal size

74
Q

Explain the respiratory adjustments at birth

A

The fetal lungs are either collapsed or partially filled with amniotic fluid

The respiratory system is fairly well developed at 7 months so premature maybe delivered and can breathe/cry

After delivery mother’s oxygen supply ceasesand amniotic fluid in fetal lungs absorbed

CO2 is no longer removed and builds stimulating respiratory center to cause respiratory muscle to contract and take an unusually deep first inspiration (lungs have no air yet) then cries

75
Q

Describe the difference in breathing rate of a full term baby and a normal breathing rate

A

A full term baby may breathe 45 times per minute for the first 2 weeks after birth

Breathing rate gradually decreases to a normal 12 breaths per minute

76
Q

Describe cardiovascular adjustments for infants at birth

A

Foramen oval is closes leaving the fossa ovalis

Ductus arteriosus closes and becomes ligamentum arteriosum

After umbilical cord is tied off and blood no longer flows through umbilical arteries, they fill with connective tissue, distal portions become medial umbilical ligaments

The umbiblical vein becomes the ligamentum teres(round ligament) of the liver

The ductus venosus collapses and the remnants become the ligamentum venosum

77
Q

Describe the fetal white blood cell count at birth

A

High at birth but decreases in the seventh day

78
Q

Describe the infant’s pulse rate at birth

A

At birth may range from 120 -160 beats per minute, may go as high as 180 in excitation

79
Q

Describe the use of oxygen as a new born infant

A

At birth, oxygen use increases which stimulates an increase in the rate of red blood cell and hemoglobin production

80
Q

Summarize the second week of pregnancy

A
  1. Oocyte-> ootid-> zygote
  2. Zygote forms inner cell mass and trophoblast
  3. Trophoblast divided into synchtiotrophoblast and cytotrophoblast. Both develop into Lacunae and Chorion respectively
  4. Inner cell mass divided into hypoblast( forms visceral and parietal hypoblasts) and epiblast(extraembryonic mesoblast and amnion)
81
Q

Trace the formation of the connecting stalk in the second week of pregnancy

A
  1. Oocyte becomes ootid and then zygote
  2. Zygote formed by inner mass cells and trophoblast
  3. Inner mass cells forms epiblast and hypoblast
  4. Epiblast forms extraembryonic mesoblast which form the connecting stalk
82
Q

Trace the formation of the chorionic in the second week of pregnancy

A
  1. Oocyte form ootid then zygote
  2. Zygote forms inner cell mass and trophoblast
  3. Trophoblast form synchtiotrophoblast and cytotrophoblast
  4. Cytotrophoblast forms the chorion
83
Q

Trace the formation of the primary yolk sac in the second week of pregnancy?

A
  1. Oocyte forms ootid which then forms the zygote
  2. Zygote forms inner cell mass and trophoblast
  3. Inner cell mass forms hypoblast and epiblast

4 hypoblast forms visceral hypoblast and parietal hypoblast, which both form into primary yolk sac

84
Q

Trace the formation of the amnion in the second week of pregnancy

A
  1. Oocyte forms into ootid which forms the zygote
  2. Zygote formed by inner cell mass and trophoblast
  3. Inner cell mass forms hypoblast and epiblast
  4. Epiblast forms extraembryonic membrane and amnion

3rd Block (5 decks)

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