Repro 5 - Pregnancy and Parturition

Question 1

Hormone that inhibits uterine contractions

Answer 1

Relaxin

Question 2

Relaxes pelvic bones/ligaments, softens cervix

Answer 2

Relaxin

Question 3

Significant lactation is inhibited by high levels of these

Answer 3

Estrogen and progesterone

Question 4

Main cholesterol source for placenta

Answer 4

Maternal LDL

Question 5

Major site of estrogen synthesis during pregnancy

Answer 5

Placenta

Esp. the fetal zone of the fetal adrenal gland

Question 6

The fetal adrenal gland may be this big during pregnancy, as compared to normal ratio to height

Answer 6

20x

Question 7

Less bioactive form of DHEA

Answer 7

DHEA-S

Question 8

Process by which the placenta makes estrone and estriol

Answer 8

Removing the sulfate from DHEA-S

Question 9

Marker for fetal well-being

Answer 9

Estriol (made only from fetal liver precursors)

Question 10

This hormone Inhibits uterine contractions and prostaglandin production

Answer 10

Progesterone

Question 11

Upregulates alpha-adrenergic receptors that promote myometrial relaxation

Answer 11

Progesterone

Question 12

Stimulates alveolar pouches in breast to produce milk

Answer 12

Progesterone

Question 13

Ratio that maintains uterine quiescence, sustenance of fetus

Answer 13

Progesterone&raquo_space; Estrogen

Question 14

Ratio that promotes parturition

Answer 14

Estrogen&raquo_space; Progesterone

Question 15

Hormone in contraceptives that prevents LH secretion

Answer 15

Progestional hormone

Question 16

Hormone in contraceptives that prevents FSH release

Answer 16

Estrogen

Question 17

Changes in maternal cardiac output and TPR

Answer 17

CO goes up
TPR goes down
*TPR goes down more than CO goes up, so mean arterial pressure decreases

Question 18

Amount of blood flow that reaches uterus

Answer 18

30%

Question 19

Respiratory changes during pregnancy

Answer 19

Increase in tidal volume, no change in frequency

Functional hyperventilation leads to respiratory alkalosis, which is then offset by increased bicarb excretion

Question 20

Any change in GI tract during pregnancy?

Answer 20

GI motility slows, allowing for more time for nutrient absorption
Also a decrease in LES tone, resulting in potential heartburn for the mother

Question 21

Maternal metabolic state during first half of pregnancy

Answer 21

Anabolic
Normal or increased sensitivity to insulin
Increased fat and glycogen stores
Promotes growth of breast tissue (“stockpiling” nutrients for fetus)

Question 22

Maternal metabolic state during second half of pregnancy

Answer 22

Accelerated starvation state
Insulin resistance (pregestational diabetes is common)
Mediated by hCG

Question 23

Hormone that peaks during parturition, related to contracture response to prostaglandins and oxytocin

Answer 23

CRH (cortisol releasing hormone)

increases E2. Fetal cortisol amplifies placental CRH synthesis (localized positive
feedback)

Question 24

Term for false contractions

Answer 24

Braxton-Hicks

Question 25

This hormone increases the number of OT receptors in endometrial tissue, increasing sensitivity

Answer 25

Estrogen

Question 26

Uterus sensitivity to estrogen (timeline)

Answer 26

0-20 weeks: insensitive
20-36 weeks: gradually increases to 80x
during labor: 200x

Question 27

Signal for the distension of the cervix

Answer 27

Ferguson reflex

Question 28

Does OT promote or inhibit prostaglandin release?

Answer 28

Promote (promotes contractions

Question 29

Alpha adrenergic receptors for catecholamines in myometrial contraction

Answer 29

Increase contractions

Question 30

Beta adrenergic receptors for catecholamines in myometrial contraction

Answer 30

Decrease contractions

Question 31

E2 and prostaglandins increase which adrenergic receptors?

Answer 31

Alpha adrenergic receptors

Question 32

Colstrum vs normal human milk

Answer 32

More protein, less fat, more cells

Question 33

Essential factors for continued milk production (3)

Answer 33

Prolactin, cortisol, insulin

Question 34

Stimulates breast for milk ejection (“letdown”)

Answer 34

Oxytocin

Question 35

Mechanism for milk production

Answer 35

Afferents from spinal cord inhibit dopamine release from arcuate nucleus, removing the tonic inhibition of prolactin. This leads to increased levels of prolactin and milk production

(also causes a decrease in GnRH)