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3rd year > Repro - physiology (labour & pregnancy) > Flashcards

Repro - physiology (labour & pregnancy) Flashcards

1
Q

where does fertilisation occur? when?

A

ampulla

day 1

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2
Q

where does implantation occur? when?

A

uterus

day 5-8

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3
Q

what happens when the blastocyst attaches to the uterus

A

trophoblastic cells being to penetrate the endometrium and tunnel in

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4
Q

when is implantation finished

A

day 12 = when the blastocyst is completely buried in endometrium.

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5
Q

what cells become the embryo

A

inner blastocyst cells

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6
Q

what cells become the placenta

A

outer blastocyst cells + decidual tissue

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7
Q

when does the placenta start to function

A

week 5

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8
Q

is there direct contact between the maternal and foetal blood? why?

A

NO

separated via villius

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9
Q

how does blood reach the foetus

A

umbilical vein

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10
Q

what are the 3 factors that facilitate oxygen supply to foetus

A

foetal Hb has increases ability to carry O2

higher [Hb] in foetal blood

Bohr effect

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11
Q

what supplies the early nutrition of the embryo

A

invasion of trophoblastic cells into decidua

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12
Q

what supplies late nutrition of the embryo

A

placenta diffusion

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13
Q

what is the role of HCG? when does it increase?

A

prevent involution of corpus lutem
development of sex organs

huge spike in pregnancy

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14
Q

what is the role of the corpus lutem in pregnancy

A

stimulates progesterone and oestrogen

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15
Q

when is Human Chorionic Somatomammotrophin (HCS) produced

A

from 5wk of pregnancy onwards

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16
Q

what is the effect of Human Chorionic Somatomammotrophin (HSC)

A

growth hormone like effects = protein tissue formation
decreases insulin sensitivity in mother
breast development

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17
Q

what is the role of progesterone in pregnancy

A

Decreases uterus contractility
Preparation for lactation
Involved in the development of decidual cells

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18
Q

what is decidual cells

A

modified uterus lining

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19
Q

what is the role of oestrogens in pregnancy

A

enlargement of uterus
breast development
relaxation of ligaments

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20
Q

what condition can be caused by an increase in HCG

A

hyperthyroidism

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21
Q

what conditions can be caused by an increase in HSC

A

hypertension

gestational diabetes

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22
Q

what happens to the following in pregnancy:

CO 
SV 
HR
plasma volume 
peripheral vascular resistance 
BP
A

CO = increases
SV = increases
HR= increases
plasma volume = increases
peripheral vascular resistance = decreases
BP = increases then drops in 2nd trimester

23
Q

what happens to the following in pregnancy:

RR
tidal volume
pCO2
pO2

A

RR = increases
tidal volume = increases
pCO2 = decreases
pO2 = no change

24
Q

what supplements should be given in pregnancy

A

folic acid = pre-conception and 1st 12 weeks
vit D = throughout pregnancy and breastfeeding
may require iron

25
Q

how much folic acid should be prescribed

A

400mg

5mg if obese, diabetic, on anti-epileptics

26
Q

what is parturition

A

initiation of labour

27
Q

what hormones affect contractility during labour

A 
oestrogen = increase contractility 
progesterone = decrease contractility 
oxytocin = increases contractions and excitability
28
Q

what hormone initiates and sustains contractions

A

oxytocin

29
Q

what is true labour

A

the timing of contractions become evenly spaced and the time between them gets shorter and shorter

30
Q

what are the types of maternal pelvis? which is most common

A 
gynaecoid = most common 
anthropoid = oval shaped 
android = triangular/heart shaped
31
Q

what is the normal position for a foetus

A

longitudinal lie
cephalic presentation
occipito-anteiror position

32
Q

what are the 7 mechanisms of labour

A 
engagement 
decent 
flexion 
internal rotation 
extension 
external rotation 
expulsion
33
Q

what is involved in the engagement during labour

A

passage of the widest diabetes of the presenting part below the plane of the pelvic inlet

(widest diameter of head haas entered brim of pelvis OR 3/5ths of head entered pelvis)

34
Q

what is involved in the descent during labour

A

downwards passage of the presenting part through pelvis

35
Q

what is involved in the flexion during labour

A

flexion of head occurs passively due to shape of pelvis and resistance from tissue

36
Q

what is involved in the internal rotation during labour

A

Rotation of the presenting part from its original position as it passes through the pelvis

usually from transverse to anterior

37
Q

what is involved in the extension during labour? what is it also known as?

A

aka crowning

foetus has reached level of interiotus (appearance of large segment of foetal head)

38
Q

what may be required during extension stage

A

episiotomy

39
Q

what is involved in the external rotation during labour? what is it also known as?

A

aka restitution

return of foetal head to correct anatomical position in relation to torso

40
Q

what is involved in the expulsion during labour? what goes first?

A

delivery of rest of body

anterior shoulder goes first

41
Q

what are the 3 stages of labour

A 
1st = split into latent and active 
2nd = full dilatation
3rd = delivery
42
Q

what is defined as the latent stage of labour? what happens during it

A

<4cm dilatation

mild, irregular contractions. cervix shortens and softens. encourage to stay at home

43
Q

what is defined as the active stage of labour? what happens during it

A

4cm and above dilatation

decent of presenting parts

44
Q

what is the normal rate of progress during the active stage of labour

A

1-2 cm per hr

45
Q

what is defined as full dilatation

A

10cm

46
Q

what is the average duration of the 3rd stage of labour? when would you start to plan alternative method

A

10mins

prep for alternative after 1hr

47
Q

when does expulsion of placenta take place

A

5-10mins after delivery

48
Q

what are the signs of placenta separation after labour

A

Uterus contracts, hardens and rises
Umbilical cord lengthens permanently
Gush of blood
Placenta and membranes appear

49
Q

where does placental separation occur? what is the most common type

A

occurs in the spongy layer of the decidua via sheering force

common = mathew Duncan

50
Q

what are the methods of induction of labour

A 
prostaglandins (gel, pessary)
membrane sweep 
foley balloon catheter
amniotomy 
IV syntocin
51
Q

what is bishops score used for

A

to determine if it is safe to induce labour

sore of 5 = induce

52
Q

what is puerperium? how long does it take?

A

state of repair and recovery post labour which returns tissues to their non-pregnancy state

6 wks

53
Q

what is lochia

A

vaginal discharge containing blood, mucus and endometrial castings

3rd year (12 decks)

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