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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
how much folic acid should be prescribed
400mg | 5mg if obese, diabetic, on anti-epileptics
26
what is parturition
initiation of labour
27
what hormones affect contractility during labour
``` oestrogen = increase contractility progesterone = decrease contractility oxytocin = increases contractions and excitability ```
28
what hormone initiates and sustains contractions
oxytocin
29
what is true labour
the timing of contractions become evenly spaced and the time between them gets shorter and shorter
30
what are the types of maternal pelvis? which is most common
``` gynaecoid = most common anthropoid = oval shaped android = triangular/heart shaped ```
31
what is the normal position for a foetus
longitudinal lie cephalic presentation occipito-anteiror position
32
what are the 7 mechanisms of labour
``` engagement decent flexion internal rotation extension external rotation expulsion ```
33
what is involved in the engagement during labour
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
what is involved in the descent during labour
downwards passage of the presenting part through pelvis
35
what is involved in the flexion during labour
flexion of head occurs passively due to shape of pelvis and resistance from tissue
36
what is involved in the internal rotation during labour
Rotation of the presenting part from its original position as it passes through the pelvis usually from transverse to anterior
37
what is involved in the extension during labour? what is it also known as?
aka crowning foetus has reached level of interiotus (appearance of large segment of foetal head)
38
what may be required during extension stage
episiotomy
39
what is involved in the external rotation during labour? what is it also known as?
aka restitution return of foetal head to correct anatomical position in relation to torso
40
what is involved in the expulsion during labour? what goes first?
delivery of rest of body anterior shoulder goes first
41
what are the 3 stages of labour
``` 1st = split into latent and active 2nd = full dilatation 3rd = delivery ```
42
what is defined as the latent stage of labour? what happens during it
<4cm dilatation mild, irregular contractions. cervix shortens and softens. encourage to stay at home
43
what is defined as the active stage of labour? what happens during it
4cm and above dilatation decent of presenting parts
44
what is the normal rate of progress during the active stage of labour
1-2 cm per hr
45
what is defined as full dilatation
10cm
46
what is the average duration of the 3rd stage of labour? when would you start to plan alternative method
10mins prep for alternative after 1hr
47
when does expulsion of placenta take place
5-10mins after delivery
48
what are the signs of placenta separation after labour
Uterus contracts, hardens and rises Umbilical cord lengthens permanently Gush of blood Placenta and membranes appear
49
where does placental separation occur? what is the most common type
occurs in the spongy layer of the decidua via sheering force common = mathew Duncan
50
what are the methods of induction of labour
``` prostaglandins (gel, pessary) membrane sweep foley balloon catheter amniotomy IV syntocin ```
51
what is bishops score used for
to determine if it is safe to induce labour sore of 5 = induce
52
what is puerperium? how long does it take?
state of repair and recovery post labour which returns tissues to their non-pregnancy state 6 wks
53
what is lochia
vaginal discharge containing blood, mucus and endometrial castings

3rd year (12 decks)

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