Substrate usage and body changes during pregnancy

Question 1

What does the foetus demand large amount of?

Answer 1

CHO/glucose

Question 2

What does the increased oestrogen cause hyperplasia of? and where?

Answer 2

B-cell in the pancreas

Question 3

What happens to maternal insulin production?

Answer 3

Increases

Question 4

The stimulation of lipogenesis by the mother from insulin production does what?

Answer 4

Increases fat deposition

Question 5

What resistance may develop during late gestation?

Answer 5

Insulin resistance

Question 6

What % of women have gestational diabetes?

Answer 6

2-3%

Question 7

What hormone counters insulin effects?

Answer 7

Human Placental Lactogen

Question 8

What happens due to reduced CHO use by the mother?

Answer 8

More CHO for foetus, mum has to rely on body fat = lipolysis and reduced adiposity.

Question 9

Own insulin is less effective so has consequence of negating the hypoglysaemia risk - but what does this do for the foetus?

Answer 9

Leaves more sugar in blood for baby to steel via placenta

Question 10

What is common in obese mothers?

Answer 10

Gestational diabetes

Question 11

What % of mums with GDM become type II diabetic 4 years after delivery?

Answer 11

60%

Question 12

What can happen to the baby from GDM?

Answer 12

Increase birth weight because more CHO available, disproportionate growth, baby at risk of low blood glucose post partum because of high insulin production

Question 13

How can maternal exercise help?

Answer 13

Lower blood sugar = less insulin required.

Question 14

What is the incidence of preeclampsia?

Answer 14

3-7%

Question 15

What are the 6 things preeclampsia are associated with?

Answer 15

• Hypertrigliceridemia
• Insulin resistance
• SNS overactivity
• Atherosclerotic lesions in placenta
• Increased leptin
• Increased risk of becoming hypertensive later (20% vs 2%)

Question 16

How much % less is preeclampsia in active women?

Answer 16

35-70%

Question 17

Does exercise decrease or increase C-reactive protein?

Answer 17

Decrease

Question 18

Why will a reduction in C-reactive protein help with preeclampsia?

Answer 18

Increased Nitric Oxide production by endothelium which will increase vasodilation

Question 19

Why may leptin contribute to hypertension?

Answer 19

Because of its role in stimulating SNS activity to burn fat which increases blood pressure

Question 20

How does exercise effect leptin?

Answer 20

Decreases it

Question 21

Why does constipation and slowing of gastrointestinal motility occur during pregnancy?

Answer 21

Due to increased plasma progesterone and increased uterine size

Question 22

Relaxation of the lower oesophageal sphincter leads to what?

Answer 22

heartburn (increased gastric reflux)

Question 23

Does progesterone have a vasodilating or vasocontriction function?

Answer 23

Vasodilating

Question 24

What % of women experience low back pain during pregnancy?

Answer 24

60%

Question 25

What hormonal increases promote during pregnancy?

Answer 25

Ligament and joint laxity

Question 26

Which way does centre of gravity move?

Answer 26

inferiorly and anteriorly

Question 27

What hormone causes pelvic area to be susceptible to dislocation?

Answer 27

Relaxin

Question 28

What happens to the abdominals?

Answer 28

Separate away from midline

Question 29

What incident rate does Diastasis Recti occur?

Answer 29

20-90%

Question 30

What is the average weight gain?

Answer 30

12kg