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BIOSCIENCE FOR MIDWIFERY > Week 2 > Flashcards

Week 2 Flashcards

1
Q

Hormones of pregnancy

A

Human chorionic gonadotropin (hCG)
Human placental lactometer (hPL)
Oestrogen
Progesterone

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2
Q

Human chorionic gonadotropin (hCG)

A

Glycoprotein, secreted by the trophoblast. hCG forms the basis of the pregnancy test, where hCG antibodies are used to identify the presence of hCG in the woman’s urine. Maintains the corpus luteum so that it will continue to produce oestrogen & progesterone

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3
Q

Human placental lactose not (hPL)

A

Polypeptide, secreted by the syncytiotrophoblast. It facilitates growth, changing maternal metabolism to maximise the nutrients available to the fetus in utero.

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4
Q

Steroid hormones

A

Oestrogen and progesterone, responsible for the maintenance of pregnancy, are initially released from the corpus luteum in the ovaries. The placenta takes over this role at about 7 weeks gestation.

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5
Q

Describe the role of oestrogen in pregnancy?

A

Growth and development of breasts; maintains endometrium, promotes growth of Myometrium muscle.
Development of secondary sex characteristics and sex organs.
Increases blood flow which can cause swelling of the vessels which can than cause congestion or headaches.

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6
Q

Describe the role of progesterone in pregnancy?

A

Relaxes smooth muscle; reduces uterine muscle contractility; Helps suppress immune system; relaxation of blood vessels.

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7
Q

Describe the role of the corpus luteum?

A

Maintains the endometrium for implantation and embryonic development, suppress ovulation: through release of oestrogen and progesterone

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8
Q

Which hormone is released 5 days after fertilisation?

A

Human Chorionic Gonadotropin (hCG)

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9
Q

What 2 hormones do the corpus luteum produce?

A

Oestrogen and progesterone suppresses ovulation and maintains the uterus for the growing embryo.

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10
Q

What does oestrogen and progesterone suppress during pregnancy?

A

Ovulation and menstruation

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11
Q

What stage of pregnancy does the placenta take over from the corpus luteum?

A

3 months

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12
Q

What are the changes to breast development as a result of hormone changes and pregnancy?

A

Embryogenesis - first 8 weeks, 4th week primitive milk streak; 5th week mammary ridge.
Mammogenesis - Growth & development of mammary glands
Lactogensis - Initiation of colostrum and milk after birth

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13
Q

What are the changes to the immune system as a result of hormonal changes and pregnancy?

A

White blood cells are increased and more responsive
hCG stimulates nutraphil production and response (WBC)
Increase in corticosteroids suppresses phagocytic activity (phagocytes attach foreign bodies such as bacteria)
Prostaglandins suppress NK cell activity (cells that respond to viral infection)

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14
Q

What are the changes to the cardiovascular system as a result of hormonal changes and pregnancy?

A

Location of the heart displaced in the diaphragm
Heart enlarges and cardiac volume increases
Cardiac output increases
Heart rate increases from 4 weeks
Increase in plasma volume and red blood cell mass
Decrease in diastolic blood pressure 1st & 2nd trimester and returns to pre-pregnancy levels in 3rd trimester

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15
Q

What are the changes to the respiratory system as a result of hormonal changes and pregnancy?

A

Diaphragm moves upward
Lung capacity isn’t altered though due to increase of diameters of the thoracic cavity
Tidal volume increases; residual decreases
O2 consumption increases to accommodate the needs of the foetus

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16
Q

What are the changes to the renal system as a result of hormonal changes and pregnancy?

A

Kidneys enlarge by 1 - 1.5cm in length
Increased blood flow to kidneys
Bladder is displaced upward and forward, with reduced capacity resulting in frequent urination
Glomerular filtration increases by 50% which therefore increases secretion of electrolytes

17
Q

What are the changes to the GIT system as a result of hormonal changes and pregnancy?

A

Displaced the uterus
Tone & motility decreased (progesterone)
Symptoms included constipation, haemorrhoids, nausea and vomiting, indigestion.
Liver: size and blood volume unchanged
Gall bladder - increased risk of gall stones; hypotonic, distended, slow emptying
NVP
Indigestion due to pressure of uterus and relaxation of sphincter so

18
Q

What are the presumptive (possible) signs of pregnancy?

A 
Breast changes (3-4)
Amenorrhea (4)
Morning sickness (4-14)
Bladder irritability (6-12)
Quickening (14-20)
19
Q

What are the probable signs of pregnancy?

A 
Biochemical pregnancy tests (hCG)
- Blood (9-10 days)
- Urine (14 days)
Hegar's sign (softened isthmus) (6-12)
Chadwick's sign (blueing of vagina) (8)
Oslander's sign (pulsation of fornices) (8)
Uterine growth (8)
Braxton hicks contractions (16)
Ballottement of fetus (16-28)
20
Q

What are the positive signs of pregnancy?

A

Ultrasound (transvaginal) (5)
Doppler (12)
Fetal movements palpable (22)
Fetal parts palpable (24)

21
Q

What are the initial screening tests in pregnancy?

A

Blood tests

  • full blood count (haemoglobin)
  • Blood group
  • Rhesus factor
  • Red blood cell

Tests (selective)

  • Urinalysis
  • Vitamin D levels
  • Haemaglobinopathies
  • Chalmydia
22
Q

TORCH Screening

A 
Toxoplasmosis
Others:
-Hepatitis B & C
-Varicella
-Listeriosis
Rubella
Cytomegalovirus (CMV)
Herpes simplex
23
Q

Subsequent screening tests in pregnancy?

A

Pre-eclampsia
Anaemia - repeat haemoglobin at 28 weeks gestation
Atypical red-cell all antibodies
Gestational diabetes - Glucose challenge or glucose tolerance test
Streptococcus group B (GBS)

24
Q

What is the initial screening for the baby in utero?

A

Ultrasound
- Gestational age (10 - 13 weeks)
Down’s syndrome screening
- 10-14 weeks (combined test - nuchal translucency, beta-human chorionic gonadotropin, pregnancy-associated plasma protein A)

25
Q

What are the 3 major growth and development phases of the mammary gland?

A
  1. In utero
  2. 1 to 2 years of life
  3. Puberty
26
Q

What are the placental hormones that accelerate breast development in early pregnancy?

A

Oestrogen, placental lactogen, prolactin, chorionic gonadotropin, progesterone

27
Q

Montgomery’s tubercles are structures which?

A

Secrete lubricate onto the areole and nipple during pregnancy and lactation.

28
Q

Breast milk is manufactured within the ?

A

Alveoli

29
Q

When gastrulation is complete the 3 germ layers are termed?

A

Ectoderm, endoderm; and mesoderm

30
Q

Which gestational week would you expect the neural tube to close?

A

By week 4

31
Q

What is a screening test?

A

To detect potential disease indicators

32
Q

What is a diagnostic test?

A

To establish presence/absence of disease

33
Q

What are risk factors for gestational diabetes?

A 
High blood pressure
Overweight
Previous history
Smoking
Being of African, Asian or Pacific Islander
Unexplained stillbirth
34
Q

What is conceptus?

A

Denotes the embryo and its adnexa or associated membranes
The conceptus includes all structures that develop from the zygote, both embryonic and extraembryonic. It includes the embryo as well as the embryonic part of the placenta and its associated membranes - amnion, chorion (gestational sac), and yolk sac.

BIOSCIENCE FOR MIDWIFERY (4 decks)

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