Physiology of Pregnancy Flashcards

1
Q

What is the role of the placenta?

A

To produce hormones in order to maintain pregnancy.

The driving force behind maternal adaptations.

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2
Q

What is the role of HCG?

A

Signals the corpus luteum to continue secreting progesterone.

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3
Q

What is the role of placental villi?

A

Project into the uterine wall, providing anchorage and increasing contact between the uterus and the placenta, allowing for a greater rate of nutrient/waste exchange.

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4
Q

What plays the role of the foetal lungs?

A

The placenta.

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5
Q

What factors facilitate the supply of foetal oxygen?

A

Foetal haemoglobin (increased O2 capacity)
Increased haemoglobin in foetal blood
Bohr effect

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6
Q

How does the Bohr effect impact foetal oxygenation?

A

Hb can carry more O2 due to a low PCO2.

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7
Q

How do electrolytes cross the placenta?

A

With water during osmosis.

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8
Q

Name 2 drugs to avoid in pregnancy due to their teratogenicity?

A

Carbamazepine

Tetracyclines

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9
Q

What is the role of human placental lactogen (HPL)?

A

A growth hormone, causing increased formation of protein tissue.

Reduces insulin sensitivity of mother - allowing energy to reach the foetus.

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10
Q

At around which week does HPL begin to be produced?

A

Week 5.

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11
Q

What is the role of progesterone in pregnancy?

A

Decreases uterine contractility

Enlarges breasts for lactation

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12
Q

What is the the role of oestrogen in pregnancy?

A

Enlarges uterus
Enlarges breasts
Relaxation of ligaments

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13
Q

How often should HCG levels double in early pregnancy?

A

Every 48 hours.

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14
Q

What symptoms are associated with increasing levels of HCG?

A

Nausea and vomiting

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15
Q

What does a slow rising/static HCG level indicate?

A

Ectopic pregnancy

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16
Q

What does a falling HCG level indicate?

A

Miscarriage or an unviable pregnancy.

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17
Q

What do extremely high levels of HCG suggest?

A

Multiple pregnancy

Molar pregnancy

18
Q

At which gestation does HCG levels begin to fall again?

A

12-14 weeks.

19
Q

What change is seen in cardiac output during pregnancy?

A

Increase by 30-50%.

20
Q

What change is seen to BP in pregnancy?

A

Drops in 2nd trimester by around 15mmHg, with a rise in the 3rd trimester expected.

21
Q

What is anaemia defined as in the first trimester?

A

<110g/L of Hb

22
Q

What is anaemia defined as in the second and third trimesters?

A

<105g/L of Hb

23
Q

What is a normal haemoglobin level in a healthy individual?

A

120-160g/L of Hb

24
Q

Why do Hb levels drop in pregnancy?

A

Increased plasma volume.

25
Q

What respiratory changes are seen in pregnancy?

A

Increased respiratory rate
Increased tidal and minute volume
Slight decrease in PCO2

26
Q

Are vital capacity and PO2 changed by pregnancy?

A

No

27
Q

Are GFR and plasma affected by pregnancy?

A

Yes, they increase by 30-50%.

28
Q

Why does urinary frequency increase during pregnancy?

A

Increased uterine pressure

Increased urinary formation (minimal)

29
Q

Is pregnancy a hypercoagulable state?

A

Yes

This is advantageous in preventing haemorrhage, however there is increased risk of thromboembolism.

30
Q

What supplementation is advised in pregnancy?

A
Folic acid
Vitamin D
High protein diet
High energy intake
Iron supplements (if needed)
Vitamin B
31
Q

What rises to increase uterine excitability towards the end of pregnancy?

A

Oestrogen : Progesterone ratio

The greater the amount of oestrogen present, the greater the rate of uterine contraction.

32
Q

What is the role of oxytocin?

A

Increase contractions and uterine excitability.

33
Q

Where is oxytocin produced?

A

The posterior pituitary of the mother.

34
Q

What are Braxton-Hicks contractions?

A

Tightenings of the uterus felt towards the end of pregnancy.

These are not labour.

35
Q

Are Braxton-Hicks contractions regular and painful?

A

No, they are neither of these things.

36
Q

What is the first stage of labour?

A

Dilatation of the cervix (can take 8-24 hours).

37
Q

What is the second stage of labour?

A

Passage of the foetus through the birth canal (can take a few hours).

38
Q

What is the third stage of labour?

A

Expulsion of the placenta.

39
Q

What role does oestrogen play in breast development?

A

Maturation and growth of the ductile system of the breasts, allowing for milk production.

40
Q

What role does progesterone play in breast development?

A

Allows for development of the lobule-alveolar system.

41
Q

Which hormone stimulates milk production?

A

Prolactin

42
Q

What is the antibody-rich milk produced in the first few days following birth called?

A

Colostrum