intrauterine programming

Question 1

3 major pregnancy complications

Answer 1

pre-term labour, pre-eclampsia, intrauterine growth restriction (IUGR)

Question 2

definition of preterm labour

Answer 2

labour before 37 weeks gestation

Question 3

what is polyhydramnios?

Answer 3

excess amniotic fluid

Question 4

incidence and mortality of perterm labour

Answer 4

• 5 -8% of deliveries

* 80% perinatal mortality and morbidity

Question 5

characteristics of pre-eclampsia

Answer 5

high maternal blood pressure, proteinurea. Placental dysfunction and growth restriction.

Question 6

mortatlity of pre-eclampsia

Answer 6

15% maternal. 10% perinatal

Question 7

etiology of pre-eclampsia

Answer 7

dependant on trophoblast

Question 8

treatment of pre-eclampsia? why?

Answer 8

delivery, irrespective of stage of pregnancy. As placenta is compromising mother, removing it will solve issue

Question 9

incidence of IUGR?

Answer 9

10%

Question 10

what percentage of birth size is dependant on genotype?

Answer 10

15%

Question 11

what factors control fetal growth

Answer 11

genes, hormones (placenta) and environemnt

Question 12

describe the hormonal factors contributing to fetal growth

Answer 12

IGF, thyroid and insulin promote fetal growth. GnRH not so active

Question 13

which hormone inhibits fetal growth? what are the implications

Answer 13

glucocorticoids. stressed mother can inhibit fetal growth

Question 14

r/ship b/w exercise and fetal growth?

Answer 14

moderate very important but excess will divert blood from fetus leading to IUGR

Question 15

main cause of fetal growth restriction in West and 3rd world respectively.

Answer 15

placenta insufficiency, maternal undernutrition

Question 16

main take away from lecture? (fetal programming)

Answer 16

babies born small have increased risk of developing adult disease.

Question 17

r/ship b/w accelerated growth of a small baby and adult disease

Answer 17

accelerated growth is risk if inhibits normal trajectory, not good to fatten baby up.

Question 18

describe fetal programming

Answer 18

Exposure of the fetus to sub-optimal conditions causes adaptations that help it survive short term but increase chances of developing disease in adult life

Question 19

in Mary’s research what are 5 factors that act as 2nd hits and can cause dysfunction

Answer 19

gender, diet, lifestyle, age, pregnancy