Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2 - RDA > Labour > Flashcards

Labour Flashcards

1
Q

What is defined as miscarriage?

A

<23 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Term vs. Pre-term?

A

Term - 37-41 weeks

Pre-term - 23-47 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define Labour

A

Increasing FUNDALLY-DOMINATED CONTRACTIONS combined w. increasing cervical ripening and effacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the process of labour involve?

A 
Labour involves:
 • Cervical ripening and effacement 
  – INCREASING
 • Co-ordinated myometrial contractions 
 – INCREASING
 • Rupture of foetal membranes
 • Delivery of infant --> then delivery of placenta
 • Contraction of uterus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Explain the stages (terms) of labour

A

Involves:
• 3 trimesters

3rd trimester made up of 3 phases:
• Phase 1 - many hours
• Phase 2 - hours (baby delivered)
• Phase 3 - 30mins (placenta delivered)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is thought to initiate labour both during ‘term’ & ‘pre-term’?

A

Term:
• NOT SURE
• may be oestrogen, LOW progesterone, CRH OR OXTC

Pre-term:
 • Intrauterine infection
 • Bleeding
 • Multiple pregnancy
 • Stress (maternal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

State the 3-stage part of the labour process

A

(1) Cervical ripening & effacement
(2) Co-ordinated myometrial contractions
(3) Rupture of foetal membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain (1) of the labour process

A

(1) Cervical ripening & effacement

  • change from rigid –> flexible structure
  • remodelling (loss of ECM)
  • recruitment (of leucocytes e.g. neutrophils)
  • inflammation (PGE2, IL-8)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Explain (2) of the labour process

A

(2) Co-ordinated myometrial contractions

  • A FUNDAL dominance (w. increased power & co-ordination of contractions)
  • Key mediators (PGE2, OXTC receptors increase, contraction proteins)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain (3) of the labour process

A

(3) Rupture of fetal membranes

  • Loss of strength due to changes in amnion BM component
  • Inflammation & leucocyte recruitment (exacerbated in preterm labour)
  • Increased MMPs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Summary of tissues and processes in the cervix, myometrium & fetal membrane?

A

o Cervix
• PGE2
• IL-8
• MMPs

o Myometrium
• PGE2 F2alpha increased from fetal membranes
• OXTC receptor increased
• Contraction associated proteins

o Fetal membranes
• Inflammatory process in fetal membranes
• PGs, ILs, MMPs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain NF-kB

A

Pro-inflammatory transcription molecule

Has MANY initiators so can induce MANY effects (mainly inflammation) through:
• COX-2, IL-8, IL-1B, MMPs, OXTC/PG receptors, contraction associated proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Evidence to support that NF-kB has many initators?

A

Pro-labour genes have NF-kB binding domains in promotor regions

Modification of NF-kB sites in the domains led to loss of expression of the cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a key regulator of labour?

A

NF-kB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is strongly linked with term labour?

A

Constitutive PGE2 synthesis
• expressed BEFORE any changes can be witnessed

Equally, some tissues could NOT be stimulated to express PGE2 as the levels are ALREADY HIGH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where does control of labour mainly come from?

A

CRH & PAF

These then activate other molecules and ultimately MMPs, PGE2 & upregulation of OXTC receptors

(onenote image!)

17
Q

What do CRH & PAF stand for?

A

CRH - corticotrophin releasing hormone

PAF - platelet activating factor

18
Q

Explain the link between CRH & labour

A

Produced not only by PG BUT also by the HUMAN PLACENTA

  • Levels RISE @ end of pregnancy
  • CRH-binding proteins DROP towards end of pregnancy

High CRH correlated w. HIGH COX2 expression

19
Q

Explain link between PAF & labour

A

Part of lung surfactant that is produced by maturing lungs BEFORE birth
• levels in amniotic fluid INCREASE near term (as PAF part of surfactant that also increases)

HENCE levels of PAF are a signal of foetal maturity (may stimulate labour)

20
Q

What can BOTH CRH & PAF upregulate?

A

Expression of PGE2 & COX2

IL-1beta (inflammatory mediator) levels

[cannot prove however as unethical!)

21
Q

What is the hypothesis of parturition?

A

PAF
• directly made by the lungs
• acts to create ILs which stimulates PG production

CRH
• made primarily by placenta
• stimulates the baby hypothalamus & adrenals to produce cortisol

22
Q

What is odd about the cortisol production in the placenta?

A

Cortisol has a +VE feedback of CRH production in the placenta

23
Q

What are potential theories drawn for labour from the parturition hypothesis?

A
  1. Anything that INCREASES CRH may = labour
    • e.g. stress, multiple infants
  2. Anything that INCREASES MUSCLE CONTRACTION may = labour
    • e.g. xs stretch of uterus
  3. Anything that ACTIVATES INFLAMMATORY CASCADE = labour

ALL the above also applies to pre-term labour
• i.e. stress due to intrauterine bleeding etc.

24
Q

Why is Progesterone needed in pregnancy?

A

To SUSTAIN pregnancy

i.e. if P.Receptor-blockade = pregnancy loss

25
Q

What has been found about Progesterone levels during pregnancy?

A

Levels remain VERY HIGH
• UNTIL the delivery of the placenta

i.e. the effect of Progesterone LOST in normal term labour

26
Q

Explain the interaction between NF-kB and Progesterone

A

HIGH LEVELS of NF-kB BEFORE TERM
• can BLOCK the PRs
• hence REDUCE the effect of P. to sustain pregnancy
• SO can begin labour

i.e. NF-kB levels are HIGH towards end of term so….!

27
Q

Explain the 2 kinds of PR

A

PR-B
• mediates main effects of P.

PR-A
• less able to mediate than PR-B

Ratio of PR-A:PR-B INCREASES towards TERM so P. has LESS of an effect

28
Q

What can loss or change in PR lead to/

A

A ‘functional P. withdrawal’ which is physiologically normal towards term labour

29
Q

What effect does P. has on labour pathways?

A

Can SWITCH OFF MANY labour pathways

onenote picture!!

30
Q

What does labour strongly resemble & the main active tissues?

A

Labour strongly resembles an inflammatory response in
• fetal membranes & cervix

Main active tissues are
• myometrium & cervix

Year 2 - RDA (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions