Endo-Repro L26 The Fetus and its Preparations for birth: Flashcards Preview

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Flashcards in Endo-Repro L26 The Fetus and its Preparations for birth: Deck (42)
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1
Q

Pattern of fetal growth is: Determined by

A

Genome of fetus

2
Q

Pattern of fetal growth is: Modulated by

A
Placenta
Hormones
Environment
•	Nutrition
•	Health
Metabolic
3
Q

Pattern of fetal growth is: Hormones

A

Glucocorticoids, insulin
Insulin-like growth factors (IGFs or sometomedins)
Thyroid hormones
Human placental lactogen

4
Q

Growth Retardation → IUGR

A

Defined as birth weight that is more than two standard

5
Q

Types of IUGR

A

Type 1 → symmetric
Type II → Asymmetric
Intermediate IUGR

6
Q

Type 1 (symmetric IUGR )

A

Decreased growth potential ~20%

7
Q

Type II (asymmetric) IUGR

A

Restricted growth ~ 70% cases

8
Q

Intermediate IUGR

A

Combination of types I and II

9
Q

The human placental interface →

A

Maternal and fetal circulations pass close to each other, but do not mingle, to facilitate the exchange of materials.

10
Q

Transport Across the placenta types:

A
  1. Transported intact
  2. Partially consumed
  3. Metabolised
  4. Not Transported
11
Q

The Oxyhaemoglobin Dissociation Curve and the Bohr Effect →

A

The oxygen–hemoglobin dissociation curve plots the proportion of haemoglobin in its saturated form on the vertical axis against the prevailing oxygen tension on the horizontal axis.

12
Q

Rightward shift → decreased affinity

A
  • This makes it more difficult for haemoglobin to bind to oxygen (requiring a higher partial pressure of oxygen to achieve the same oxygen saturation)
  • It makes it easier for the haemoglobin to release oxygen bound to it.
  • The effect of this rightward shift of the curve increases the partial pressure of oxygen in the tissues when it is most needed, such as during exercise, or haemorrhagic shock.
13
Q

The Double Bohr Effect:

A
  • Fetal demand for oxygen regulates fetal oxygenation.

* Increased ph leads to a left shift of curve and an increased affinity for oxygen uptake.

14
Q

Fetus capacity for gluconeogenesis

A

Little

15
Q

Glucose supply

A

Maternal

16
Q

Maternal glucose levels depend on

A

Nutrition

Endocrine control mechanisms

17
Q

Early pregnancy Glucose and Carbohydrates:

A

Progesterone:

  1. Increases maternal appetite
  2. Builds fat stores
18
Q

Late pregnancy Glucose and Carbohydrates:

A

Maternal tissues insulin insensitive:

  1. More glucose available to fetus
  2. Diabetes mellitus may develop in mother
19
Q

Glucose storage provides for

A

The metabolic neds of the newborn baby until feeding begins

20
Q

Glycogen is stored

A

In the liver and cardiac muscle

21
Q

Glycogen and Fat: Regulated by

A

Fetal adrenal cortex

22
Q

Which organ has no glycogen stores

A

The brain

23
Q

What regulates fetal fat stores

A

Insulin

24
Q

White fat stores

A

Fatty acids

25
Q

Brown fat

A

Heat generation (Nonshivering thermogenesis)

26
Q

Brown fat plays a crucial role in

A

Maintaining body temperature of the newborn baby after birth

27
Q

Brown fat location

A

Head, neck, back and chest

28
Q

White fat location

A

Lower back and buttocks

29
Q

Amino acids

A

No increase in materal protein intake

Progesterone increases maternal metabolism efficiency

30
Q

Fatty acids

A

Mother accumulates lipids in early pregnancy

Placental transfer and fetal synthesis meet fetal demands

31
Q

Salt and water

A

Oestrogen and progesterone stimulate maternal retention

Water exchanges at placenta and non-placental chorion

32
Q

Iron

A

Fetal blood has a 2-3 times higher concentration of iron

Maternal iron absorption is enhance

33
Q

Calcium

A

Fetal ossification demands much calcium from mother

Maternal absorption of calcium is more efficient

34
Q

Fetal development requires

A

Folic acid and vitamin B12

35
Q

Folic acid

A

Amino acid metabolism

36
Q

Vitamin B12
Made by
Provided by

A

Fatty acid and amino acid metabolism

Provided at expense of maternal stores

37
Q

Recommended weight gain

A

11.5-16 kg

38
Q

Weight gain from Intrauterine contents:

A

Fetus → 3.3 kg
Placenta → 0.7 kg
Amniotic fluid → 1.0kg

39
Q

Weight gain maternal contribution

A

Uterus → 0.7 kg
Blood → 1.3 kg
Breasts →2.0 kg
Adipose tissue and interstitial fluid → 5.0 kg

40
Q

Response of the Mother to Pregnancy: Cardiovascular changes

A

Blood volume expands

Cardiac output increases

41
Q

Response of the Mother to Pregnancy: Respiratory system

A

Alveolar ventilation increases

42
Q

Response of the Mother to Pregnancy: Nutrition

A

Maternal diet should be supplemented with iron and folic acid

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