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):
1

Pattern of fetal growth is: Determined by

Genome of fetus

2

Pattern of fetal growth is: Modulated by

Placenta
Hormones
Environment
• Nutrition
• Health
Metabolic

3

Pattern of fetal growth is: Hormones

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

4

Growth Retardation → IUGR

Defined as birth weight that is more than two standard

5

Types of IUGR

Type 1 → symmetric
Type II → Asymmetric
Intermediate IUGR

6

Type 1 (symmetric IUGR )

Decreased growth potential ~20%

7

Type II (asymmetric) IUGR

Restricted growth ~ 70% cases

8

Intermediate IUGR

Combination of types I and II

9

The human placental interface →

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

10

Transport Across the placenta types:

1. Transported intact
2. Partially consumed
3. Metabolised
4. Not Transported

11


The Oxyhaemoglobin Dissociation Curve and the Bohr Effect →

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

Rightward shift → decreased affinity

• 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

The Double Bohr Effect:

• Fetal demand for oxygen regulates fetal oxygenation.
• Increased ph leads to a left shift of curve and an increased affinity for oxygen uptake.

14

Fetus capacity for gluconeogenesis

Little

15

Glucose supply

Maternal

16

Maternal glucose levels depend on

Nutrition
Endocrine control mechanisms

17

Early pregnancy Glucose and Carbohydrates:

Progesterone:
1. Increases maternal appetite
2. Builds fat stores

18

Late pregnancy Glucose and Carbohydrates:

Maternal tissues insulin insensitive:
1. More glucose available to fetus
2. Diabetes mellitus may develop in mother

19

Glucose storage provides for

The metabolic neds of the newborn baby until feeding begins

20

Glycogen is stored

In the liver and cardiac muscle

21

Glycogen and Fat: Regulated by

Fetal adrenal cortex

22

Which organ has no glycogen stores

The brain

23

What regulates fetal fat stores

Insulin

24

White fat stores

Fatty acids

25

Brown fat

Heat generation (Nonshivering thermogenesis)

26

Brown fat plays a crucial role in

Maintaining body temperature of the newborn baby after birth

27

Brown fat location

Head, neck, back and chest

28

White fat location

Lower back and buttocks

29

Amino acids

No increase in materal protein intake
Progesterone increases maternal metabolism efficiency

30

Fatty acids

Mother accumulates lipids in early pregnancy
Placental transfer and fetal synthesis meet fetal demands

31

Salt and water

Oestrogen and progesterone stimulate maternal retention
Water exchanges at placenta and non-placental chorion

32

Iron

Fetal blood has a 2-3 times higher concentration of iron
Maternal iron absorption is enhance

33

Calcium

Fetal ossification demands much calcium from mother
Maternal absorption of calcium is more efficient

34

Fetal development requires

Folic acid and vitamin B12

35

Folic acid

Amino acid metabolism

36

Vitamin B12
Made by
Provided by

Fatty acid and amino acid metabolism
Provided at expense of maternal stores

37

Recommended weight gain

11.5-16 kg

38

Weight gain from Intrauterine contents:

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

39

Weight gain maternal contribution

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

40

Response of the Mother to Pregnancy: Cardiovascular changes

Blood volume expands
Cardiac output increases

41

Response of the Mother to Pregnancy: Respiratory system

Alveolar ventilation increases

42

Response of the Mother to Pregnancy: Nutrition

Maternal diet should be supplemented with iron and folic acid

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