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Human Repro > Lecture 11 > Flashcards

Lecture 11 Flashcards

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1
Q

first trimester nutrition

A

histotrophic supplied from uterine secretions by diffusion

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2
Q

second/ third trimester nutrition

A

hemochorial supplied from maternal blood

arises from interstitial implantation

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3
Q

when does foetus develop

A

at physiological hypoxia (lack of o2)

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4
Q

what do glands produce

A

secretions to supply nutritional needs, partially supplied by glucose

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5
Q

histiotroph

A

under influence of progesterone

endometrial glands produce secretions during the first trimester

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6
Q

what does histiotroph secretions contain

A

glucose oligomers
glycoproteins

uterine milk

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7
Q

histiotrophic nutrition

A

endometrial gland secretions cross the chorionic plate into the coelomic cavity

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8
Q

structure before 11 weeks

A

route of diffusion
bottom of decidual gland
build up of trophoblast - multilayer called shell
trophoblast attaches placenta at surface of uterus

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9
Q

villus placenta

A

nutrients are transferred cross tiny capillaries to bigger capillaries

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10
Q

near term ultrasound

A

major changes to uterus vascular supply are required to accommodate and support the foetus and placenta

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11
Q

pregnancy referred to as

A

exercise challenge

demands on cardiovascular system of woman

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12
Q

foetal growth depends on

A

provision of o2 and nutrients from mother

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13
Q

adaptive mechanisms in cardiovascular

A

support growth of foetus whilst preserving maternal health

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14
Q

stimuli for changes in cardio parameters

A

hormonal
metabolic
mechanical

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15
Q

blood volume

A

progressive increase of 35-50%

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16
Q

systemic changes

A

increase in CO
increase in SV
increase in HR

decrease in TPVR

BP stays the same

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17
Q

cardiac output

A

cardiac output increases as weeks increase

change in blood vessels that locally supply uterus

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18
Q

uterine artery

A

bilateral (2)
passes from myo to endo
coiled arteries to spiral arterioles
endo lost in period

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19
Q

cross section of artery

A

smooth muscles
endothelial cells
lumen

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20
Q

number of smooth muscle cells

A

depends on size of artery

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21
Q

Poiseuille’s Law

A

flow related to diameter of artery

as volume flow increases more rapidly, you get a slight increase in radius

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22
Q

relax

A

volume flow increase exponentially

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23
Q

contract

Study These Flashcards
A

volume flow decrease exponentially

24
Q

Right and left uterine artery flow 5-16 weeks

Study These Flashcards
A

increase in volume and velocity

25
uterine artery blood flow increases
from 20 weeks to term
26
volume change
unilateral | occurs after 16 weeks so there is an increase in velocity
27
increase in blood flow
increase in artery size from 20 weeks onwards
28
16 weeks
flow rate increases pressure decreases diameter increases
29
alteration in vascular function determined by
endothelial mediators constriction relaxation
30
endothelium-derived vasodilators
prostanoids such as prostacyclic NO EDHF communicate by gap junctions
31
20 weeks blood flow
increasing blood flow to uterus mainly due to dilation of uterine artery estrogen increases
32
spiral arteries rhesus monkey
interphase between myo and endo high level of resistance longer vessel, more resistance
33
implanting placenta
interacts with maternal spiral arterioles
34
The interaction with invasive trophoblast
initially prevents blood flow | to the developing placenta (first 11 weeks)
35
profound remodelling of the spiral arterioles
leads to a high volume, low pressure blood supply locally to the intervillous space of the placenta
36
incomplete remodelling
pathogenesis
37
week 18-20
Trophoblast invasion of the endometrial stroma (decidua) | occurs from immediately after implantation
38
invasive cells called?
extravillous trophoblast
39
Secondary villus stage (second week of pregnancy)
Cytotrophoblast cells invading the endometrium radiate away from the trophoblastic shell towards a group of glands
40
plug
invading cells plug the mouths of endometrial spiral arterioles, preventing blood from accessing the developing intervillous space
41
Blocking
by cytotrophoblast plugs
42
Spiral artery remodelling
effected by maternal leukocytes (uNK cells and macrophages) in collaboration with trophoblast cells derived from the placenta
43
CD45+ cells
maternal white blood cells in the wall of a spiral artery during remodelling These are macrophages and specialised uterine NK cells
44
remodelling process
internal elastic lamina and the medial SMC are removed progressively, first by uNK cells and then by invasive trophoblast
45
Loss of the internal elastic lamina and the medial SMC
high flow, low resistance channels that lack vasomotor control
46
Loss of vascular smooth muscle
renders the arterial supply to the placenta insensitive to maternal vasoconstriction and ensures that blood is delivered to the intervillous space at low pressure
47
Loss of the vascular elastic lamina
This ensures loss of elastic recoil, and irreversible expansion of the arterial channel
48
Leukocyte
extracellular matrix interactions | VSMC interactions
49
Trophoblast
extracellular matrix interactions | VSMC interactions
50
Cellular interactions during vascular remodelling
highly regulated, slow process which rebuilds the arteriole wall that lacks the smooth muscle walls
51
Pre-11 weeks
blood does not flow in the intervillous space of the placenta fetus and placenta are highly hypoxic at this time
52
Pre-11 weeks vascular supply
remodelling to avoid exposing the placenta to shear stresses associated with arterial blood pressure
53
From 11 weeks
plugs are displaced and the intervillous space becomes a shunt: oxygenated maternal blood passes through at low pressure
54
Trophoblast continues to invade up to
18 weeks reaches arterial segments in the inner third of the myometrium
55
Functions of trophoblast
``` Transport Immunological barrier Secretion/endocrine Anchorage Plugging of arteriolar openings Migration and vascular remodelling ```
56
Uterine Artery Doppler
Ultrasound data reinforces that changes to blood flow to the uterus continue after trophoblast invasion has ceased at ~20 weeks. That is, the remodelling of the spiral arteries is not causative – it protects the placenta from damage.

Human Repro (11 decks)

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