Lecture 13 - Placenta III Flashcards Preview

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Flashcards in Lecture 13 - Placenta III Deck (21):
1

Human chorionic Gonadotrophin (hCG)?

two chain hormone, shares alpha chain with TSH, LH and FSH, all hormones have unique beta chain, produced by pre-implantation zygot and placenta, detectable in mothers blood days after implantation

2

hCG concentration progression?

major rise following LMP, peaks around ned of 1st trimester where it flattens and then declines slightly

3

hCG functions?

stimulate the production of progesterone and oestrogen by ovary during first 6-8wk pregnancy, doubles size of corpus luteum - essentially preventing uterus's normal cycle and causing CL to continually secrete p and oe to maintain endometrium into duodenal form

4

hCG and LH?

share same receptor, similar signalling pathway

5

Proof of importance of hCG in pregnancy?

vaccine of beta-hCG antibodies induces infertility

6

hCG and male fetuses?

LH-like activity stimulating testosterone synthesis by Leydig cells of fetal testis

7

Progesterone from placenta?

produces by syncytiotrophoblasts using LDL-cholesterol (no ovary dependence)

8

Functions of progesterone?

bind to receptors on glands and stromal cells in endometrium/decidua, maintain uterine inactivity (w oestrogen) for pregnancy environment

9

Oestrogen from placents?

cannot produce from scratch, modifies testosterone and other androgens, fetus produce these androgens but cannot convert, anencephalic pregnancies have low oestrogen

10

Primary maternal adaptations?

CVS, haemotological, immunity, genitals

11

Preeclampsia?

dangerously elevated maternal blood pressure and protein in urine, exaggerated inflammatory response preventing normal vascular adaptation to pregnancy

12

CVS adaptation?

increased stroke volume and pulse rate, decreased peripheral resistance (abnormally high in preeclampsia) - changes most important for first 9 weeks gestation

13

Oestrogen and CV changes?

reduce vascular resistance (mainly reproductive), alter type I:type II ratio of collagen in vessel wall - spiked levels not reached until 9wk where fetal adrenals form

14

Angiotensin II?

levels increase in pregnancy, but effects appear blunted (likely due to receptor changes)

15

haemotological changes?

increase in blood volume, plasma faster than cells therefore reducing haematocrit

16

Blood loss during birth?

half litre (full in c section and twins), but hypervolaemia means loss leads to restoration of haemotocrit

17

Infections of increase severity in pregnancy?

listeriosis, leprosy

18

Neutrophils?

increase in luteal phase and remainduring pregnancy, peak @ 30 weeks then rise again @ labour

19

Lymphocytes?

th2 increase that support antibody imunity rather than th1 driven cell immunity

20

Presence of T cells in decidua?

not high, higher in repeated miscarraige, potentially attacks placenta

21

Abdominal wall and skin?

increased blood flow to hands and feet, pigmentation changes of skin (nipples), likely linked to melanocyte stimulating hormone