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Lecture 3 Flashcards

Pregnancy and physiological changes (57 cards)

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1
Q

Conception/Fertilization (5 important steps)

A

1- Ovulation
2-Fertilisation
3-Cleavage
4-Blastocyst
5-Implantation

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2
Q

Ovulation

A

development of follicles which end up turning into an egg and through the release of chemicals during the hormonal stages, once a follicle is developed chemicals are released and this tells the fallopian tube that and egg is ready to be collected

Fallopian tube is where fertilisation occurs

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3
Q

Fertilisation

A

after fertilisation has occured we have what is called a zygote and a zygote is genetically complete

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4
Q

Cleavage

A

Cleavage through mitosis - dividing of the cell which ends up in a morula 16-cell stage and the morula brings nutrients into the cell

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5
Q

Blastocyst

A

trophoblast outer (placenta) has a lot of specialised cells that create finger like structures which helps the now blastocyst to implant into the uterus
Embryoblast inner (fetus)

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6
Q

Implantation

A

Implantation of the blastocyst onto the uterus lining

pregnancy hormonal changes occurs through this time which stops the release of more eggs

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7
Q

EDD

A

Estimated Date of Delivery typically counted from the first day of last menstrual period: 40 weeks from LMP or 38 weeks after conception

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8
Q

1st trimester

A

Conception to 12th week

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9
Q

2nd trimester

A

13th to 28th week

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10
Q

3rd trimester

A

28th week until birth

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11
Q

Pre-trem (premature)

A

<37 weeks

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12
Q

Term

A

37-42 weeks

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13
Q

Post-Term (postmature)

A

> 42 weeks

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14
Q

How many births occur on the due date

A

<10%

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15
Q

Perinatal varies from

A

20-24 weeks and there is a 50% survival chance at 24 weeks

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16
Q

Placenta

A

An organ that starts forming at implantation of the balstocyst

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17
Q

Placenta carries

A

Oxygen, nutrients and antibodies from mother to fetus and waste materials including CO2 from fetus to mother

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17
Q

The placenta is fully formed by

A

18-20 wks but continues to grow throughout pregnancy. At delivery is weighs about 0.5kg

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18
Q

The placenta takes over the hormonal roles of the

A

Ovary

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19
Q

The placenta is connected to the … by the

A

Connected to the embryo/ fetus by an umbilical cord

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20
Q

3 components to the umbilical cord

A

Umbilical vein
Umbilical cord
Umbilical arteries

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21
Q

Teratogens

A

Any agent that can disturb the development of an embryo or fetus. May cause a birth defect in the child or halt the pregnancy.

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22
Q

The classes of teratogens include

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A

radiation, maternal infections, chemicals and drugs

23
Q

Hormonal changes during pregnancy

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A

Progesterone and oestrogen rise continually throughout pregnancy, suppressing the hypothalamic axis and thus the menstrual cycles

24
High circulating levels of oestrogen promote
prolactin production (pituitary gland enlargement by 50%).
25
what does prolactin production mediate
This mediates a change in the structure of the mammary gland from ductal to lobular-aveolar =milk hormone
26
Parathyroid hormone change
is increased to enhance calcium uptake in the gut and reabsorption by the kidney
27
adrenal hormones such as ....... also
adrenal hormones such as cortisol and aldosterone also increase
28
Human placental lactogen is produced by the
Placenta
29
HPL decreases
Maternal insulin sensitivity and maternal glucose utilisation which raises maternal blood glucose levels, which helps to ensure adequate fetal nutrition
30
HPL increases
Gluconeogensis to increase maternal glucose levels so more glucose is available for the fetus
31
chronic hypoglycemia leads to rise in
HPL induces lipolysis with the release of free fatty acids which become available for the maternal organism as fuel, so that relatively more glucose can be utilised by the fetus. Also, ketones formed from free fatty acids can cross the placenta and be used by the fetus.
32
Hematological changes - Blood volume increases
40-45% (proportionally with cardiac output)
33
Plasma volume increases early in pregnancy and faster than
RBC volume, the hematocrit falls until the end of the second trimester, when the increase in the RBC is synchronised with the plasma volume increase - Hematocrit then stabilises
34
If plasma volume increases during pregnancy
The haemoglobin will be lower (this is called dilution anemia)
35
Gastrointestinal changes - as pregnancy progresses, pressure from the enlarging uterus
uterus on the rectum and lower portion of the colon commonly causes constipation
36
GI motility decreases because
elevated progesterone levels relax smooth muscle
37
Heartburn and belching are common possibly resulting from
delayed gastric emptying and gastroesophageal reflux due to relaxation of the lower esophageal sphincter
38
hydrochloric acid production ....
decreases thus peptic ulcer disease is uncommon during pregnancy and preexisting ulcers often become less severe
39
Morning sickness
Nausea & vomiting in pregnancy (NVP) definition spans from slight dizziness and dry retching to continuous vomiting
40
Morning sickness commonly occurs between
5 and 18 weeks of pregnancy with between a 50% to 80% of women reporting some degree of nausea with or without vomiting
41
Severe morning sickness
Hyperemesis gravidarum (HP)
42
Hyperemesis gravidarum (HP)
Extreme form of NVP accompanied by weight loss, electrolyte imbalance and dehydration requiring hospitalisation
43
Recent research of HP has found a link between the hormone
Growth Differentiation Factor 15 (GDF15) and NVP GDF15 plays a crucial role in NVP severity
44
women who have lower levels of GDF prior to pregnancy will not
be as tolerant to it during pregnancy so may not be able to handle it as well during pregnancy
45
Pregnancy outcomes when experiencing NVP or NP (4)
Pelvic girdle pain, high blood pressure, proteinuria, preeclampsia, gestational diabetes
46
Delivery and birth outcomes of NVP or NP (4)
Gestational length, C-section delivery, mortality, growth of infant
47
Women with NVP or NP more likely to develop pregnancy complications but do
exhibit mostly favourable delivery and birth outcomes
48
Management of NVP
1- Reduce symptoms via changes in diet/environment and by medication 2- Correct/prevent consequences or complication of NVP 3-Minimise fetal effects pf maternal NVP and their treatment
49
Management of NVP: diet
Eat what appeals- avoid trigger foods and odours Eat slowly and small amounts every 1-2 hours: avoid a full and empty stomach Frequent small CHO meals such as dry toast: evidence that consistent protein intake is key to prevent nausea Fluids better tolerated if cold, clear, carbonated or sour Ginger and B6 supplements
50
NVP: Ginger and Vitamin B6
Ginger improved general NVP symptom, reduced severity of nausea but did not reduce vomiting Ginger more effective than B6 on reducing nausea but not significantly different
51
what does of ginger is safely prescribe ?
The total dose is usually approximately 1 g per day, divided into 3-4 per day
52
What do some cultures do with the placenta
bury the placenta for varoius reasons. Maori traditionally bury the placenta from a newborn child to emphasize the relationship between humans and the earth
53
In the western world, the placenta is most often
incinerated..... or more recently encapsulated
54
Placental encapsulation benefits
- Improved lactation -Prevent postpartum depression -Relieve pain -Bonding with your baby -Increasing iron stored -Increasing energy
55
Placental encapsulation concerns
-Safe release of placenta from hospital setting -Introducing harmful bacteria through processing
56
placentophagia should be
discouraged as exposes mothers and offspring to infectious risks

HUNT243 (29 decks)

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