Module 1 Flashcards
(26 cards)
which uterine layer is responsible for contractions?
myometrium
What is the purpose of spiral artery remodelling?
facilitate maternal-fetal blood flow
which placental hormone primarily drives insulin resistance?
PGH
which placental hormone primarily drives beta cell expansion?
hPL
Diagnosis of pregnant woman with FBGL of 6mmol/L
GDM
list 3 major CV adaptations during pregnancy and their physiological importance
increased work: O2 and nutrient delivery
increased plasma vol: enhances uteroplacental perfusion for fetal growth
decreased peripheral resistance: facilitates blood flow to uterus, prevents HTN
how is prog secretion maintained in early preg and why is this essential?
prog secretion maintained as early blastocyst secretes hCG which prevents atrophy of and stimulates the corpus luteum to continue secreting progesterone. Essential for decidualisation and maintain pregnancy
list the 3 stages of cx remodelling and the biochemical changes
softening: gradual loss of compliance whilst maintaining competence, collagen breakdown and restructuring
ripening: loss of compliance and competence, increase in cytokines, PG, leukocytes and NO
dilation: increase PG and oxytocin activity
describe oxidative phosphorylation and potential impact of oxidative stress
NADH and FADH act as electron donors in the mitochondria and are synthesised over complexes resulting in 32 ATP, ROS can be made as byproduct if imbalance bw antioxidants -> oxidative stress causing cell death/damage
compare anabolic and catabolic phases of mat metabolism in preg
anabolic: increased insulin production under influence of hPL causes storage of glucose and fats (lipogenesis)
catabolic: insulin sensitivity reduces under control of PGH causing release of stored fats and glycogen for growing fetus
describe effects of hyperventilation in pregnancy
lowers arterial CO2 pressure causing mild resp alkalosis
how does estrogen affect total TH levels?
estrogen increases TBG which causes increase in TH to give to the fetus
what is the main Ig in colostrum?
IgA
lactogenesis II is caused by
fall in prog after birth
when does fetal TH production begin?
week 10-12 where iodine can be concentrated
what is the first line asthma reliever inhaled in pregnancy?
salbutamol
what does poorly control asthma increase risks of in pregnancy?
LBW and preterm labour
describe 3 stages of lactogenesis
lactogenesis I: mid preg, secretory differentiation of alveolar cells under PL
II: 2-5 days PP, milk secretory onset w drop in prog and increase PL/oxytocin
III: maintenance of mature milk supply through supply and demand
list mat and fetal consequences of untreated hypothyroidism in preg
mat: PET, plac abruption, anaemia, PPH
fetal: LBW, IUFR, preterm, impaired neuro dev, fetal hypothyroid
when does placenta become the main producer of prog?
around K7
what effect does IgA have on newborn?
promotes mucosal immunity
compare effects of PL and oxytocin on breast milk
PL: milk production
oxytocin: milk ejection through actions on myoepithelial cels
what are the preferred AEDs in preg
levetiracetam and lamotrigine
what is the first line pharm tx for N and V in preg?
doxylamine-pyridoxine
