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OBGYN rotation review > phys- pregnancy > Flashcards

phys- pregnancy Flashcards

(56 cards)

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1
Q

what are the 4 stages of pregnancy

A
  1. initiation
    • fertilization
    • implantation
    • secretion of HCG to rescue the corpus luteum
  2. gestation
  3. parturition
  4. lactation
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2
Q

____ and ____ relax and soften pelvic ligaments

A

estrogen and relaxin

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3
Q

why does lactation not occur during pregnancy

A

inhibition by placental estrogen and progesterone

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4
Q

when is the blastocyst formed (fertilization)

A

days 3-4

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5
Q

estrogen and progesterone levels ___ pregnancy

A

increase throughout

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6
Q

the normal optimal menstrual cycle days of implantation are what and why

A

days 20-24 because of progesterone

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7
Q

what is parturition (stage 3 of pregnancy)

A

labor, delivery, and birth

mucus plug dislodges, cervical canal dilates, uterine myometrium contracts

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8
Q

what is pitocin

A

pharmaceutical synthetic form of OT

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9
Q

fertilization must occur within ___ of ovulation

A

24 hours

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10
Q

which hormone stimulates production (secretion) of milk

A

prolactin

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11
Q

how does inflammation cause premature labor

A

increased macrophages (due to increased pulmonary surfactant), uterine stretching, bacterial infections, allergic reactions, and multi-fetus pregnancies

⇒ activation of NF-kB in the uterus

⇒ increased production of IL-8 inflammatory cytokines and prostaglandins

⇒ cervical softening

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12
Q

what is involution

A

when the uterus shrinks to its pregestational size after delivery

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13
Q

____ makes estrogen and progesterone during the first trimester

____ makes estrogen and progesterone after that

A

corpus luteum makes estrogen and progesterone during the first trimester

placenta makes estrogen and progesterone after that

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14
Q

how long does sperm survive in the female reproductive tract

A

usually 48 hours but up to 5 days

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15
Q

in non-lactating women, how long does it take for ovulation to resume

A

7 to 10 weeks postpartum

*** not to be used as a contraceptive method ***

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16
Q

levels of maternal ___ may be used as an index of fetal health

A

maternal urine hCG

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17
Q

early on, the placenta makes ____ but as it matures it makes ____

A

early on, the placenta makes hCG but as it matures it makes estrogen and progesterone

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18
Q

what is the zona reaction

A

a structural change in the zona pellucida- happens when fertilin on the sperm fuses to the integrin receptor on ovum’s membrane:

cortical granules released and ZP3 degraded so that no polyspermy

⇒

2nd ovum meiosis completed

⇒

fusion of sperm and ovum

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19
Q

how does the female reproductive tract aid in sperm migration

A

myometrium contractions

oviduct smooth muscle contractions

allurin (chemical that attracts sperm to the ampulla so it can reach the egg)

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20
Q

withdrawal of placental estrogen and progesterone at parturition initiates

A

lactation

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21
Q

prolactin (the major hormone resoponsible for lactogenesis) is synthesized/ secreted by lactotrophs in ____, and then released under the control of ___ and ___

A

prolactin (the major hormone resoponsible for lactogenesis) is synthesized/ secreted by lactotrophs in the pituitary, and then released under the control of thyrotopin releasing hormone (stimulatory) and dopamine (inhibitory)

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22
Q

how does CRH affect fetal lungs?

A

placenta secretes CRH ⇒ increases fetal ACTH ⇒ fetal cortisol ⇒ promotes fetal lung maturation

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23
Q

only the placenta makes ___

while the placenta and the fetus make ___

Study These Flashcards
A

only the placenta makes progesterone

while the placenta and the fetus make estrogen

24
Q

when does the placenta become functional

what are these functions

Study These Flashcards
A

5 weeks after implantation

functions:

  • organ of exchange- digestive, respiratory, renal
  • prevents immunologic rejection
  • secretes hCG (2nd and 3rd tri), estrogen, progesterone
25
what hormones stimulate the synthesis of milk enzymes during gestation
prolactin
26
which hormone causes milk ejection
OT
27
when and what is gestation (stage 2 of pregnancy)
about 38 weeks from conception or 40 weeks from LMP when the physical changed in the mother meet the demands of pregnancy
28
where is the site of fertilization
oviduct normally the ampulla (upper third)
29
hormone that helps form the cervical plug
progesterone
30
when does the blastocyst embed and become the trophoblast
days 6 to 8 embeds b/c of enzymes
31
when is labor initiated
when **OT receptor concentration reaches a critical threshold** that permits the onset of strong coordinated contractions in response to **ordinary** levels of circulating OT
32
\_\_\_\_ are needed to synthesize estrogen during pregnancy
both the fetus and the placenta
33
**what is the outcome of the high estrogen levels** during labor that increase the production of prostaglandins
collagen fibers are degraded by enzymes causing **cervical ripening** (softening) increased OT receptors in the myometrium causing **increased responsiveness to OT**
34
**what is the outcome of the high estrogen levels** during labor that increase the concentration of myometrial receptors for OT
an increased responsiveness to OT
35
what initiates parturition
increased estrogen
36
the most important estrogen of pregnancy
estriol
37
what levels in maternal plasma act as a placental clock for timing parturition based on fetal lung maturation
Corticotrophin-Releasing Hormone (CRH) high = premature deliveries low = late deliveries
38
where is OT made and stored
produced in the hypothalamus stored in the posterior pituitary
39
who makes progesterone
weeks 6-12 : corpus luteum after week 12 : placenta
40
**what is the outcome of the high estrogen levels** during labor that promote synthesis of connexons for gap junctions within uterine smooth muscles
cells are linked to create a coordinated contraction
41
when does fertilization happen
days 1-2
42
what are the stages of labor (parturition)
1. cervical dilation- few to 24 hours (longest stage) 2. delivery of baby- 30 to 90 minutes 3. delivery of placenta- 15 to 30 minutes
43
prior to onset of labor, circulating OT levels are ___ but \_\_\_
are **constant** but **uterine responsiveness is 100 x greater due to increased myometrial OT receptors**
44
what hormones promote development of mammary glands during gestation
estrogen and progesterone
45
what does hCG do
maintains pregnancy stimulates the corpus luteum to secrete progesterone and estrogen
46
what do hCG levels look like with an ectopic pregnancy
a slower hCG level rise
47
what do hCG levels look like w/ a hydatidiform mole
slow, continuous rise
48
stages of fertilization
capacitation acrosomal reaction zona reaction
49
how is sperm activated and what is this called
capacitation while sperm goes through reproductive tract, the cholesterol cap comes off so that it can penetrate
50
when is hCG detected where does it come from
after implantation is complete (8-11 days after conception) from the primitive placenta
51
what is the acrosomal reaction
sperm penetrates corona radiata ⇒ acrosin is released to allow sperm to penetrate the zona pellucida ⇒ sperm binds to the ZP3 receptors on the zona pellucida
52
what do hCG levels NORMALLY look like
peak at weeks 9-12 then decline then plateau
53
in lactating women, how long does it take for ovulation to resume
27 weeks (7 months) \*\*\* not to be used as a contraceptive method \*\*\*
54
anovulation occurs after lactation due to
GnRH inhibition ⇒ FSH and LH release
55
what do hCG levels look like with fetal death
levels rise normally, then fall with a half life of 24 hours
56
\_\_\_\_ is needed to synthesize progesterone during pregnancy
maternal cholesterol

OBGYN rotation review (14 decks)

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