Physiologic/Endocrine Changes during Pregnancy and Parturition Flashcards Preview

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Flashcards in Physiologic/Endocrine Changes during Pregnancy and Parturition Deck (53)
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1

ovulation

regularly around day 15

increasing P and E from corpus luteum

2

if fertilization occurs

blastocyst hatches from zona pellucida and inplantation begins day 22-23

release of hCG

3

hCG

rescues corpus luteum

secreted from trophoblast after it attaches to endometrium

4

receptive period

day 20-24 approx

decreased antiadhesion protein and increased adhesion protein uterine endometrium

5

pregnancy duration

determined by date of last menstrual cycle

nornally aound 40 weeks
-38 weeks from ovulation

6

hormone pregnancy test

beta-hCG

can be detected 24 hours after implantation in urine

7

major hormones of pregnancy

hCG
progesterone
estrogens
hPL / hCS

8

estrogens

estradiol
estrone
estriol

9

hPL

human placental lactogen

10

hCG

important first trimester
-rescue corpus luteum

11

luteal placental shift

production of progesterone and estrogen from corpus luteum to placenta

8 weeks

very important
if doesnt occur - no pregnancy

12

2nd and 3rd trimester

progesterone and estrogen levels continue to rise

release by placenta

13

hCG

produced by syncytiotrophoblasts
half-life 30 hours

detected by pregnancy tests

may be responsible for morning system

peaks 10 weeks after implantation

double every 2 days during first 6 weeks

14

hCG structure

similar to LH, FSH, TSH - mostly LH
binds to receptors with high affinity
-maintain corpus luteum

can also bind TSH receptors
-transitional gestational hyperthyroidism

15

transitional gestational hyperthyroidism

hCG weakly binds TSH

16

other hCG actions

stimulates leydig cells > testosterone (mimics LH)
stimulates adrenal cortex

17

progesterone

increases rapidly when production switches to placenta

around 8 weeks

required to maintain a uterus - quiescent myometrium**

cannot be indicator of fetal healthy
-just placental function

18

high levels of progesterone need

CYP11A1, 3-beta hydroxysteroid DH, and maternal cholesterol

19

actions of progesterone

decreased uterus motility/contractions

increased secretions of uterus
-nourishment, growth, implantation of embryo

increased fat deposition early in pregnancy
-appetite, sugar to fat

20

estrogens

placenta takes over production around week 8

21

estrogen synthesis

require products from fetus
-19 carbon androgen (DHEA-S) from adrenal gland

can indicate fetal status

22

estriol

major estrogen of pregnancy

levels used as indicator of fetal health

23

actions of estrogen

initiation parturition
-important end of term

increased blood flow
increased smooth muscle hypertrophy
increased prostaglandins
increased oxytocin
increased mammary gland growth
increased prolactin secretion
increased LDL receptors on syncytiotropoblasts

24

estrogen:progesterone ratio

shifts later in pregnancy
-preparing for parturition

25

after parturition

decreased progesterone - allows for PRL action on breast and lactation

26

hPL

aka hCS

produced by syncytiotrophoblasts
-detected in maternal serum by 3 weeks
-rise throughout pregnancy
-proportional to placental growth

27

rises in proportion to placenta growth

hPL (hCS)

28

actions of hPL

increased glucose availability to fetus **

antagonizes insulin action
-inhibits maternal glucose uptake
-lipolytic
-stimulates mammary gland development

29

maternal-placental-fetal unit

distinct but work together

fetal health can decline with functioning placenta

non-functioning placenta always detrimental to fetus

30

placenta

site of exchange
gas, nutrients, exchange, hormones, antibodies, drugs, viruses