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Charis & Ellie VS Reproduction > Physiology of Pregnancy > Flashcards

Physiology of Pregnancy Flashcards

1
Q

What does fertilized ovum do?

A

Divides progressively and differentiates into blastocyst as it moves form fertilization in upper oviduct to site of implantation in the uterus

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2
Q

How many days after fertilization is blastocyst transported and to where?

A

3-5 days

Uterus

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3
Q

What happens at 5-8 days post transplantation?

A

Attaches to lining of uterus

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4
Q

What do inner cells of blastocyst develop into?

A

Embryo

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5
Q

Outer cells of blastocyst develop into?

A

Placenta

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6
Q

Outer cells of blastocyst are collectively called?

A

Trophoblast

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7
Q

Placenta is derived from what?

A

Trophoblast and decidual tissue

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8
Q

What do trophoblast cells differentiate into?

A

Multinucleate cells which invade decidua and break down capillaries to form cavities filled with maternal blood

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9
Q

What week of pregnancy are foetal HR and placenta functional by?

A

5th week of pregnancy

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10
Q

PO2 maternal is higher or lower than foetal?

A

Higher

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11
Q

Is the PO2 levels maternalLY and foetally similar to CO2?

A

No it follows a reversed gradient

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12
Q

What does fetal oxygenated blood blow to the fetus in?

A

Via umbilical vein

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13
Q

Maternal oxygen poor blood flows back into which vessels?

A

Uterine veins

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14
Q

Foetal oxygen supply is facilitated by what 3 factors?

A
  • Fetal Hb has increased ability to carry O2
  • There is a higher Hb conc in fetal blood, 50% more than in adults
  • Bohr effect means fetal Hb can carry more oxygen in low PCO2 than in high
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15
Q

Placenta transport of nutrients and waste? (water)

A

Water diffuses into placenta along osmotic gradient

Exchange increased during pregnancy up to 35th week (3.5L a day)

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16
Q

What follows H20 in placental transport?

A

Electrolytes (Iron and Ca2+) only go mother to child so mum must have a lot

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17
Q

Fetus main source of energy?

A

Glucose (passes the placenta via simplified transport high to low conc)

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18
Q

What does hCG do?

A

Prevents involution of corpus luteum

Effect on male testes of fetus

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19
Q

HCG in ectopic pregnancy?

A

Static or slow rising

20
Q

Falling HCG levels indicate?

A

Failing pregnancy

21
Q

Molar pregnancy HCG levels?

A

Very high levels

22
Q

Multiple pregnancy HCG levels?

A

High levels

23
Q

When does HCG level fall?

A

from 12-14 weeks

24
Q

What is HPL?

A

Human Placental Lactogen (Human chorionic somatomammotropin)

25
Q

When is HPL produced?

A

From week 5 of pregnancy

26
Q

Effects of HCS/HPL?

A

Growth like effects causing protein tissue formation
Decreases insulin sensitivity in mother so more glucose for fetus
Involved in breast development

27
Q

What happens with progesterone in pregnancy?

A

Rises from early pregnancy throughout
Involved in development of decidual cells
Decreases uterus contractility
Preparation for lactation

28
Q

What happens to oestrogens throughout pregnancy?

A

Rise throughout pregnancy espesh estradiol

Involved in enlargement of uterus, breast development and relaxation of ligaments

29
Q

Hormonal problems in pregnancy?

A

-Placenta produces CRH which can cause ACTH production, increased cortisol, increased aldosterone which = HT, oedema, insulin resistance and gestational diabetes

30
Q

What does placenta produce and what can this cause?

A

HCG = N&V

HC thyrotropin= hyperthyroidism

31
Q

CV changes in pregnancy?

A

-Increase in CO
-ECG changes, murmurs and added heart sounds= normal
CO decreases slightly in last 8 weeks
HR increases
BP drops during Tri 2

32
Q

Haem changes in pregnancy?

A

-PV increases proportional to CO (50%) but erythropoiesis only by 25% so Hb is decreased (diluted)

33
Q

Resp changes in pregnancy?

A

-In order to lower CO2 levels: RR increase, TV and Minute Vl increase, PCO2 decrease slightly, VC and PO2 dont change

34
Q

General description of resp changes in preg?

A

Bigger breaths

More often

35
Q

Changes in rep pregnancy are due to?

A

Progesterone

Enlarging uterus interfering with lung function

36
Q

Urinary changes in pregnancy?

A

GFR and renal plasma increase up to 30-50% and peak about 16-24 weeks
Increased reabsorption of ions and water
Slight increase of urine formation

37
Q

What type of coagulation state is pregnancy?

A

Hypercoagulable

38
Q

What does pregnancy being a hypercoagulable state mean for the woman?

A

Reduces risk of haemorrhage during and after delivery

Does increase risk of VTE

39
Q

Nutrition/metabolism in pregnancy?

A

200kcal extra should be ingested

30g of protein daily

40
Q

Week 1-20 of pregnancy is what nutritional phase?

A

Mother’s anabolic phase where mother builds up fetus and only has small demands

41
Q

Week 21-40 is mothers what nutritional phase?

A

Catabolic phase

-High demands from fetus and accelerated starvation of mother

42
Q

How much acid and what type of it should pregnant mums be taking?

A

Folic acid

400mg 1st 12 weeks and ideally 3 months before conception

43
Q

What vitamin should pregnant women take daily and how much?

A

Vitamin D
10mg/day

B vitamins as well to help with erythropoiesis

44
Q

Common acute problems throughout pregnancy

A

N&V
UTI
Pain
Heartburn

45
Q

Risk to foetus in 1st trimester?

A

Early miscarriage
Organogenesis
Teratogenic drugs

46
Q

Examples of teratogenic drugs?

A 
ACEi/ARBs 
Androgens 
Antiepileptics 
Cytotoxics 
Lithium 
Methotrexate 
Retinoids 
Warfarin
47
Q

Risks to foetus in 2nd and 3rd trimester?

A

Growth of foetus
Functional development
Toxic effects on foetal tissue

Charis & Ellie VS Reproduction (71 decks)

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