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Flashcards in Physiology of pregnancy Deck (53):
1

Around which days, does the blastocyst attach to the lining of the uterus?

Days 5-8

2

The blastocyst becomes completely buried in the uterine lining by which day?

Day 12

3

The placenta is derived from which tissues?

Trophoblast and decidua

4

The trophoblast cells (chorion) differentiate into what?

Syncytiotrophoblasts (multi-nucleated cells)

These invade the decidua and break down capillaries to form cavities filled with maternal blood

5

By which week of pregnancy is the PLACENTA and foetal heart functional?

5th week of pregnancy

6

Where does the embryo get its nutrition from in early development?

Trophoblastic cells (these invade decidua)

(Progesterone stimulates decidual cells to concentrate glycogen, proteins and lipids)

7

HCG does what to corpus luteum?

Stops the corpus luteum from breaking down

(corpus luteum to continue secreting progesterone etc)

(progesterone stimulates decidual cells to concentrate glycogen, proteins and lipids)

8

Which organ acts as a physiological arteriovenous shunt?

The placenta

(circulation within the intervillous space acts partly as an ateriovenous shunt)

9

Which organ plays the role of the "fetal lungs"

The placentah

10

The supply of the fetus with oxygen is facilitated by which 3 factors?

1) fetal Hb (increased ability to carry O2)
2) higher Hb concentration in fetal blood (50% more than adults)
3) Bohr effect (fetal Hb can carry more oxygen in low pCo2 than in high pCo2)

11

How do fatty acids pass through placenta?

Free diffusion

12

How does glucose pass through the placenta?

Simplified transport

13

What is the fetus's main source of energy? And which trimester is there a high need for this substance?

Glucose
(high glucose need in 3rd trimester)

14

What is the trophoblast?

The surface layer of cells of the blastocyst

15

What passes through the umbilical veins?

Oxygen saturated blood to fetus

16

What passes through the uterine veins?

Oxygen poor blood (from fetus to mother)

17

How are electrolytes transported across the placenta?

Electrolytes follow water (iron and calcium only go from mother to child)

18

HCG effect on male fetus?

Development of sex organs

19

When is human chorionic somatomammotropin produced in pregnancy?

Produced from week 5

20

What does human chorionic somatomammotrophin do?

It has growth hormone like effects - protein tissue formation
-decreases insulin sensitivity in mother SO THERE IS MORE GLUCOSE FOR THE FETUS
-involved in breast development and possible lactation

21

Which hormone is responsible for:
-development of decidual cells
-decreases uterus contractility
-preparation for lactation?

Progesterone

22

Progesterone and decidual cells

Progesterone causes development of decidual cells

23

Progesterone and uterus contractility?

Progesterone decreases uterus contractility

24

Progesterone and lactation

Progesterone helps with preparation for lactation

25

Which hormone causes:
-enlargement of uterus
-breast development
-relaxation of ligaments?

Estrogen

26

Which hormone is an indicator of the vitality of the fetus?

Estriol

27

Estrogen and breasts?

Estrogen causes breast development

28

Cardiac output and pregnancy?

Cardiac output increases (beginning week 6 and peaking around week 24)

(decreases in the last 8 weeks as becomes sensitive to body position - uterus compresses vena cava)

29

Iron requirements for 2nd half of pregnancy

6-7mg per day

30

How do the following change in pregnancy:
-plasma volume
-erythropoesis (RBC)
-Hb concentration

-Plasma volume increases proportionally with cardiac output (50%)
-erythropoesis increases (25%)

-although both are increasing, plasma volume increases more so Hb concentration is diluted (this decreases blood viscosity)

31

Why do you get odema in pre-eclampsia?

Kidney function declines and you get salt and water retention (function probably declines because of high blood pressure or something)

32

Is pre-eclampsia more common in women with a single baby or twins?

More common in multiple gestation (e.g. twins)

33

Average weight gain in pregnancy?

24lbs (fetus - 5kg, mother -6kg)

34

How many extra calories a day does the mother need?

250-300 extra calories

35

How much extra protein does the mother need?

30g

36

When is the mother's anabolic phase?

1st-20th week of pregnancy
-anabolic metabolism of mother
-quite small nutritional demands of the mother

37

When does accelerated starvation of the mother occur?
(catabolic phase)

21-40th week of pregnancy (especially 3rd trimester)
-high metabolic demands of fetus
-accelerated starvation of mother

38

Which hormones are responsible for insulin resistance in pregnancy?

HCS, cortisol and growth hormone

39

Does the following occur in the anabolic or catabolic phase of pregnancy?

- normal or increased sensitivity to insulin
- lower plasmatic glucose level
- lipogenesis, glycogen stores increases
- growth of breasts, uterus,weight gain

Anabolic phase

40

Does the following occur in the anabolic or catabolic phase of pregnancy?

- maternal insulin resistance
- increased transport of nutritients through placental membrane
- lipolysis

Catabolic phase

41

What iron supplement should the mother take?

300 mg ferrous sulfate

42

Why does a mother need to take B vitamins?

Erythropoeisis

43

What does folic acid (folate) help to protect against?

Neural tube defects

44

When is vitamin K given and why?

Given right before giving birth - helps prevent intracranial bleeding during labour

45

Estrogen and progesterone and their effects on contractility of the uterus?

-Estrogen increases contractility
-Progesterone decreases contractility
-The ratio of these alter just before giving birth

46

Where is oxytocin produced?

Maternal posterior pituitary gland

47

Oxytocin and contractility of uterus?

Oxytocin increases contractions and excitability

48

Which hormones are responsible for controlling timing of labour?

Oxytocin
Adrenal gland
Prostaglandin

49

What are braxton hicks contractions?

These are prodromal contractions (like practise ones) they start around week 6 of pregnancy but are not usually felt until 2nd/3rd trimester. They increase towards the end of pregnancy and eventually become real ones

50

Growth of ductile system

Estrogen

51

Development of lobule-alveolar system

Progesterone

52

Estrogen and progesterone effects on milk production

Estrogen and progesterone inhibit milk production
(at birth, estrogen and progesterone suddenly drop)

53

Two hormones needed for milk production

Prolactin
Oxytocin (produced by sucking stimulus)