Physiology of pregnancy and lactation Flashcards

1
Q

Which cells form a) the embryo and b) the placenta?

A

a) inner cell mass b) trophoblast

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2
Q

How does the blastocyst become embedded within the endometrium? When is this process usually complete by?

A

Cords of trophoblastic cells invade the endometrium. 12 days

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3
Q

How is oxygenation of foetal blood made possible? (3)

A

Has a higher oxygen affinity than maternal haemoglobin; foetal blood has more haemoglobin; Bohr effect

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4
Q

How long does the placenta secrete HCG for?

A

10 weeks

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5
Q

What is the purpose of the placenta secreting HCG?

A

Maintains the corpus luteum

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6
Q

What does HCG do in XY foetuses?

A

Stimulates leydig cells to produce testosterone

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7
Q

Where does fertilization usually occur?

A

Ampulla

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8
Q

Implantation occurs around hen?

A

5-7 days after fertilization

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9
Q

What consequences can foetal release of corticotrophin releasing hormone have on the mother?

A

Hypertension

Insulin resistance/gestational diabetes

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10
Q

Describe cardiac output during pregnancy

A

Increases 30-50% beginning 6 weeks gestation, peaking around 24 weeks.
Decreases in last 8 weeks (vena cava compression)

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11
Q

Two nutritional “phases” of pregnancy

A

Anabolic (weeks 1-20)

Catabolic (weeks 21-40)

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12
Q

Special nutritional needs in pregnancy (6)

A
High protein/energy diet
Iron supplementation
B Vitamins
Folic acid
Vitamin D3, calcium
Vitamin K before parturition
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13
Q

What underlies the increase in excitability of the uterus as gestation increases?

A

Increasing oestrogen:progesterone ratio

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14
Q

Cardiac output in pregnancy

A

Increases due to increased stroke volume and heart rate

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15
Q

Blood pressure during pregnancy

A

Falls due to lower peripheral resistance until 24 weeks; steady rise until term

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16
Q

Causes of oedema in pregancy (2)

A

Salt and water retention due to increased angiotensin II

Venous stasis due to pressure effect of uterus

17
Q

Haematological changes in pregnancy (2)

A

Dilutional anaemia

Hypercoagulable state

18
Q

Respiratory changes in pregnancy (3)

A

Increased tidal volume
Increased o2 consumption
Decreased residual volume

19
Q

Urinary/renal changes in pregnancy (2)

A

Increased GFR

5% have asymptomatic bacteruria

20
Q

Potential consequences of increased GFR

A

Mild glycosuria/proteinuria

21
Q

Approximate weight gain in pregnancy

A

12.5kg

22
Q

Hormone responsible for:

a) breast duct development
b) alveolar/lobule system development

A

a) oestrogen

b) progesterone

23
Q

Hormone which stimulates milk production

A

Prolactin

24
Q

Hormone which stimulates milk expression

A

Oxytocin

25
Q

Stimuli for the milk let-down reflex (2)

A

Suckling

Sound of child’s cry

26
Q

Where is oxytocin released from?

A

Posterior pituitary