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Repro and Sexual Health > Physiology of Pregnancy and Lactation > Flashcards

Physiology of Pregnancy and Lactation Flashcards

(65 cards)

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1
Q

what cells invade into the endometrium to allow implantation?

A

trophoblast cells

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2
Q

day 1 of fertilization?

A

fertilization occurs in the ampulla of fallopian tube

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3
Q

day 3-5 of fertilization?

A

transport of blastocyst into the uterus

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4
Q

day 5-8?

A

blastocyst attaches to lining of uterus

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5
Q

what does blastocyst develop into?

A

inner cells = embryo

outer cells = burrow into uterine wall and become placenta

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6
Q

what does placenta do?

A

//

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7
Q

impnataion>

A

..

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8
Q

…..

A

..

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9
Q

..

A

..

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10
Q

..

A

..

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11
Q

..

A

..

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12
Q

placenta is derived form what tissue?

A

trophoblast and decidual tissue

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13
Q

how does placenta develop?

A 
trophoblast cells (chorion) differentiate into multinucleate cells (syncytiotrophoblasts) which invade decidua and break down capillaries to form cavities filled with maternal blood
.......
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14
Q

HCG released by trophoblast signals the corpus luteum to continue secreting which hormone?

A

progesterone

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15
Q

where does early nutrition of the embryo come from?

A

trophoblast (invasion into the decidua)

…

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16
Q

laetr nutrition>

A

…

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17
Q

how does the placenta act as a atriovenous shunt?

A

,,

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18
Q

key role of placenta?

A

oxygen transport (foetal lungs) and CO2 removal

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19
Q

how does foetal respiration occur?

A

takes place between maternal blood and the umbilical blood (arterial/venous mix, O2 poor)
oxygen diffuses from maternal into fetal circulation
CO2 follows a reverse gradient

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20
Q

the suply of oxygen tot the foetus is facilitated by the increased ability of fetal haemoglobin to carry oxygen, the conc of fetal ???ms;MDOWQFNGUW

A

DNDVB

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21
Q

3 factors which facilitate the supply of oxygen to fetus?

A 
fetal Hb (increased ability to carry O2)
higher Hb (50% more than in adults)
bohr effect
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22
Q

water transport in fetus?

A

diffuses into placenta along its osmotic gradient

exchange increases during pregnancy up to the 35th week

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23
Q

electrolyte transport in fetus?

A

follows water (iron and Ca2+ only go from mother to child)

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24
Q

glucose transport?

A

fetus main source of energy

passes placenta via simplified transport (high glucose needed in 3rd trimester)

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25
fatty acid transport?
free diffusion
26
waste products transport?
diffusion based on concentration gradient
27
drugs which can cross the placenta?
//
28
HCG changes in pregnancy?
peaks at weeks 8-12 preventa degeneration of corpus luteum has effect on testes of male fetus (development of sex organs)
29
HPL/HCS changes in pregnancy?
produced from week 5 GH like effects (protein tissue formation) dcreases ..........
30
progesterone function in pregnancy?
developemnt of decidual cells decreases uterus contractility preparation for laction breast development
31
function of oestrogen in pregnancy?
enlargement of uterus breast development relaxation of ligaments
32
how should HCG levels increase in pregnancy?
double every 48 hours in early pregnancy
33
uses of measuring HCG?
monitor changes in levels to help diagnose - ectopic pregnancy (static or slow rising) - failing pregnancy (falling) - ongoing viable pregnancy (doubling or >60% rise)
34
side effects of HCG?
nausea vomiting (effect peak at 8-10 weeks when levels peak)
35
when can high levels of HCG occur?
multiple pregnancy | molar pregnancy
36
..
..
37
other hormonal changes in pregnancy?
placenta produces CRH > ACTH released in mother > aldosterone and cortisol preoduced > .... ...... .........
38
how much does cardiac output increase in pregnancy?
``` around 40% (can be 30-50%) - due to demands of uteroplacental circulation (placental circulation, metabolism, skin thermoregulation, renal circulation etc) - begins at week 6 and peaks at 24 weeks - then decreases in last 8 weeks ```
39
normal CO related changes in pregnancy?
ECG changes functional murmurs changed heart sounds
40
HR changes in pregnancy?
increases up to 90 to increase CO
41
BP changes in pregnancy?
``` //// drops in 2nd trimester ```
42
haematological changes in pregnancy?
Plasma volume increases proportionally with CO (50%) erythropoeisis (RBCs) increase (25%) therefore Hb is decreased by dilution (which decreases blood viscosity) iron requirements increase (.......) .....
43
resp changes in pregnancy?
lung function changes occur partly due to progesterone increases and partly because the enlarging uterus interferes with lung function - progesterone signals the brain to //// . ....
44
urinary system changes?
... GFR and RPF increases increased reabsorption of ions and water (due to placental steroids and aldosterone) slight increase in urine formation
45
how do postural changes affect renal function in pregnancy?
//
46
what is pre-eclampsia?
pregnancy induced hypertension and proteinuria
47
features of pre-eclampsia?
..
48
most significant risk for pre-eclampsia?
previous episode of pre-eclampsia
49
what causes pre-eclampsia?
possibly - extensive secretion of placental hormones - immune response to fetus - insufficient .....
50
...
..
51
average maternal weight gain in pregnancy?
11kg
52
what is weight gain made up of?
``` fetus (3.5kg) extra-embryonic fluid/tissues (2kg) uterus (1kg) breasts (1kg) .... . . . ``` .
53
extra food intake in pregnancy?
extra 200kcal per day extra 30kg protein per day at end of pregnancy - fetal glucose need 5mg/kg/min (Mother 2.5mg/kg/min)
54
2 phases of pregnancy in terms of metabolism?
//////
55
describe mothers anabolic phase?
normal/increased insulin sensitivity lower plasmatic glucose level lipogenesis,glycogen stores increase growth of breasts, uterus and weight gain
56
...
..
57
special nutritional needs in pregnancy?
``` folic acid (reduced neural tube defects) Vit D supplements high protein diet, higher energy intake iron supplemets B vitamins (erythropoeisis) ```
58
how does the uterus change at time of birth?
becomes more exciteable towards end of pregnancy estrogen:proegsterone ratio changes which increases excitability (progesterone inhibits contractility which oestrogen does the opposite) oxytocin (from maternal posterior pituitary) increases contractions and excitability fetal hormones (oxytocin, adrenal gland, prostaglandins and ...) ...... ... . .
59
describe the onset of labour
//
60
initiation of labour? (feedback systems)
//
61
third stage of labour is defined as what?
delivery of placenta
62
2nd stage?
passage through birth canal (few mins to 120 mins)
63
stage 1?
cervical dilation (8-24 hours)
64
what hormones are required for milk release from breast?
oestrogen = growth of ductile system progesterone = development of lobule-alveolar system (both inhibit milk production, sudden drop in Oe and P after birth) prolactin = milk production (steady risk in levels week - birth, induces .... .....
65
feedback system in breastfeeding?
//

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