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Nutr 337 > Placenta Metabolism > Flashcards

Placenta Metabolism Flashcards

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1
Q

fastest growth of the placenta?

A

first half of pregnency (before the fetal growth spurt)

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2
Q

forms the fetal surface of the placenta

A

the chorionic plate

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3
Q

cytotrophoblasts

A

cells from the placenta that connect the mother and the fetus ( these cells attach to the uterus, and eventually evolve into tumor-like cells that invade the mothers uterus to establish blood flow to the fetus )

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4
Q

fetal and maternal placenta are anchored together by which type of cell

A

cytotrophoblasts

forming the cytotrophoblastic shell and anchoring villi

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5
Q

maternal blood is driven into the ________ spaces in funnel- shaped spurts

A

intervillous

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6
Q

major functioning unit of the placenta

A

the chorionic villus

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7
Q

IUGR infants have microscopically ___ _____ of the villi

A

less branching ( the branching creates more surface area and allows for more exchange of nutrients and wastes)

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8
Q

placenta functions

A 
metabolism 
transport
endocrine
hormone catabolism
nutrient storage
protection from xenobiotics
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9
Q

placenta metabolism

A

synth of compounds the fetus needs ( glycogen, lactate, CH )

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10
Q

how much glucose and oxygen dos the actual placenta use

A

50% oxygen and 65% glucose

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11
Q

the umbilical ____ carries oxygenated blood to the fetus

A

vein

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12
Q

what are the mechanism of transport of the placenta similar too?

A

similar to the intestine (active, facilitated, passive)

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13
Q

Passive Diffusion

A 
O2, Co2
FA
steroids
electrolytes
Fat sol vitamins
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14
Q

facilitated diffusion

A

sugar and long chain PUFA

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15
Q

active transport

A

amino acids and cations

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16
Q

solvent drag

A

electrolytes

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17
Q

what does maternal malnutrition lead to in pregnancy

A

reduced blood volume
inadequate cardiac output
decreased placenta blood flow
smaller placenta size–> reduced nutrient transfer–> fetal growth retardation

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18
Q

when does fetal weight more than double

A

3rd trimester ( last 10 weeks)

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19
Q

does placenta weight increase in the last 10 weeks ?

A

not as dramatically as fetus ( about 50%), it grew a lot before to prepare for the growth spurt. however the blood flow increases to compensate

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20
Q

last 4 weeks of gestation

A

progressive decline in amount of nutrients transferred/unit fetal body mass/ unit time

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21
Q

the decline in nutrient transferred in the last 4 weeks is partially responsible for what?

A

deceleration in fetal growth rate

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22
Q

FFA transport

A

partially passive but bc fetus replies on energy from fat and brain development so have facilitated diffusion with transporters (PUFA)

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23
Q

there is ____ transport of fat sol vitamin

A

poor

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24
Q

sugar transport

A

carrier-mediated facilitated diffusion - partially protective to hyperglycaemia bc max rate

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25
hyperglycaemia in the mother
not in fetus bc protective mechanism with max rate in transporters
26
fetal size is proportional to ______ size
placenta
27
iron def on placenta and fetal status
iron def= low blood volume expansion= decreased cardiac output = decreased placental blood flow--> decreased growth
28
what would cause decreased uterine blood flow?
hypotension, renal disease and placenta infarction ( caused by and obstruction to the blood flow to placenta)
29
key nutrient for optimal placental development
``` essentail FA ( blood flow and optimal function is closely related to eicosanoids, from essential FA's) ```
30
low concentrations of linoleum acid, arachidonic acid, DHA, were associated with
low birth weight | short gestation and small head circumference
31
EFA deficiencies cause
defect in placental integrity and function - needed for vasodilation and contractions - growth - brain
32
explain the biomagnification of DHA in the human fetus
the fetal Brian gets the most - increasing order from maternal RBC to fetal cord blood to fetal liver to the brain - this is bc of a sensitive transfer from the maternal circulation
33
DHA
better cognitive function in offspring
34
brain is structurally?
a lipid rich organ - -> 50-60% of structural matter is lipid - using high amounts of DHA and arachidonic acid
35
Endocrine functions of the placenta ( what 4 does it release?)
hCG HCS progesterone estrogen
36
hCG
maintains the corpus lute to secrete estrogen and progesterone
37
HCS (human chorionic somatotrophin- or placenta lactogen )
produced in late gestation and influences fat and carb metabolism - may be responsible for insulin resistance and carbohydrate intolerance observed in pregnancy
38
progesterone larghi reduced by the ______ up until 10 weeks
corpus lutem
39
after 10 weeks what takes over secreting progesterone
placenta
40
what may be responsible for insulin resistance and carbohydrate intolerance observed in pregnancy
HCS ( placental lactogen)
41
progesterone
suppresses contractility in the uterus smooth muscles to prevent early birth - at the end of pregnancy with high levels of estrogen this is suppressed
42
when is estrogen maximally secreted
end of pregnancy
43
what does estrogen stimulate
myometrium growtth ( inner middle part of the uterus which contains lots of smooth muscles), antagonists myometrial- suppression by progesterone, and stimulates mammary gland development
44
which hormones does the placenta metabolize (catabolize) into there inactive forms so that high levels don't harm the fetus?
glucocorticoids (cortisol), insulin, thyroxin
45
what happens to the hormones that are normally metabolized by placenta if the placenta doesn't develop properly
harm to fetus | - example excess insulin may lead to excess fetal growth
46
HCS breaks down what energy source for fuel
fat ( late in pregnancy )
47
when do the majority of major physiological adaptations occur during pregnency
first half
48
major physiological adaptations during pregnency
kidney - GFR increase and tubular reabsorption goes down --> more excretion of waste stomach - heartburn, less histamine and pepsin hemodilution slower digestion- better absorption lungs- increase ventilation heart- increased cardiac output altered plasma lipid and glucose profiles
49
altered plasma lipid levels
increase in TG and CH --> want to conserve glucose
50
altered plasma glucose levels
in third trimester fetus needs go way up, maternal blood glucose fall, however increase lipolysis and mild ketosis
51
decreased muscle breakdown + increased placental uptake of alanine
low alanine availability--> so impaired hepatic gluconeogenesis --> less alanine bc less muscle breakdown and more placenta uptakes of alanine
52
anabolic phase
early ( first half of pregnency) - increased storage of fat, CHO and protein - CHO stored as glycogen or converted to fat due to sharp rise in insulin - fats= converted to TG for fat stores - want to store more rather than use for energy ( so less lipolysis) - increase in maternal protein synthesis, particularly in the placenta and RBC
53
anabolic stage CHO
CHO stored as glycogen or converted to fat due to sharp rise in insulin
54
anabolic stage - fats
converted to TG for fat stores | - want to store more rather than use for energy ( so less lipolysis)
55
anabolic stage- protein
increase in maternal protein synthesis, particularly in the placenta and RBC
56
catabolic phase
fat mobilized to conserve glucose for the fetus | - increase in ketones and blood CH
57
post-pran-di-al
during or relating to the period after dinner or lunch
58
what happens to postprandial insulin levels in the catabolic stage?
insulin levels are blunted by estrogen, progesterone and placental lactogen --> which cause catabolism of maternal fat and glycogen and protein - results in insulin resistance in the mother
59
does the placenta rely on insulin for glucose uptake
no
60
why do we want high catabolism in the second half of pregnancy?
what to break down fat, so that we can conserve glucose for the fetus
61
blunted insuring response means?
increase in glucose (hyperglycaemia) so that more glucose will reach the placenta
62
what % body fat should woman have before pregnancy?
22%
63
average weight gain of ___%
12% , of which 40% = fetal, placenta and amniotic fluid
64
if BMI >29, limit weight gain to ?
6kg
65
adolescent mothers need to gain?
more weight | aim for 12.5-18kg
66
twins
35-45lb regardless of pregnency weight
67
20-27 BMI weight gain should be
11.5-16 kg (25-35 lb)
68
patterns of weight gain
3-4lb for the first 10 weeks pregnenncy | then 1lb per week thereafter
69
gaining over ___ /week raises concerns as it is probably due to edema
1 kg
70
obligatory wt gain
fetus, placenta, increase blood volume, breast enlargement, enlarged uterine
71
40% of energy needed for pregnency is deposited in the 1st ____ weeks
20 - in subcutaneous fat ( lower body - thighs)
72
why does hematocrit decrease
hemodilution, more increase in volume than Hb
73
fetal weight shows a ___ curve
S | - very little weight gain at the start, rapid weight gain, then tapers off right at the end
74
preterm birth
before 37 weeks
75
IUGR
intra-uterine growth retardation | - below 2 SD in weight for gestational age, or below 10%, or below 2500 g

Nutr 337 (10 decks)

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