Pregnancy

Question 1

Durations of the Pregnancy Trimesters

Answer 1

First Trimester: Last Menstrual period to Week 12
Second Trimester: Weeks 13 to 27
Third Trimester: Weeks 28 to 40

Question 2

First Trimester
Weeks 3-8 is called …

Answer 2

embryonic period

Question 3

First Trimester
Week 9 until delivery is called …

Answer 3

fetal period

Question 4

First Trimester
Major event of Week 10

Answer 4

Placenta Formation

Question 5

First Trimester
During Week 10, the Placenta takes over …

Answer 5

Progesterone Production

Question 6

First Trimester
What develops during First Trimester

Answer 6

Organ Systems of Embryo

Question 7

First Trimester
What may occur due to toxic exposure during Organ Development?

Answer 7

Congenital Abnormalities

Question 8

First Trimester
What happens to the Uterus during the First Trimester?

Answer 8

Enlarges and softens

Question 9

First Trimester
Complications

Answer 9

Ectopic Pregnancy
Mother-To-Child Transmission (MTCT)
Spontaenous Abortion/Miscarriage

Question 10

First Trimester
Examples of MTCT

Answer 10

Congenital Rubella Syndrome
Congenital Syphilis
Congenital HIV
Congenital Hepatitis B

Question 11

Second Trimester
Characteristics of fetus

Answer 11

Reaches Viability

Can survive outside the womb

Question 12

Second Trimester
Characteristics of Uterus

Answer 12

Expands into abdomen
Quickening

Question 13

Second Trimester
What is Quickening?

Answer 13

Woman becomes aware of fetal movements at 20 weeks

Question 14

Second Trimester
Morning Sickness

Answer 14

Effects recede as β-hCG concentration levels off

β-hCG is produced by Placenta and causes Morning Sickness symptoms

Question 15

Second Trimester
Complications

Answer 15

Gestational Diabetes Mellitus
Hemolytic Disease of Fetus/Newborn

Question 16

Third Trimester
Characteristics of fetus

Answer 16

Fully formed and can survive outside womb

Question 17

Third Trimester
Which organs are not fully developed at this point?

Answer 17

Lungs (which is completed at 36 weeks)

Question 18

Third Trimester
Why may patients feel uncomfortable during this trimester?

Answer 18

Weight of Uterus and Contents
Esophageal Reflux
Edema
Venous Congestion causing Hemorrhoids and Low Extermity Varicosities

Question 19

Third Trimester
Complications

Answer 19

Preterm Labor (less than 37 weeks)
Relative Surfactant Deficiency causes Respiratory Distress Syndrome in Premature Babies
Preeclampsia (high b.p. during pregnancy causing systemic vasoconstriction)

Question 20

Function of Placenta

Answer 20

Transfer:
Oxygen
Nutrients
Carbon Dioxide
Fetal Waste Products

Question 21

Which hormones are secreted by Placenta?

Answer 21

Progesterone
Estrogen
Relaxin
β-hCG
Human Placental Lactogen
Corticotropin-Releasing Hormones

Question 22

Where is Human Placental Lactogen produced?

Answer 22

Syncytiotrophoblast Cells

Question 23

Function of Human Placental Lactogen

Answer 23

Ensures fetus has Adequate Nutrition

Question 24

How does Human Placental Lactogen ensure that fetus has adequate nutrition?

Answer 24

Alters Mother’s metabolism including:
Increased glucose levels
Lowers glucose utilization
Increasing lipolysis

Question 25

Where is Corticotropic-Releasing Hormone produced?

Answer 25

Syncytiotrophoblast

Question 26

Functions of Corticotropic-Releasing Hormone

Answer 26

Prostaglandin Production Increasing DHEA Levels Uterine Contractions (at term) Regulation of Placental Blood Flow

Question 27

Placental Gaseous Transport Process

Answer 27

Question 28

Fill out the following about Nutrient Transport through Placenta

Answer 28

Question 29

How is the Fetus protected from Maternal Immune Responses?

Answer 29

Altered HLA Expression Fas Ligand Placental Indoleamine 2,3-Dioxygenase (IDO)

Question 30

**Altered HLA Expression** Definition

Answer 30

Atypical HLA-G cell-surface proteins

Question 31

**Altered HLA Expression** Function

Answer 31

Interact with mother's Natural Killer Cells and Cytotoxic T Cells

Question 32

**Altered HLA Expression** Where are they produced?

Answer 32

Trophoblast

Question 33

**Fas Ligand** Function

Answer 33

Fas Ligand interacts with Fas Receptor on Maternal Lymphocytes causing Apoptosis

Question 34

**Fas Ligand** Where are they produced?

Answer 34

Trophoblast Cells

Question 35

**Placental Indoleamine-2,3-Dioxygenase (IDO)** Function

Answer 35

Degrades Typtophan into Kynurenine

Question 36

**Placental Indoleamine-2,3-Dioxygenase (IDO)** Purpose of Typtophan Degradation

Answer 36

Maternal T Cels require Tryptophan for survival Kynurenine inhibits T-cell development and survival

Question 37

**Placental Indoleamine-2,3-Dioxygenase (IDO)** Location of production

Answer 37

Placental Blastocyst

Question 38

What triggers passive immunity in the fetus?

Answer 38

Maternal IgG passes through placenta during Last Trimester of Pregnancy ## Footnote Lasts for several months

Question 39

How does IgG cross the placenta?

Answer 39

Taken up by Endocytosis Bind to intracellular F_c receptors Transport IgG to fetal side of Placenta