Pregnancy

Question 1

How many weeks are the first, second and third trimesters?

Answer 1

1st trimester: 0-13w
2nd trimester: 13-26w
3rd trimester: 26-39w

Question 2

What is term?

Answer 2

The time given to the 37th-41st week of pregnancy

Question 3

What maternal changes happen in the first trimester?

Answer 3

Altered hormones (new baby being made!)
Altered brain function (baby brain!)
Altered emotional state (aaaah baby!)
Altered appetite (quality and quantity)
Altered immune function 

Note: these changes can also happen during later stages

Question 4

What maternal changes happen in the second trimester?

Answer 4

Increased blood volume
Increased clotting tendency
Decreased BP
Altered fluid balance (peeing more, drinking more)

Note: these changes can also happen during later stages

Question 5

What maternal changes happen in the third trimester?

Answer 5

Increased weight
Altered joints (pelvic changes)

Question 6

Which hormone increases rapidly during the first 10 weeks of pregnancy and then falls?

Answer 6

HCG

Question 7

What is the function of HCG?

Answer 7

Maintains production of oestrogen and progesterone

Question 8

Morning sickness is thought to be related to rise in which hormone?

Answer 8

HCG (it peaks in the first trimester, and morning sickness is also seen in the first trimester)

Question 9

Which three other hormones are produced during the second and third trimesters? List these in order of intensity

Answer 9

Progesterone > oestradiol > placental lactogen

Question 10

What is a conceptus? Give three examples

Answer 10

Everything resulting from a fertilised egg e.g. baby, placenta, fetal membranes

Question 11

Distinguish between embryo and fetus

Answer 11

EmBryo - Before it’s clearly human

Fetus - baby that’s clearly human

Question 12

What is a blastocyst?

Answer 12

The initial bilayer of cells

Question 13

What is a yolk sac?

Answer 13

Preliminary circulatory system attached to the embryo

Question 14

What classification system is used to classify human development?

Answer 14

Carnegie stages of human development

Question 15

Discuss the advantage and disadvantage of using other animal foetuses to study human pregnancy

Answer 15

Embryos of various species looks similar

However, size of embryo differs
Length of pregnancy differs

Question 16

Describe the side of the placenta which faces the fetus

Answer 16

Baby is attached to the umbilical cord, which is attached to a 20cm long disc. This is surrounded by fetal membrane containing amniotic fluid and blood vessels.

Question 17

What is seen on the maternal side of the placenta?

Answer 17

Cotyledons

Question 18

Describe the size and distribution of cotyledons on the maternal side of the placenta

Answer 18

BIGGER in the middle, SMALLER around the edges

Question 19

What is the cotyledon made of?

Answer 19

Branches of blood vessels which come into contact with maternal blood via endometrium

Question 20

Which vessel carries deoxygenated blood from the fetus?

Answer 20

Umbilical artery

Question 21

Which vessel carries oxygenated blood from the fetus?

Answer 21

Umbilical vein

Question 22

Describe the key features of the cotyledons

Answer 22

Anchors the placenta
Provides intimate contact between maternal and paternal tissues
Large SA due to highly branched structure
Effective transport of molecules

Question 23

List the functions of the placenta

Answer 23

Connects baby to mother
Separates maternal and fetal blood 
Exchanges substances
Immunoregulation 
Biosynthesis of hormones

Question 24

List two hormones synthesized by the placenta

Answer 24

HcG

Human placental lactogen

Question 25

Describe placental development

Answer 25

Cytotrophoblast proliferates into the syncytium | A column structure is formed, which branches into villi.

Question 26

Compare blood flow from mother to baby in the first vs second trimester and explain these changes

Answer 26

1st trimester - cytotrophoblast shell limits blood flow to placenta to reduce generation of oxygen free radicals 2nd/3rd trimester trimester - spiral artery remodelling happens to facilitate increased blood flow when infant growth is greatest

Question 27

What are the main risks to the mother during pregnancy?

Answer 27

The labour process itself Left bits of placenta in the uterus (prevents adequate uterine contraction and permits blood flow and loss via spiral arteries)

Question 28

What are the main risks to the fetus during pregnancy?

Answer 28

Chromosomal abnormalities | Incomplete anchorage of placenta

Question 29

When are incompletely anchored placentas most common?

Answer 29

First term of pregnancy

Question 30

When is the limit of viability, before which the likely outcome is stillbirth?

Answer 30

23 weeks

Question 31

What is the main problem with pregnancy after the 23 weeks have been passed and what causes this?

Answer 31

Early delivery; deteriorating maternal and fetal health, or early onset of labour

Question 32

If there's early delivery, which babies are at greatest risk and why? (time period)

Answer 32

Those born before 32 weeks | Due to incomplete development of lungs, brain, digestive system and immune system.

Question 33

What do you call the babies born between 23 and 32 weeks?

Answer 33

Very preterm babies

Question 34

What do you call the babies born between 32 and 27 weeks?

Answer 34

Moderately preterm babies

Question 35

What may indicate stillbirth?

Answer 35

Decreased fetal movement

Question 36

How can you monitor fetal wellbeing to detect risk of stillbirth?

Answer 36

Ultrasound assessment | Fetal doppler

Question 37

By which week do the lungs, liver and kidneys grow?

Answer 37

8th week

Question 38

By which week do the face, ears, fingers and toes grow?

Answer 38

7th week

Question 39

What is growing at the 6th week?

Answer 39

``` Face Ears Hands Feet Liver Bladder Gut Pancreas ```