Pregnancy and Labour

Question 1

Which is the riskiest trimester

Answer 1

1st

Question 2

When does a foetus become viable

Answer 2

24-26 weeks

Question 3

When does placent change most

Answer 3

1st half of pregnancy

Question 4

What happens to the mother and in which trimester

Answer 4

1st trimester
Immune system 
Emotions 
Apetite
hormones 
brain
2nd trimester 
Blood volume increase
Increased blood pressure
Increased blood clotting
Altered Fluid Balance
3rd
Increased weight
Altered Joints

Question 5

How much does progsterone and oestrogens increase by during pregnancy (by 3rd trimester)

Answer 5

x100

Question 6

Which hormone peaks in the 1st trimester

Answer 6

HCG

Question 7

What does HCG do?

Answer 7

Maintains endometrium, increases progesterone, stops menstrual cycle

Question 8

What risks are there to the mother in pregnancy

Answer 8

Little risks in early parts

Unsafe for delivery

Question 9

What is the conceptus

Answer 9

everything resulting from the fertilised egg: baby, placenta, fetal membranes, umbilical chord

Question 10

what is an embryo

Answer 10

baby before it is clearly human

Question 11

What is a foetus

Answer 11

baby for the rest of the pregnancy

Question 12

What is an infant

Answer 12

after delivery

Question 13

What scale is a summary of embryo staging

Answer 13

carnegie scale

Question 14

How is pregnancy time frame counted

Answer 14

1st day of last menstrual period (bc its difficult to know when egg was fertilised)

Question 15

What can mal-development tell us

Answer 15

identifies when conceptus is most vulnerable

Question 16

What structures make up the placenta

Answer 16

cotyledons

Question 17

What is the contents of a cotyledon?

Answer 17

Central villous tree

Branching of vessels outwardly to smaller subdivisions

Question 18

Describe umbilical blood flow

Answer 18

Umbilical artery carries de-oxygenated blood, and the umbilical vein carries oxygenated blood

Question 19

Functions of the placenta

Answer 19

separation, exchange, biosynthesis, immunoregulation, connection

Question 20

What is spiral artery remodelling

Answer 20

removal of maternal endothelial and smooth muscle cells in the placenta to increase blood flow

Question 21

If the placenta doesn’t form properly, what happens?

Answer 21

Miscarriage in late first trimester, early second trimester

pre-eclampsia, and foetal growth restriction

Question 22

What is the clinical definition of labour

Answer 22

Fundally dominant contractions, cervical ripening and effacement

Question 23

The processes of labour

Answer 23

cervical effacement and ripening
co-ordinated myometrial contractions
rupture of foetal membranes
delivery of infant
delivery of placenta
contraction of uterus

Question 24

What causes term labour?

Answer 24

unknown but maybe low progesterone, CRH or Oxytocin

Question 25

What causes pre-term labour

Answer 25

intrauterine infection intrauterine bleeding multiple pregnancy stress

Question 26

How does cervical ripening occurr

Answer 26

recruitment of leucocytes, its an inflammatory process | PGE, IL-8,

Question 27

How does contraction of myometrium occur?

Answer 27

``` Fundal dominance Increased co-ordination of contractions Increased power of contractions Key mediators Prostaglandin F2a (E2) levels increased from fetal membranes Oxytocin receptor increased Contraction associated proteins ```

Question 28

How does rupture of fetal membranes occur?

Answer 28

Loss of strength due to changes in amnion basement component Inflammatory changes, leukocyte recruitment Modest in normal labour, exacerbated in preterm labour Increased levels and activity of MMPs Inflammatory process in fetal membranes

Question 29

Which factor is massively important in signalling in labour

Answer 29

NFkappaB and causes a positive feedback which makes labour difficult to stop

Question 30

What molecules does NFkappaB influence

Answer 30

COX-2 (prostaglandins - PGs), IL-8, IL-1b, MMPs, Oxytocin receptor, PG receptors; contraction-associated proteins

Question 31

what 2 mediators rise in the last 3 weeks of pregnancy

Answer 31

CRH and Cox 2