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Repro > Pregnancy Physiology > Flashcards

Pregnancy Physiology Flashcards

1
Q

What is the role of the placenta?

A

Acts as the foetal lungs

Supplies foetus with oxygen and removes CO2

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2
Q

What 3 factors facilitate the supply of oxygen to the foetus?

A
  1. Foetal Hb- increased ability to carry O2
  2. Higher Hb concentration in foetal blood- 50% more than in adults
  3. Bohr effect- Foetal Hb can carry more O2 in low pCO2 than in high pCO2
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3
Q

Describe the way in which water and electrolytes pass from the mother to foetus via the placenta

A

Water diffuses into the placenta along osmotic gradient- this exchnage increases during pregnancy up until the 35th week

Electrolytes follow water

Iron and Calcium can only go from mother to foetus

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4
Q

What is the role of HCG on the corpus luteum?

A

Prevents involution in the first 12 weeks of pregnancy

The CL stimulates progesterone and oestrogens

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5
Q

What is the role of progesterone?

A
  • Development of the decidual cells
  • Decreases uterine contractility
  • Prepares for lactation
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6
Q

What role do the oestrogens play?

A
  • Enlargement of uterus
  • Breast development
  • Relaxation of the ligaments in preperation for birth
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7
Q

True or false?

In early pregnancy the levels of HCG double every 24 hours

A

False

Levels double every 48 hours

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8
Q

Why is nausea and vomiting seen in the first trimester?

A

It is a side effect of HCG

The levels of HCG start to fall around 12-14 weeks and so does its side effects

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9
Q

During pregnancy, how much does the mother’s CO increase by?

A

Around 30-50%

(begining around week 6 and peaking week 24)

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10
Q

Why does a mother’s HR increase during pregnancy?

A

In order to increase CO- increases to around 90 bpm

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11
Q

Describe how blood pressure changes throughout pregnancy

A
  • BP initially falls, reaching its lowest point in the 2nd semester
  • At its lowest it is around 15mmHg lower than the pre-pregnancy BP
  • In the 3rd trimester BP rises, reaching pre-pregnancy levels by term
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12
Q

What 3 big changes occur in the blood of the mother?

A
  • Plasma volume increases proportionatley with CO (50%)
  • erythropoesis (RBC) increase by 25%
  • Hb is decreased by dilution (RBC increase) which increases the blood viscosity
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13
Q

Outwith pregnancy, what is the normal limit of blood iron?

A

Hb 120-160g/L

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14
Q

What is the ranges for diagnosing anaemia in pregnant women?

A

First trimester Hb < 110g/L

2nd and 3rd trimester Hb < 105g/L

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15
Q

Why do changes in lung function come about in pregnancy?

A

Partly as a result of progesterone increase (P signals brain to lower CO2 levels)

Also because the enlarging uterus interferes with lung function

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16
Q

In pregnancy, how are CO2 levels lowered? (4)

A
  • respiratory rate increases
  • tidal and minute volume increases by 50%
  • pCO2 decreases slightly
  • Vital capacity and pO2 dont change
17
Q

In pregnancy, how do postural changes affect renal function?

A

Upright position- decreases

Supine position- increases

Lateral position whilst asleep- really increases

18
Q

What happens to GFR in pregnancy?

A

Increases around 30-50% (peaks 16-24 weeks)

19
Q

How does a mother’s coagulation change through pregnancy?

A
  • Hypercoagulable state
  • This reduces risk of haemorrhage during and after delivery
  • However, increases risk of VTE
20
Q

What is the average weight gain of a mother during pregnancy?

A

11kg (can be as much as 30)

21
Q

How many extra calories does a pregnant women need to consume each day?

A

Around 200 kcal

22
Q

How are the metabolic phases of pregnancy split up?

A

Into 2 phases

First phase is the mother’s anabolic phase- week 1-20

Weeks 21-40 is the catabolic phase

23
Q

Describe the metabolic demands of the foetus on the mother?

A
  • Weeks 1-20 (mother’s anabolic phase)- small nutritional demand from the conceptus
  • From weeks 21-40- foetus has high metabolic demands and so there is accelerated starvation of the mother
24
Q

What happens to the mother in the anabolic phase?

A
  • Normal or increases sensitivity to insulin
  • Lower plasmatic glucose level
  • Lipogenesis, glycogen stores increase
  • Growth of breasts and uterus- weight gain
25
Q

What happens to the mother in the catabolic phase (accelerated starvation)?

A
  • Maternal insulin resistence
  • Increased transport of nutrients through the placental membrane
  • Lipolysis
26
Q

What changes in hormones occurs during parturition?

A
  • Eostrogen:Progesterone ratio alters which increases excitability.
    • Progesterone inhibits contractility
    • Oestrogen increases contractility
  • Prostaglandins are produced by the placenta, myometrium, decidua, and membranes
  • Oxytocin is released which increases contractions and excitability
27
Q

What part of the pituitary releases oxytocin?

A

Posterior pituitary gland

28
Q

What hormone is further released as the cervix stretches?

A

Oxytocin

29
Q

What is given to induce labour?

A

Prostaglandins and Oxytocin

Oxy is given IV, Prostaglandins are given as a gel or pessary

30
Q

What is the role of prostaglandins during child birth?

A

Stimulates more vigorous contractions of the uterus

31
Q

What are the 3 stages of labour?

A
  • 1st Stage= cervical dilation (8-24 hours)
  • 2nd Stage= passage of the foetus through the birth canal (minutes to 120 minutes)
  • 3rd Stage= expulsion of the placenta
32
Q

What are the roles of progesterone and oestrogen in regards to lactation?

A

Oestrogen - growth of the ductile system

Progesterone - development of the lobule-alveolar system

Both inhibit milk production and so drop at birth

33
Q

What hormone stimulates milk production?

A

Prolactin

Around 1-7 days after birth, prolactin induces high milk production. Stimulates first milk (colostrum)

34
Q

What hormone controls the milk ‘let-down’ reflex?

A

Oxytocin

35
Q

True or False?

Oxytocin causes milk to be ejected from the nipple

A

True (causes smooth muscle contration)

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