Pregnancy Physiology

Question 1

outline the stages an embryo goes through after fertilisation

Answer 1

ovulation - fertilisation - cleavage - morula - blastocyst - implantation

Question 2

what is the name of the clump of cells that is implanted after fertilisation

Answer 2

blastocyst

Question 3

where does fertilisation usually occur

Answer 3

ampulla of the fallopian tube

Question 4

on what days after fertilisation does the blastocyst move to the uterus

Answer 4

days 3-5

Question 5

on what days after fertilisation does the blastocyst implant onto the uterus lining

Answer 5

day 5-8

Question 6

what do the inner and outer cells of the blastocyst become respectively

Answer 6

inner - embryo

outer - placenta

Question 7

what 2 types of tissue is the placenta derived from

Answer 7

trophoblast tissue and decidual tissue (mucosal lining of the uterus)

Question 8

maternal and foetal blood do not cross true/false

Answer 8

true - separated by connective tissue

Question 9

which hormone signals for the corpus luteum to continue secreting progesterone

Answer 9

HCG

Question 10

the foetal heart and placenta are functional by which week of pregnancy

Answer 10

5th

Question 11

outline some of the main functions of the placenta

Answer 11

2 way gas exchange
water and electrolyte diffusion
glucose enters foetus through simplified transport

Question 12

de-oxygenated blood returns to the mother via which vessel

Answer 12

uterine vein

Question 13

oxygenated blood enters the foetus via which vessel

Answer 13

umbilical vein

Question 14

what is the main function of HCG

Answer 14

prevents involution of the corpus luteum

Question 15

what does the corpus luteum stimulate

Answer 15

progesterone release

Question 16

what are the main functions of HCS

Answer 16

growth hormone like effects
breast development
reduces insulin sensitivity in the mother allowing more glucose for the foetus

Question 17

outline 3 functions of progesterone

Answer 17

development of decidual cells
decreases uterine contractility
prepares for lactation

Question 18

outline 3 functions of oestrgoen

Answer 18

enlargement of uterus
breast development
relaxation of ligaments/increases uterine contractility

Question 19

how does cardiac output change in response to pregnancy

Answer 19

increases due to uteroplacental circulation demands

Question 20

why does CO decrease again roughly 8 weeks before term

Answer 20

due to uterus compressing on the vena cava

Question 21

does plasma volume increase or decrease in pregnancy

Answer 21

decrease

Question 22

what does the change in plasma volume and erythropoiesis mean for Hb concentration in pregnancy

Answer 22

erythropoiesis increases in pregnancy therefore Hb concentration decreases by dilution which in turn decreases plasma viscosity

Question 23

does GFR and renal plasma volume increase or decrease in pregnancy

Answer 23

increase causing increased resorption of ions and water

Question 24

what is the average weight gain during pregnancy

Answer 24

24 lbs

Question 25

what is the additional calorie requirement in pregnancy

Answer 25

approximately 250-300 extra calories per day

Question 26

which phase of pregnancy is sensitive to insulin and which is insensitive to insulin

Answer 26

1-20 weeks - sensitive to insulin | 21-40 - insensitive to insulin, foetus also has increased metabolic demands

Question 27

taking B vitamins helps with which process

Answer 27

erythropoiesis

Question 28

taking folic acid helps prevent which defect

Answer 28

neural tube defects

Question 29

why is vitamin K indicated before parturition

Answer 29

to prevent intracranial haemorrhage during birth

Question 30

list some drugs that are concentrated/transmitted through breast milk

Answer 30

``` amiodarone carbimazapine nicotine heroin benzodiazepines ```

Question 31

what effect on the neonate does amiodarone have

Answer 31

neonatal hypothyroidism

Question 32

what effect on the neonate does cytotoxics in pregnancy have

Answer 32

bone marrow suppression

Question 33

what effect on the neonate does benzodiazepines in pregnancy have

Answer 33

drowsiness

Question 34

what does phenytoin in pregnancy increase the risk of

Answer 34

cleft lip/cleft palate

Question 35

what does stillbestrol in pregnancy cause

Answer 35

vaginal adenocarcinoma as the child becomes older

Question 36

what does sodium valproate in pregnancy increase the risk of

Answer 36

neural tube defects

Question 37

by the end of the pregnancy, how does the oestrogen : progesterone ratio change

Answer 37

oestrogen increases to prepare for birth

Question 38

which hormone stimulates contractility and excitability of the uterus

Answer 38

oxytocin

Question 39

which hormone controls the growth of the lobular breast system

Answer 39

oestrogen | progesterone controls growth of the lobular system

Question 40

which hormone promotes the production of breast milk

Answer 40

prolactin

Question 41

describe the difference between foremilk and hindmilk

Answer 41

foremilk - protein rich | hindmilk - thinner, less protein for when the baby has been fed well

Question 42

which hormone controls the let down reflex

Answer 42

oxytocin

Question 43

describe the let down reflex

Answer 43

in response to stimuli such as a baby crying the brain senses that as hunger and promotes the let down of milk into the breast

Question 44

which hormone is responsible for nausea and vomiting in early pregnancy

Answer 44

HCG

Question 45

serum HCG levels double every __ in an early singleton pregnancy

Answer 45

48hours - if this is incorrect suspect a pathology

Question 46

an unusually high HCG is suggestive of what condition

Answer 46

molar pregnancy

Question 47

a falling HCG is suggestive of what condition

Answer 47

failing pregnancy such as miscarriage

Question 48

a static or slow rising HCG is suggestive of what condition

Answer 48

ectopic pregnancy

Question 49

how does blood pressure change in normal pregnancy

Answer 49

drops - lowest point is in second trimester | approx drops by 15mmHg from normal but returns in third trimester

Question 50

what are the normal levels of Hb in pregnancy

Answer 50

first trimester Hb 110g/L | second and third trimester Hb 105g/L