Repro Phys 3 Flashcards by lauren granger

2 methods of fetal growth?

Hyperplasia
Hypertrophy

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Which method of fetal growth is more dominant in the 1st and 2nd trimester?

Hyperplasia dominates, some hypertrophy also occurs

(think, lots of cell proliferation required for initial organ development)

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Which method of fetal growth is more dominant in the 3rd trimester?

Hypertrophy

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T or F: placental growth typically parallels fetal growth

TRUE

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When do periods of rapid fetal growth occur/when does fetal growth not parallel placental growth?

When placental villi surface area increases

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What is placental reserve

Ability of placenta to function above actual fetal needs

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What can impact placental reserve?

Smaller placenta (i.e. d/t smoking) which can lead to IUGR

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Is fetal growth predominantly hyperplastic or hypertrophic overall?

Hyperplastic

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What regulates early fetal growth and development?

Genetics

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What regulates later fetal growth and development?

Multifactorial: placental function, hormone effects, environment (maternal nutrition status, drugs, ambient O2), metabolic effects (chronic illness or disease)

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Does length or weight experience a dramatic increase at the late stages of fetal development?

Weight, length steadily increases throughout pregnancy

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How does glucose enter the placenta?

Passively crosses from maternal blood stream

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T or F: Maternal insulin can NOT cross the placenta

TRUE – fetus produces its own insulin in response to maternal glucose passively entering

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How does high maternal glucose impact the fetus?

Passively crosses over and increases fetal glucose and subsequent insulin production

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How does high maternal glucose result in macrosomia?

High maternal glucose translates to high fetal glucose and insulin levels, and insulin has a similar structure to IGF so it initiates excess fetal growth

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Is IGF high or low during fetal life?

High (baby needs to grow doesn’t it)

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IGF is independent/dependent on GH stimulation during fetal life

Independent

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When does fetal thyroid hormone production begin

2nd trimester

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Clinical manifestations of fetal hypothyroidism

Reduced growth of heart, liver, kidneys, and spleen

Neurological compromise

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Location of fetal erythropoiesis in:
Earliest parts of development
~halfway through pregnancy
Right at term

Earliest = yolk sac
Halfway = liver and then spleen
Right at term = bone marrow

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There is a (high or low) percent of reticulocytes in early fetal life

High!

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T or F: fetus makes itws own proteins

TRUE – 3-4x increase during 3rd trimester

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Purpose of fetal fat storage

Energy reservoir and temperature regulation

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Gonadal sex refers to…

Presence of ovaries or testes

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Turner and Klinefelter genotype

Turner: XO Klinefelter: XXY

Mesonephric/Wolffian ducts ultimately differentiate into ______

Vas deferens

Paramesonephric/Mullerian ducts ultimately differentiate into _______

Uterus and proximal vagina

Leydig cells produce _____ which promotes growth of ______ ducts

testosterone; Wolffian/mesonephric

Sertoli cells produce ____ which inhibits development of ______ ducts

AMF; Mullerian/paramesonephric

Absence of _____ promotes development of paramesonephric/Mullerian ducts and absence of ______ results in degeneration of mesonephric/Mullerian structures

AMH; testosterone

When is surfactant produced?

~week 24 --> fetus considered viable at this point

Canalicular period of lung development

16-25 weeks: - branching of bronchi (changing shape)

Terminal sac period of lung development

~24-32 weeks: - minimal surfactant production - thinning of respiratory epithelia - improved interaction of blood and epithelium interface

Alveolar period of lung development

32 weeks up until age 8: - continued growth in number of alveoli

How do fetal glucocorticoids impact pulmonary development?

Stimulate type 2 pneumatocytes to produce more DPCC and surfactant

When do fetal respiratory movements begin

1st trimester

What stimulates fetal respiratory movements?

Hypoxia and tactile stimulation

What are the 4 fetal shunts?

Placenta, ductus venosus, ductus arteriosus, foramen ovale

How many umbilical arteries are there? Veins?

2 arteries, 1 vein THINK: arteries is the longer word so there are two of them

Umbilical arteries carry ______ blood and umbilical veins carry ______ blood

Deoxygenated; oxygenated

Placenta acts as the ______ of the fetus

Lungs --> where oxygenation takes place

Ductus venosus bypasses the _____ and sends blood to the IVC to enter the RA

liver

_________ shunts a portion of oxygenated blood form the RA to the LA

Foramen ovale

Where do we have the highest fetal [O2]

Foramen ovale

Oxygenated blood from the fetal heart is preferentially shunted to ______

head and UE

Ductus arteriosus shunts blood from _______ to ______

pulmonary trunk; aorta

What substance keeps the ductus arteriosus open during fetal life?

PGE2 produced by the placenta (rapidly declines at birth which contributes to ductus arteriosus closure)

What causes pulmonary circulation to dominate at birth?

- Sclerosis of umbilical vein inhibits maternal fetal communication - First breath (lung expansion) decreases pulmonary resistance/P and increases vascular resistance/P - Foramen ovale closes with first breath - Vasoconstriction of ductus venosus increases liver perfusion via hepatic portal system

How do: pulmonary vascular resistance, pulmonary blood flow, and mean pulmonary arterial P change at birth?

Resistance: decrease Blood flow: increase P: decrease

First breath requires large (negative or positive) P to expand lungs

Negative

How long can it take for the FO to permanently close?

Up to 6 months

How long does the DA remain open after birth?

24-48 hours

Fetal metabolic rate is ____ than an adult's

Greater (2x)

T or F: Neonatal kidneys can fully concentrate urine

FALSE -- only partially developed and can only partially concentrate urine as a result --> leads to frequent urination and a higher plasma osmolality (lower urine osmolality)

Neonatal liver performs (ineffective/effective) gluconeogenesis

Ineffective

Impact of ineffective gluconeogenesis on neonatal physiology?

Quick declines in blood glucose when unfed

Why do neonates have poor fat absorption?

Limited amylase activity

Which antibodies cross from the placenta to the fetus?

IgG (IgA, IgE and IgM too large)

Immunological developments in utero:

Development of complement, lysozymes, IFN-gamma

Which immunoglobulin is transferred via breast milk?

IgA

When are IgG levels highest?

Right after birth, nadir at ~3 months old

How long does it take for IgG to be fully functional?

Sometimes more than a year, production of IgG is slow

At what age do neonates have a very high risk of infection? Why?

~6 months because maternal IgG levels have depleted and the baby has not yet started making their own IgG

Repro Phys 3 Flashcards

(63 cards)