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22 Cards in this Set
- Front
- Back
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Effects of Hormones During Pregnancy |
- Estrogens, Progesterones, and hCG - Corpus Luteum degenerates between 12-17 weeks Placenta • Converts weak androgens secreted by adrenal glands to estrogens; ovulation prevention, fetal tissue growth, maturation of lungs + liver, maternal tissue growth, uterus and mammary glands |
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What takes over as endocrine organ? Progesterones, hCG, Relaxin |
ANS: Placenta Progesterones: Ovulation prevention, inhibition of uterine contractions (drop in late gestation allows contractions to occur) hCG: Stimulates testosterone in male fetus Relaxin: Increases in elasticity in joints and ligaments in pelvis
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Changes in Organ Systems During Pregnancy |
- Digestive and Urinary • 1st Trimester: Morning Sickness, decreased intestinal peristalsis, pregnancy-related hormones • Mid pregnancy: Kidneys become more efficient, frequent urination - Rise in blood volume, rise in pulse, rise in blood pressure |
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Dangerous Complication: Gestational Diabetes |
- Pregnancy-related hormones cause insulin resistance - Increased risk of pre-term labor and type 2 diabetes in future - If not treated can lead to pre-eclampsia, polyhydramnios, large fetus, birth trauma, c-sections, perinatal mortality, neonatal metabolic complications |
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Dangerous Complication: Pre-Eclampsia |
- Elevated blood pressure, protein in urine, headache, abdominal pain, vision changes, swelling, potential liver and kidney damage, bleeding, fetal growth restriction and even death - Treatment: monitoring and bed rest if severe hospitalization and pre-term delivery - If untreated: Eclampsia; Seizures, Coma, Renal Failure |
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Physiological Changes During Pregnancy (Respiratory & Integumentary) |
Respiratory; volume of gas increases, upward pressure on diaphragm causes shortness of breath, mucosa swell Integuementary; Stretch marks, increase in melanocyte stimulating hormone and estrogens |
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Physiology of Labor |
- Parturition within a week of due date - Progesterone plateaus at month 7 then drops - Estrogen climb - Increased estrogen; progesterone makes myometrium sensitive to stimuli which promotes contractions - Braxton Hicks week and irregular contractions |
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True Labor |
- Stimulation of uterine contraction • Positive Feedback Loop: Oxytocin, Prostaglandins --> Pictosin to induce labor • Stretching of myometrium and cervix by baby in vertex position; Pain due to myometrial hypoxia during contractions |
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Positive Feedback Loop |
Oxytocin and estrogen from ovaries and placenta --> induce oxytocin receptors on uterus --> stimulates myometrial to start undergoing contractions --> oxytocin also stimulates prostaglandins which stimulate more contractions |
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What causes pain during contractions? What is an epidural? |
Temporary loss of oxygen -Epidural --> pain relief --> into cannel around spinal chord --> local anesthesia to spine to numb lower part of body |
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Irregular Contractions |
Irregular contractions --> induced labor --> esp if water breaks --> amniotic sac will rupture --> fluid released --> if contractions are still irregular --> dangerous --> exposure to bacteria --> really want labor to progress --> Piton is synthetic version of oxytocin and prostaglandins |
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Stages of Labor; Cervical Dilation |
- Positive feedback in which uterine contractions stretch/thin cervix --> induces uterine contractions - Longest stage - Sharp reduction in o2 to fetus during each contraction - Rupture of amniotic fluid |
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Stages of Labor; Expulsion Stage |
- Orientation of fetus affects length of stage - Tearing in perineum versus episiotomy - Presentation of newborn head • Aspiration of mucus from mouth and nose |
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Breech Position |
- 3% of fetuses - Buttocks or lower limbs presented first rather than head
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Stages of Labor; After Birth |
- Myometrium contracts to shear placenta from back of uterine wall - Continued contractions reduce blood loss - If placenta not expelled after 30 mins must be manually removed - Involution (shrinking) |
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Cesarean Delivery |
- Baby removed via surgical incision in abdominal wall and uterus - Various reasons; unusual position, health condition, STI in mother, fetal distress, placenta previa |
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Adjustments of Infant at Birth; Respiratory |
- Neonatal Period: 1-30 day outside uterus - Respiratory; stimulation of first breath (constriction of umbilical blood vessels during uterine contractions; low O2 high CO2; acidosis stimulates respiratory centre in brain - 1st breath within 10 seconds of birth; inflate lungs to nearly full capacity, decrease lung pressure, alveoli open and capillaries fill with blood, amniotic fluid drains or absorbed
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Adjustments of Infant at Birth; Circulatory |
- Closing of shunts, clamping of umbilical cord; collapsed vessels become ligaments and ductus venous becomes ligamentum venousum - First breath initiates transition from fetal to neonatal circulation, decrease blood pressure in RA and RV, reversal of blood flow from LA to RA blocks foramen ovale with tissue flaps, becomes fossa ovalis, ductus arteriosus constricts due to increase O2, becomes ligamentum arteriosum and all blood pumped to pulmonary circuit becomes oxygenated |
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Thermoregulatory Adjustments |
- Produce heat more slowly and lose it quickly - Non-shivering thermogenesis; break down of brown fat, back chest and shoulders; highly vascularized, packed with special mitochondria that produce less ATP and more heat |
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Barker Hypothesis |
- Inverse correlation between incidence of coronary heart disease and birth weight - See among full-term births in normal range - Associations are independent of adult lifestyle and occur in different populations, levels of SES, alcohol and nicotine use and obesity |
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Barker Hypothesis, Cont'd |
- Organs and metabolic/endocrine pathways programmed during embryonic and fetal development according to environmental factors - Programming is long-lasting and determines the set points of physiological and metabolic responses that persist into adulthood |
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Studies in Rats, Mice and Sheep agree with Epidemiological Studies |
- Preg. rats fed low protein diet; offspring born smaller but catch up, and higher risk of obesity, elevated BP, hyper-insilinemia - Chemical exposures increase risk of obesity - Underlying mechanisms; hypothalamic-pituitary-adrenal axis and levels of stress hormones in fetus (glucocorticoids); epigenetic modifications |
