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What is the primary role of Human Chorionic Gonadotropin (hCG) during early pregnancy?
What is the primary role of Human Chorionic Gonadotropin (hCG) during early pregnancy?
Which hormone is primarily responsible for stimulating testosterone production from the fetal adrenal medulla?
Which hormone is primarily responsible for stimulating testosterone production from the fetal adrenal medulla?
What hormone is the first indicator of pregnancy that is detectable in the bloodstream?
What hormone is the first indicator of pregnancy that is detectable in the bloodstream?
What occurs to hCG levels approximately 12 weeks into pregnancy?
What occurs to hCG levels approximately 12 weeks into pregnancy?
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Which hormone's levels increase significantly over the first 24 weeks of pregnancy and stimulates placental production of hCG?
Which hormone's levels increase significantly over the first 24 weeks of pregnancy and stimulates placental production of hCG?
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What is the primary reason for increased food preferences during pregnancy?
What is the primary reason for increased food preferences during pregnancy?
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What is a typical duration for hyperemesis gravidarum?
What is a typical duration for hyperemesis gravidarum?
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What effect does progesterone have on the gastrointestinal system during pregnancy?
What effect does progesterone have on the gastrointestinal system during pregnancy?
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What is a common unusual craving experienced during pregnancy that might indicate a deficiency?
What is a common unusual craving experienced during pregnancy that might indicate a deficiency?
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What nutritional element is mainly transferred across the placenta through active transport?
What nutritional element is mainly transferred across the placenta through active transport?
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What is one of the symptoms associated with increased sensitivity during pregnancy?
What is one of the symptoms associated with increased sensitivity during pregnancy?
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What is a result of the decreased motility in the gastrointestinal system during pregnancy?
What is a result of the decreased motility in the gastrointestinal system during pregnancy?
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What is one effect of the increased levels of erythropoietin during pregnancy?
What is one effect of the increased levels of erythropoietin during pregnancy?
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What physiological change contributes to the feeling of 'pregnancy glow'?
What physiological change contributes to the feeling of 'pregnancy glow'?
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How does the respiratory system adapt during pregnancy to enhance oxygen intake?
How does the respiratory system adapt during pregnancy to enhance oxygen intake?
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What is a common risk associated with the hypercoagulability condition during pregnancy?
What is a common risk associated with the hypercoagulability condition during pregnancy?
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What anatomical change occurs in the uterus during pregnancy to support fetal growth?
What anatomical change occurs in the uterus during pregnancy to support fetal growth?
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What could a decrease in tidal volume during pregnancy indicate?
What could a decrease in tidal volume during pregnancy indicate?
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What compensatory mechanism occurs to offset the squashing of the lungs during pregnancy?
What compensatory mechanism occurs to offset the squashing of the lungs during pregnancy?
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What is a common symptom related to the increased oxygen demand during pregnancy?
What is a common symptom related to the increased oxygen demand during pregnancy?
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What is the role of increased Aldosterone during pregnancy?
What is the role of increased Aldosterone during pregnancy?
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What are common symptoms of gestational hypothyroidism?
What are common symptoms of gestational hypothyroidism?
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How does pregnancy affect proteinuria and glycosuria levels?
How does pregnancy affect proteinuria and glycosuria levels?
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What condition is characterized by itching and leakage of bile salts into the bloodstream during pregnancy?
What condition is characterized by itching and leakage of bile salts into the bloodstream during pregnancy?
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What hormonal changes are associated with the body's response to fetal needs during pregnancy?
What hormonal changes are associated with the body's response to fetal needs during pregnancy?
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What commonly happens to venous valves during pregnancy?
What commonly happens to venous valves during pregnancy?
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Which hormone is primarily responsible for preparing mammary glands for lactation during pregnancy?
Which hormone is primarily responsible for preparing mammary glands for lactation during pregnancy?
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What is a common maternal issue linked to increased blood volume during pregnancy?
What is a common maternal issue linked to increased blood volume during pregnancy?
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What role does oestrogen play during pregnancy in terms of tissue support?
What role does oestrogen play during pregnancy in terms of tissue support?
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At what point during pregnancy does hCG peak?
At what point during pregnancy does hCG peak?
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What is one of the primary effects of relaxin during pregnancy?
What is one of the primary effects of relaxin during pregnancy?
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How much does blood plasma increase during pregnancy?
How much does blood plasma increase during pregnancy?
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Which hormone is primarily involved in preparing mammary glands for lactation?
Which hormone is primarily involved in preparing mammary glands for lactation?
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What is the primary cause for the increase in cardiac output during pregnancy?
What is the primary cause for the increase in cardiac output during pregnancy?
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What does the chorion secrete at the early stages of pregnancy?
What does the chorion secrete at the early stages of pregnancy?
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Which hormone is known to increase cortisol levels during pregnancy?
Which hormone is known to increase cortisol levels during pregnancy?
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Which hormone primarily increases flexibility of tendons during pregnancy?
Which hormone primarily increases flexibility of tendons during pregnancy?
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What effect does human Placental Lactogen (hPL) have on maternal insulin levels?
What effect does human Placental Lactogen (hPL) have on maternal insulin levels?
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What is one of the roles of Progesterone during early pregnancy?
What is one of the roles of Progesterone during early pregnancy?
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Which hormone is responsible for increasing blood cell production during pregnancy?
Which hormone is responsible for increasing blood cell production during pregnancy?
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What effect do Glucocorticoids have on maternal glucose levels during pregnancy?
What effect do Glucocorticoids have on maternal glucose levels during pregnancy?
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Which hormone is primarily involved in milk production during lactation?
Which hormone is primarily involved in milk production during lactation?
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Which hormone helps increase kidney function during pregnancy?
Which hormone helps increase kidney function during pregnancy?
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What is the primary role of Adrenocorticotrophic Hormone (ACTH) during pregnancy?
What is the primary role of Adrenocorticotrophic Hormone (ACTH) during pregnancy?
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What physiological change does Relaxin promote during childbirth?
What physiological change does Relaxin promote during childbirth?
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Which hormone is responsible for increasing calcium absorption during pregnancy?
Which hormone is responsible for increasing calcium absorption during pregnancy?
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Study Notes
Physiological changes in Pregnancy
- This presentation details physiological changes during pregnancy.
- Slides were adapted from Dr. Allyson Clelland.
- Dr. Alpana Asurlekar, UM2010, presented the material.
Lecture Plan
- Identify key hormones and endocrine organs in reproduction and pregnancy maintenance.
- Explain the function of hormones during pregnancy.
- Identify and explain how hormones affect other bodily systems.
Maintenance of Pregnancy
- Key events in pregnancy include maintaining pregnancy and placenta formation/growth.
- Pregnancy hormones initially released by the corpus luteum after ovulation.
- Key hormones involved include Human Chorionic Gonadotrophin (hCG), Progesterone and Oestrogen.
- Placenta takes over hormone production from the corpus luteum post ovulation.
Human Chorionic Gonadotrophin and Gonadotrophin Releasing Hormone in Pregnancy
- GnRH increases over 24 weeks, stimulating placental hCG production.
- hCG is secreted by the developing placenta.
- hCG maintains the corpus luteum (CL) for 6-7 weeks.
- Maintains progesterone and oestrogen production from the CL, preventing menstruation and embryo loss.
- hCG peaks around 12 weeks before decreasing, potentially linked to morning sickness.
- Stimulates testosterone production from fetal adrenal medulla, supporting external genitalia development.
Hormonal Changes
- Early Pregnancy Factor (EPF) is found in the bloodstream shortly after conception.
- It's an immunosuppressant, stimulating trophoblast (placental) growth during peri-implantation.
- β-human chorionic (β-hCG) gonadotropin is used diagnostically with ultrasound to confirm pregnancy.
- Increase in Progesterone (P), Oestrogen (E), and Human Chorionic Gonadotrophin (hCG) during pregnancy.
- Decrease in Gonadotrophin Releasing Hormone (GnRH), Follicle Stimulating Hormone (FSH), and Luteinising Hormone (LH) during pregnancy.
Hormonal Changes in the Mother
- Increases: Human Placental Lactogen (hPL) interacts with maternal insulin to raise serum glucose, fostering maternal fat storage. Relaxin increases tendon flexibility for fetal growth and birth, relaxing the uterus, and dilating the cervix for childbirth. Adrenocorticotrophic Hormone (ACTH) stimulates the adrenal cortex. Thyroid Stimulating Hormone (TSH) influences TH (glucose availability and growth).
- Decreases: Vasopressin affects smooth muscle (blood vessels, uterus, and mammary glands). Prolactin inhibits ovulation, controls salt and water balance, and facilitates milk production. Thyroid Hormones (TH) increase maternal basal metabolic rate.
Changes Continued for Pregnancy Support
- Renin increases kidney function.
- Erythropoietin increases blood cell production.
- Vitamin D increases Ca++ absorption, significant during teenage pregnancies.
- Parathyroid Hormone (PTH) increases serum calcium levels.
- Glucocorticoids increase maternal glucose levels.
Roles for Progesterone in Supporting Early Pregnancy
- Progesterone inhibits uterine contractions, preventing embryo loss.
- Supports embryo nourishment and maintenance of the endometrium.
- Inhibits follicle-stimulating hormone (FSH) and prevents ovulation.
Progesterone in Later Pregnancy
- Increases in progesterone affect mammary gland development.
- Progesterone promotes prostaglandin precursors for labor.
- Promotes expansion of the uterus, increases blood vessel capacity, and affects constipation due to slowed GI tract.
- Glucose regulation is modulated, and placental lactogen and cortisol effects are altered.
Roles of Oestrogen in Pregnancy
- Oestrogen is secreted by placenta (first by corpus luteum).
- Oestrogen is influenced by fetal and maternal androgens (adrenal glands).
- Oestrogen relaxes pelvic ligaments for uterine expansion and birth passage from 2-3mm to 9mm.
- Oestrogen supports proliferation of fetal and maternal tissues (uterus, breasts, and external genitalia).
- Oestrogen increases cortisol levels.
Hormonal Changes (Summary)
- hCG is detectable at 8 days, peaks around 9 weeks, and decreases from weeks 4-5.
- Chorion secretes oestrogen from 3-4 weeks and progesterone from 6 weeks.
- Relaxin is produced by the placenta, increasing during pregnancy to prepare the body for birth.
- Placental Lactogen prepares mammary glands for lactation.
- Corticotrophin Releasing Hormone (CRH) alters glucose availability.
Cardiovascular System
- Blood volume increases from 2.6 liters to 3.8 liters.
- Cardiac output increases due to increased stroke volume and normal heart rate.
- Blood pressure decreases, blood supply increases to the kidney and skin.
- Blood clotting (hypercoagulability) increases to prevent postpartum blood loss.
Cardiovascular System (Oxygen Use)
- Oxygen use by pregnant women increases by 16%.
- Cardiac output increases, meaning more blood flow to the lungs.
- Tidal volume increases by 40% (from 500ml to 700ml).
Reproductive System
- Uterine tissue undergoes hypertrophy and hyperplasia.
- Muscle fiber arrangement changes: upper portion has spiral arrangement, lower portion has circular arrangement.
- Blood vessels in the uterus are closed during contractions.
- Strength of contractions is affected.
Gastrointestinal System
- Food preferences change throughout pregnancy (e.g., cravings).
- Nausea is common.
- Cardiac sphincter relaxes, leading to reflux.
- Motility and gastric acid secretion decline.
- Metabolic rate increases.
- Progesterone relaxes smooth muscle to slow gut motility, often leading to constipation.
- Increased nutrient transfer to the fetus through the placenta.
Gastrointestinal System (Continued)
- Constipation, hospitalization, and increased fluid absorption can occur.
- Increased caloric intake and protein needs are necessary for third-trimester pregnancy.
Urinary System
- Urinary collection system (calyces, renal pelves, ureter) dilate.
- Increased blood flow to kidneys, glomerular filtration rate (GFR) increases.
- Increased protein and sugar levels in urine compared to non-pregnant women.
- Increased water retention.
- Higher protein and glucose levels can signal problems.
Other Considerations
- Varicose veins and edema are common.
- Bladder infections and mild infections are possible.
- Leg cramps are possible.
- Significant breast development and growth are common.
- Venous valve malfunction contributing to varicose veins and edema.
- Immune system modifications are common.
Maternal Responses to Fetal Requirements
- Maternal responses include: volume expansion, vasodilation, respiratory rate increases, peripheral insulin resistance, increased mineral absorption by the kidneys, increased renal glomerular filtration, hepatocellular stimulation, and uterine quiescence.
Problems With Pregnancy
- Gestational Diabetes: Decreased TSH levels mimicking normal pregnancy symptoms (tiredness, mood changes).
- Gestational Hypothyroidism: Persistent vomiting, weight loss, tremors; increased T4 levels because hCG stimulates T4 production (resolving around 20 weeks).
- Obstetric Cholestasis: Pruritis (itching), bile salt leakage into blood (common in multiple pregnancies).
- Gestational Transient Thyrotoxicosis: Thirst, hunger, increased blood sugar; insufficient insulin production.
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Description
This quiz focuses on the physiological changes that occur during pregnancy, including hormonal shifts and their effects on the body. Explore key hormones such as hCG, progesterone, and oestrogen, and understand their roles in maintaining pregnancy and supporting the developing fetus.
