Physiology of Pregnancy
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Questions and Answers

What change occurs to the cardiac output (COP) during the last 8 weeks of pregnancy?

  • It remains at normal levels.
  • It falls to only a little above normal levels. (correct)
  • It decreases below normal levels.
  • It significantly increases above normal levels.
  • By how much does maternal blood volume increase during pregnancy?

  • About 30% (correct)
  • Exactly 50%
  • Over 40%
  • Approximately 20%
  • What is one factor that may explain the variability in cardiac output during late pregnancy?

  • Hormonal changes in early pregnancy.
  • Increased fetal activity.
  • Unexplained reasons. (correct)
  • Maternal age.
  • When does the change in cardiac output to slightly above normal occur during pregnancy?

    <p>In the last 8 weeks of pregnancy. (C)</p> Signup and view all the answers

    What can be inferred about the relationship between maternal blood volume and pregnancy?

    <p>It increases approximately 30% above normal levels. (B)</p> Signup and view all the answers

    How does high levels of progesterone affect the respiratory center?

    <p>It increases sensitivity to CO2. (B)</p> Signup and view all the answers

    At what stage of pregnancy is human chorionic somatomammotropin (HPL) secreted by the placenta?

    <p>5th week (A)</p> Signup and view all the answers

    What physical change occurs due to the growing uterus related to the abdominal contents?

    <p>It presses upward against the abdominal contents. (B)</p> Signup and view all the answers

    Which hormone is primarily associated with the function of human chorionic somatomammotropin (HPL) during pregnancy?

    <p>Insulin (D)</p> Signup and view all the answers

    Which of the following statements is true regarding progesterone's effects?

    <p>It enhances the respiratory center's reaction to CO2 levels. (A)</p> Signup and view all the answers

    What is the primary source of human chorionic somatomammotropin (HPL) in a pregnant woman?

    <p>Placenta (A)</p> Signup and view all the answers

    Which of the following statements regarding the secretion of human chorionic somatomammotropin (HPL) is false?

    <p>HPL secretion increases significantly after the first trimester. (C)</p> Signup and view all the answers

    What is a consequence of the uterus pressing against abdominal contents?

    <p>It causes displacement of other organs within the abdomen. (A)</p> Signup and view all the answers

    Increased sensitivity of the respiratory center due to high progesterone can lead to which of the following physiological effects?

    <p>Increased respiratory rate. (D)</p> Signup and view all the answers

    Which physiological process is NOT influenced by human chorionic somatomammotropin (HPL)?

    <p>Skeletal muscle growth (A)</p> Signup and view all the answers

    What is the primary source of progesterone during the early stages of pregnancy?

    <p>The corpus luteum (C)</p> Signup and view all the answers

    What physiological changes does progesterone induce in the uterine endometrium?

    <p>Causes decidual cells to develop (C)</p> Signup and view all the answers

    How does the secretion of progesterone change as pregnancy progresses?

    <p>It increases tremendously after the early stages (A)</p> Signup and view all the answers

    What is the role of Human Chorionic Gonadotropin (hCG) in relation to thyroid hormone levels?

    <p>It stimulates an increase in thyroid hormones. (C)</p> Signup and view all the answers

    When does the concentration of hCG typically reach its maximum during pregnancy?

    <p>10 to 12 weeks after ovulation (A)</p> Signup and view all the answers

    Which statement correctly describes progesterone's role during pregnancy?

    <p>It acts to prepare the endometrium for implantation. (B)</p> Signup and view all the answers

    What is the relationship between the corpus luteum and placenta regarding progesterone secretion?

    <p>The placenta eventually takes over progesterone secretion from the corpus luteum. (B)</p> Signup and view all the answers

    How does parathyroid hormone (PTH) affect calcium levels in the mother during pregnancy?

    <p>It mobilizes calcium from the mother's bones. (D)</p> Signup and view all the answers

    Which hormones are produced by the placenta?

    <p>Estrogen and progesterone (B)</p> Signup and view all the answers

    What physiological structure secretes Human Chorionic Gonadotropin during early pregnancy?

    <p>The syncytial trophoblast (B)</p> Signup and view all the answers

    What is the primary role of progesterone produced by the placenta?

    <p>Maintaining the uterine lining (B)</p> Signup and view all the answers

    What happens to hCG levels after reaching their peak during the first trimester?

    <p>They decrease to a lower value by 16 to 20 weeks. (B)</p> Signup and view all the answers

    Which hormone is NOT typically produced by the placenta?

    <p>FSH (A)</p> Signup and view all the answers

    Which of the following statements about placental hormones is correct?

    <p>Placental hormones regulate various functions throughout pregnancy. (C)</p> Signup and view all the answers

    Which hormone is primarily responsible for preparing the breast tissue for lactation?

    <p>Prolactin (B)</p> Signup and view all the answers

    What is the primary physiological process through which fluid is formed and absorbed during pregnancy?

    <p>Direct absorption via amniotic membranes (A)</p> Signup and view all the answers

    Which gland primarily regulates fluid absorption in relation to pregnancy hormones?

    <p>Pituitary gland (D)</p> Signup and view all the answers

    Which factor could potentially disrupt fluid absorption through amniotic membranes during pregnancy?

    <p>Hormonal imbalances (C)</p> Signup and view all the answers

    What role does the amniotic membrane play in fetal development?

    <p>It acts as a barrier to infections (D)</p> Signup and view all the answers

    Which physiological condition would most likely affect hormonal factors during pregnancy?

    <p>Thyroid dysfunction (A)</p> Signup and view all the answers

    Which hormones are specifically produced by the placenta during pregnancy?

    <p>Estrogen and progesterone (A), Progesterone and prolactin (B)</p> Signup and view all the answers

    What is one of the roles of the substance mentioned that softens the cervix during delivery?

    <p>It acts as a vasodilator, increasing blood flow. (A)</p> Signup and view all the answers

    Which of the following combinations represents hormones associated with the placenta?

    <p>Human chorionic gonadotropin and progesterone (B)</p> Signup and view all the answers

    How does the substance softening the cervix affect other physiological parameters in pregnancy?

    <p>It contributes to increased venous return and cardiac output. (D)</p> Signup and view all the answers

    What functions does progesterone serve during pregnancy?

    <p>Preparing the uterine lining for implantation (B)</p> Signup and view all the answers

    Which of the following does NOT describe a role of the substance that softens the cervix during labor?

    <p>Lowers respiratory rate. (C)</p> Signup and view all the answers

    Which hormones function collaboratively during the later stages of pregnancy?

    <p>Human chorionic somatomammotropin and progesterone (C)</p> Signup and view all the answers

    In regard to hormonal secretion, which statement is accurate concerning the placenta?

    <p>It produces hormones that modulate the maternal immune response. (C)</p> Signup and view all the answers

    In what way does the softening of the cervix during delivery relate to blood flow?

    <p>It is thought to enhance blood flow to various tissue types. (C)</p> Signup and view all the answers

    What physiological change is associated with the substance that serves as a vasodilator during pregnancy?

    <p>Enhanced renal perfusion. (C)</p> Signup and view all the answers

    What is the typical range of weight gain for a pregnant woman?

    <p>11 to 16 kg (A)</p> Signup and view all the answers

    During which trimesters does most of the weight gain in pregnancy occur?

    <p>Last two trimesters (D)</p> Signup and view all the answers

    What percentage of total weight gain is typically attributed to the last two trimesters?

    <p>Around 75% or more (A)</p> Signup and view all the answers

    Which factor primarily influences the timing of significant weight gain during pregnancy?

    <p>Fetal development stages (D)</p> Signup and view all the answers

    What is the expected weight gain pattern for a pregnant woman throughout her pregnancy?

    <p>Slow gain in first trimester, rapid in last two trimesters (B)</p> Signup and view all the answers

    Which hormone primarily influences the modulation of maternal immune response during pregnancy?

    <p>Progesterone (B)</p> Signup and view all the answers

    What is the principal mechanism of increased tidal volume observed during late pregnancy?

    <p>Increased progesterone levels (C)</p> Signup and view all the answers

    How does human chorionic somatomammotropin (HPL) contribute to maternal metabolism?

    <p>By promoting lipolysis and reducing insulin sensitivity (B)</p> Signup and view all the answers

    Which physiological change is primarily driven by the increased blood volume during pregnancy?

    <p>Increased preload and stroke volume (B)</p> Signup and view all the answers

    What physiological role does the corpus luteum fulfill during the early stages of pregnancy?

    <p>Produces progesterone to maintain the uterine lining (C)</p> Signup and view all the answers

    What is the primary effect of human chorionic gonadotropin (hCG) during early pregnancy?

    <p>To preserve the corpus luteum for hormone secretion (C)</p> Signup and view all the answers

    Which cells are stimulated by hCG in a male fetus to produce testosterone?

    <p>Leydig cells (B)</p> Signup and view all the answers

    What role does hCG play in relation to hormone secretion during early pregnancy?

    <p>It promotes the production of progesterone and estrogen from the corpus luteum (A)</p> Signup and view all the answers

    For how long does hCG maintain the secretion of progesterone and estrogen?

    <p>Typically for the first few months of pregnancy (B)</p> Signup and view all the answers

    Which hormone is primarily responsible for stimulating testosterone production in the male fetus until birth?

    <p>Human chorionic gonadotropin (hCG) (C)</p> Signup and view all the answers

    Flashcards

    Pregnancy blood volume change

    Maternal blood volume increases by about 30% during pregnancy.

    COP in late pregnancy

    COP (likely Cardiac Output) drops slightly during the last 8 weeks of pregnancy.

    Maternal blood volume

    The total amount of blood in a pregnant woman's body.

    Cardiac Output

    Amount of blood pumped by the heart each minute.

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    Normal range

    Typical range of values or levels for a certain parameter.

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    Progesterone's effect on breathing

    High progesterone levels during pregnancy make the respiratory center more sensitive to carbon dioxide (CO2).

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    Uterus pressure on internal organs

    As the uterus grows during pregnancy, it puts pressure on the abdominal organs.

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    How does the uterus affect breathing?

    The growing uterus presses upward against the abdominal contents, making breathing deeper and faster.

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    What is hCG and where is it secreted?

    Human chorionic gonadotropin (hCG) is a hormone produced by the syncytial trophoblast, a layer of cells in the developing placenta.

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    When is hCG highest?

    hCG levels peak around 10 to 12 weeks of pregnancy.

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    hCG and thyroid hormones

    hCG in pregnancy can stimulate the thyroid gland, leading to increased thyroid hormone production.

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    What happens to hCG later in pregnancy?

    hCG levels decrease after the first trimester and remain at a lower level until birth.

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    Why is calcium mobilized during pregnancy?

    Increased parathyroid hormone (PTH) levels during pregnancy mobilize calcium from the mother's bones to support fetal bone development.

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    Progesterone in Early Pregnancy

    The corpus luteum, a temporary structure in the ovary, secretes moderate levels of progesterone during the initial stages of pregnancy.

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    Progesterone in Late Pregnancy

    The placenta takes over as the primary source of progesterone production and significantly increases its secretion as pregnancy progresses.

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    Progesterone's Role in Endometrium

    Progesterone stimulates the development of specialized cells called decidual cells within the uterine lining (endometrium). These cells provide nourishment for the developing embryo.

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    Decidual Cells

    Specialized cells within the uterine lining that are crucial for providing nourishment and support to the growing embryo.

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    Progesterone's Function

    Progesterone plays a vital role in preparing the uterus for pregnancy and maintaining the pregnancy by creating a nourishing environment for the embryo and fetus.

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    Human Chorionic Somatomammotropin (HPL)

    A hormone produced by the placenta starting around the 5th week of pregnancy. It has several important effects on the mother and fetus.

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    HPL's Role in Pregnancy

    HPL plays a crucial role in preparing the body for pregnancy and supporting the fetus's growth. It helps regulate glucose and protein metabolism, and promotes breast growth.

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    HPL's Effect on Glucose

    HPL increases insulin resistance in the mother, leading to a higher blood glucose level. This ensures the fetus has enough glucose for growth.

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    HPL's Influence on Protein

    HPL encourages the mother's body to conserve protein and make it available for the growing fetus.

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    HPL and Breast Growth

    HPL prepares the breasts for lactation, leading to increased breast size and milk duct development.

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    What hormones does the placenta produce?

    The placenta, a vital organ during pregnancy, produces both estrogen and progesterone. These hormones are crucial for supporting a healthy pregnancy.

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    Estrogen's role in pregnancy

    Estrogen, produced by the placenta, helps to develop the uterus, prepare the breasts for lactation and maintain the pregnancy by preventing early labor.

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    Progesterone's role in pregnancy

    Progesterone, also produced by the placenta, helps thicken the uterine lining, relax the muscles of the uterus, and prepare the breasts for lactation.

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    Androgens in pregnancy

    While the placenta primarily produces estrogen and progesterone, it also produces smaller amounts of androgens. These hormones play a role in fetal development.

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    Prolactin and FSH in pregnancy

    The placenta doesn't produce prolactin or FSH (follicle-stimulating hormone). These hormones are regulated by the pituitary gland.

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    Weight Gain in Pregnancy

    Pregnant women typically gain between 11 and 16 kilograms, with most of the gain occurring in the last two trimesters.

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    What are the primary sources of progesterone in pregnancy?

    The corpus luteum is the primary source of progesterone in early pregnancy. However, as pregnancy progresses, the placenta takes over as the main producer, increasing progesterone levels significantly.

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    What are the effects of progesterone during pregnancy?

    Progesterone plays a vital role in preparing the uterus for pregnancy by developing the endometrium and creating a nourishing environment for the developing embryo. It also relaxes the uterus, preventing premature labor.

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    What is Human Chorionic Somatomammotropin (HPL)?

    HPL is a hormone produced by the placenta starting around the 5th week of pregnancy. It influences glucose and protein metabolism, increasing insulin resistance and promoting protein conservation in the mother, ensuring the fetus has adequate resources.

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    What is the role of HPL in breast growth?

    HPL contributes to breast growth by stimulating the development of milk ducts, preparing the mother for lactation after birth.

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    HCG's role in the corpus luteum

    Human chorionic gonadotropin (HCG) helps the corpus luteum continue producing progesterone and estrogen for the first few months of pregnancy, ensuring a stable environment for the developing fetus.

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    HCG's effect on male fetuses?

    HCG stimulates the Leydig cells in the male fetus's testes, causing them to produce testosterone, which is essential for the development of male reproductive organs.

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    What is the corpus luteum's function in early pregnancy?

    The corpus luteum, a temporary structure in the ovary, produces progesterone and estrogen in early pregnancy, helping to prepare the uterus and maintain a healthy environment for the developing embryo.

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    How does HCG affect testosterone production?

    HCG stimulates the Leydig cells in the male fetus's testes, causing increased testosterone production.

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    Amniotic Fluid Formation

    Some amniotic fluid is produced directly by the amniotic membranes, which act as a semi-permeable barrier allowing fluid exchange.

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    Hormonal Factors in Pregnancy

    Hormonal changes during pregnancy are crucial for supporting fetal growth and development, preparing the mother's body for childbirth, and maintaining a healthy pregnancy.

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    What is the role of testosterone in male fetal development?

    Testosterone, produced by the Leydig cells in the testes, is crucial for the development of male reproductive organs and characteristics in the fetus.

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    Endocrine Glands and Pregnancy

    Endocrine glands, particularly the placenta and the corpus luteum, play a significant role in pregnancy by producing hormones that regulate various physiological changes in both the mother and fetus.

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    Human Chorionic Gonadotropin (hCG)

    hCG is a hormone produced by the placenta, and its levels rise rapidly during early pregnancy. It plays a role in maintaining the corpus luteum and stimulating the production of other hormones.

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    Placenta's Hormonal Role

    The placenta, a vital organ during pregnancy, acts as a temporary endocrine gland, producing vital hormones like estrogen and progesterone. These hormones are crucial for maintaining a healthy pregnancy and supporting fetal growth.

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    Progesterone's Effect on Cervix

    Progesterone softens the cervix of a pregnant woman, making it easier for the baby to pass through during childbirth.

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    Progesterone as a Vasodilator

    Progesterone acts as a vasodilator, contributing to increased blood flow in various tissues, including the kidneys.

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    Increased Blood Flow in Pregnancy

    Progesterone's vasodilator effect leads to increased blood flow in various tissues, including the kidneys, during pregnancy.

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    VR and COP in Pregnancy

    Progesterone's effects contribute to increased VR (likely Venous Return) and COP (likely Cardiac Output) in pregnancy.

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    Progesterone's Role in Kidney Function

    Progesterone, as a vasodilator, increases blood flow to the kidneys, contributing to proper kidney function during pregnancy.

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    Placenta's Hormone Production

    The placenta, a vital organ during pregnancy, produces both estrogen and progesterone. These hormones are essential for supporting a healthy pregnancy.

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    Progesterone's Impact on Pregnancy

    Progesterone plays a vital role in preparing the uterus for pregnancy by developing the endometrium, creating a nourishing environment for the developing embryo. It also relaxes the uterus, preventing premature labor.

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    What is the role of progesterone in pregnancy?

    Progesterone thickens the uterine lining, relaxes uterine muscles, and prepares the breasts for lactation. It helps maintain a healthy pregnancy.

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    What is the role of hCG in early pregnancy?

    hCG keeps the corpus luteum active, sustaining progesterone and estrogen production for the first months of pregnancy.

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    Study Notes

    Maternal Response to Pregnancy

    • Pregnancy increases the size of sexual organs due to hormone levels.
    • Pregnant women may experience physical changes like edema, acne, or masculine/acromegalic features.
    • Weight gain during pregnancy is approximately 11-16 kg.
    • Most of this gain is in the last two trimesters.
    • Roughly 4 kg is the fetus, and approximately 1.5 kg is amniotic fluid, placenta, and fetal membranes.
    • The uterus increases by about 1 kg, and breasts increase by another 1 kg.
    • About 2 kg is extra fluid in the blood and extracellular fluid, which often leaves the body after birth.
    • The remaining 1-8 kg is typically fat accumulation.

    Metabolism During Pregnancy

    • Increased thyroxine, adrenocortical hormones, and sex hormones in pregnancy increase basal metabolic rate.
    • Basal metabolic rate (BMR) increases by roughly 15% in the second half of pregnancy.
    • Pregnant women may experience feelings of overheating due to the increased load they carry.
    • Extra energy is needed for muscle activity to support pregnancy.

    Changes in the Maternal Circulatory System During Pregnancy

    • Blood flow through the placenta increases.
    • Peripheral resistance decreases.
    • Cardiac output increases by 30-40% in the 27th week of pregnancy.
    • Cardiac output falls slightly below the rate of a non-pregnant woman during the last 8 weeks.

    Maternal Blood Volume During Pregnancy

    • Maternal blood volume increases by about 30%.
    • Increased fluid retention is due to aldosterone and estrogen.
    • At birth, the body holds 1-2 liters of extra blood volume.
    • Roughly 1/4 of this volume is lost during delivery.

    Maternal Respiration During Pregnancy

    • Minute ventilation is increased in pregnancy due to greater size and increased BMR.
    • High levels of progesterone increase respiratory center sensitivity to CO2.
    • The growing uterus puts pressure on the abdomen.

    Changes in Lung Volumes During Pregnancy

    • Functional residual capacity decreases due to reduced expiratory and residual volumes.
    • Increased displacement of the diaphragm.
    • Tidal volume increases by 40%, leading to hyperventilation and hypocapnia.

    Maternal Kidney Function During Pregnancy

    • Urine production rate is slightly elevated due to increased fluid intake and excretory products.
    • Renal tubules increase reabsorptive capacity due to hormones.
    • Renal blood flow and glomerular filtration rate increases.
    • This likely compensates for increased reabsorption of water and salt.
    • Pregnant women usually retain reasonable amounts of extra water and salt.

    Amniotic Fluid and Its Formation

    • Amniotic fluid volume is about 0.5-1 liter.
    • Derived from renal excretion, fetal excretion, and absorption from gastrointestinal and pulmonary tracts.

    Hormonal Factors in Pregnancy

    • (Various hormones are listed with their effects and the gland of origin.)

    Activities of Other End Glands

    • Anterior pituitary produces more ACTH, TSH, PRL. FSH and LH drop.
    • Adrenal cortex releases more cortisol (mobilizes amino acids), and aldosterone (water absorption). This can lead to increased blood pressure and edema.
    • Thyroid and parathyroid: Thyroid hormone is elevated by placental hCG. Parathyroid hormone releases calcium from the mother's bones.

    Human Chorionic Gonadotropin (HCG)

    • Secreted in early pregnancy by the syncytiotrophoblast.
    • Peaks in early pregnancy, then declines.
    • Maintains corpus luteum function, which produces progesterone and estrogen.

    Estrogen in Pregnancy

    • Secreted by the placenta and maternal adrenal glands (and fetuses' adrenal glands).
    • Causes enlargement of the uterus, breasts, and external genitalia.
    • Relaxes pelvic ligaments.

    Secretion of Progesterone by the Placenta

    • Secreted by corpus luteum at the start of pregnancy, then extensively by the placenta.
    • Maintains the uterine lining (endometrium).
    • Prevents miscarriage, by decreasing uterine contractility.
    • Needed for nourishing the embryo in the early stages.
    • Prepares the breasts for lactation.

    Human Chorionic Somatomammotropin (HPL)

    • Secreted by the placenta in later stages of pregnancy.
    • Promotes breast development.
    • Has growth hormone-like effects.
    • Decreases maternal insulin sensitivity and glucose utilization.
    • Promotes fatty acid release from fat stores.

    "Relaxin"

    • Secreted by ovaries and placenta.
    • Softens the cervix for delivery.
    • Acts as a vasodilator. Increases blood flow, especially to the kidneys resulting in elevated COP.
    • Contributes to increased blood flow in various tissues during pregnancy.

    Test Your Understanding

    • The placenta produces estrogen and progesterone.

    Secretion of Estriol During Pregnancy

    • Depends on both a functioning fetus and placenta.

    Question

    • Tidal volume (TV) increases during pregnancy.

    References

    • (Sources for information are listed)

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    Description

    This quiz covers the physiological changes and hormonal responses that occur during pregnancy. Questions focus on cardiac output, blood volume, and various hormones such as human chorionic somatomammotropin (HPL) and progesterone. Test your understanding of these crucial adaptations in the body during pregnancy.

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