L26 Maternal changes in Pregnancy and Lactation

• Definition of pregnancy

  Process in which fertiilised ovum eventually develops into fetus
• Give 3 aims of pregnancy

  1.Fertilization of ovum

  2.Implantation in uterus

  3.Changes in moher's body during pregnancy
• Describe the initial phase of ovum fertilization until mature sperm, reach the ampullary-isthmic junction of the fallopian tube.

  -Take place in ampulla of one of fallopian tubes

  -After ovulation, ovum enters one of fallopian tubes.

  -Cilia of fimbrated ends of fallopian tube help entry of ovum

  -Sperm reach ampulla aided by contraction of uterus and fallopian tube
• What hormone stimulate transport of sperm?

  Prostaglandins
• Explain further division occur after entry of sperm

  -Secondary oocyte undergoes further cell division and form female pronucleus

  -Female pronucleus contains 23 unpaired chromosomes, one of it is the X chromosome

  -A mature sperm contains 23 unpaired chromosomes, one of it either X chromosome or Y chromosome

  -Male pronucleus form as entering into ovum

  -Both female and male pronuclues align and reforming complete set of 46 chromosomes in fertilised ovum
• Explain gender determination

  -Depends on sex chromosome carried by sprem

  -Male child born if Y chromosome from sperm paired with X chromosome

  -While, female child born if X chromosome from sperm paired with X chromosome from ovum
• When does implantation of fertilized ovum trophoblasts cell?

  About 5th to 7th day after ovulation
• Where does fertilized ovum gained nutrition before and after implantation ?

  Before: Endometrial secretion

  After: Decidual cells that replaced by placenta after about 12 weeks
• State 3 functions of placenta

  1.Diffusion of oxygen

  2.Diffusion of carbon dioxide

  3.diffusion of nutrient
• State 4 hormones secreted by placenta and its function

  1.Progesterone - early nutrition

  2.Human Chorionic Gonadotropin (hCG) - persitence of corpus luteum

  3.Placental estrogen - enlargement of mother's uterus

  4.Relaxin - increase flexibility of pubic symphysis ligament (preparation for parturition)
• Who take responsibility of secreting Human Chorionic Gonadotropin (hCG) after trophopblast during early pregnancy ?

  Placenta
• State 2 functions of hCG

  1.Prevent shedding of endometrium

  2.Helps to form decidual cells
• The rate of secretion of Human Chorionic Somatomammotropin (hCS) increase simultaneously with ?

  Placental mass
• State 2 functions of hCS

  1.Helps prepare mammary glands for lactation

  2.Decrease use of glucose by mother
• State 2 functions of placental estrogens

  1.Enlargement of mother's uterus

  2.Enlargement of mother's breast
• State the sources of relaxin and its functions

  Initially by corpus luteum then continue by placenta

  Increase flexibility of pubic symphisis symphysis and sacroiliac joint ligaments for parturition

  Dilate uterine cervix during labor
• State the hormone that produced by placenta but then secreted by hypothalamus for non pregnant woman ? State its function

  -Corticotropin - releasing hormone

  -Increase secretion of cortisol for maturation of fetal lungs

  -Production of surfactant
• State 4 changes to mother's body

  -Size of various organ increase

  -Weight gain

  -Blood volume increase

  -Urine rate formation increase
• State the nutrients which highly demand as come to last trimester ?

  -Protein

  -Iron

  -Calcium

  -Phosphates
• What hormone trigger morning sickness in first few month of gestation ?

  Human Chorionic Gonadotropin (hCG)
• Two sites where pregnant uterus put pressure during pregnancy

  1.Pelvic blood vessels - varicose veins

  2.Bladder 0- urine incontinence
• What hormones involved during parturition

  -relaxin

  -oxytocin - contraction of uterus

  -estrogen - growth of uterus

  -progesterone
• Differences ductal system + stroma and lobule alveolar system development

  Hormones - Focus growth - Final production

  
• Hormones involves for secretion of milk and its function

  Prolactin - secretion of milk

  Human Chorionic Somatomammotropin (hCS) - Supports prolactin

  Insulin & Cortisol - Provides amino acids, fatty acids, glucose and calcium
• Briefly explain ejection of milk from baby suckles

  -Nipples senses baby suckles

  -Nerve impulse send to spinal cord

  -Hypothalamus promote secretion of oxytocin and prolactin

  -Both hormone transmit to breasts
• State function of prolactin and oxytocin

  Prolactin - Production of milk

  Oxytocin - Ejection of milk
• Which hormone known as natural contraception ?

  Prolactin
• What happen after feeding baby every 2 hours ?

  No ovulation
• Main function of glycogen

  -Rich uterine secretions during early pregnancy

  -Provide energy to develop embryo