Pregnancy, Menopause & Contraception Flashcards

Flashcards based on lecture notes about pregnancy, menopause, and contraception.

What hormone stimulates the release of glandular secretions during the implantation window (days 20-24)?

Oestrogen stimulates the release of glandular secretions.

What hormonal change relaxes the isthmic sphincter during pre-implantation?

Increased progesterone:oestrogen ratio

What secretes hCG, approximately 1 week post-fertilisation?

Syncytiotrophoblast of the implanting embryo

What does the presence of hCG in urine or blood indicate?

Biochemical pregnancy

From what is progesterone produced, and by what?

Cholesterol by syncytiotrophoblast

What takes over progesterone production from the corpus luteum at approximately week 6 of pregnancy?

Placenta

Which oestrogen is predominant during pregnancy?

Oestriol

Which two organs produce Oestrogen cooperatively?

Placenta and foetus

What is the metabolic effect of human placental lactogen (hPL)?

Anti-insulin, decreased insulin sensitivity, increased maternal blood glucose

What produces human placental lactogen (hPL)?

Trophoblast cells

Which cells release prolactin (PRL) during pregnancy?

Lactotroph cells of the anterior pituitary and decidua

Which hormone stimulates prolactin release?

Oestrogen stimulates prolactin release

What are the three stages of parturition?

Contractions begin, shortening/effacement and dilation of cervix, Fully dilated – delivery of baby, and Delivery of placenta

Which substances contribute to cervical ripening/softening?

Prostaglandin E, relaxin, and NO

How does progesterone suppress myometrial contractility?

Decreasing oxytocin receptor expression

Where is oxytocin synthesised?

Hypothalamus and decidual tissue

What is the Ferguson Reflex?

Pressure/stretching of the cervix stimulates oxytocin release.

What fetal process triggers the timing of parturition?

Maturation of fetal HPA axis

What increases in the fetus at term, leading to oestrogen and prostaglandin production?

Fetal glucocorticoids and corticotrophin releasing hormone (CRH)

What does cortisol contribute to in the fetus?

Lung maturation and synthesis of surfactants

What medication can be administered in pre-term labor to aid fetal lung maturation?

Dexamethasone

How many lobes of glandular tissue does the breast have?

15-20 lobes of glandular tissue

Which cells make up the alveoli?

Epithelial cells, myoepithelial cells and basement membrane

What changes occur in the breast during puberty?

Lactiferous ducts sprout and branch, alveoli start to develop, and deposition of connective tissue.

Which hormones inhibit milk secretion during pregnancy?

Oestrogen and progesterone inhibit milk secretion

What stimulates PRL synthesis postpartum?

Suckling

Which hormone stimulates contraction of myoepithelium, leading to milk ejection?

Oxytocin

How does hyperprolactinaemia impact the menstrual cycle?

Hyperprolactinaemia leads to lactational amenorrhea

Which hormonal changes are seen in perimenopause?

Falling oestrogen/ rising FSH/LH

Which form of oestrogen predominates after menopause?

Oestrone

Where is oestrone produced after menopause?

Adrenals and adipose tissue

What are the consequences of oestrogen withdrawal during menopause?

Loss of anti-PTH activity, change in blood lipid ratios, reduction in vaginal lubrication, and behavioural changes

What are the risks of HRT?

Increased risk of CVD and breast cancer

Approximately how many unintended pregnancies occur per year?

121 million

What are the types of contraception?

Hormonal, Barrier, IUDS, Permanent, and Natural

What is the Pearl index?

Number of failures per 100 woman years of exposure

What causes feedback inhibition on the HPG axis in hormonal methods of contraception?

Progesterone

What effects does progesterone have on contraception?

Thickening of the cervical mucus and decreases endometrial receptivity

How do barrier methods work?

Prevent pregnancy by blocking the egg and sperm from meeting

What kind of condoms are there?

Male and female

How do Cu-IUDs work?

Release of leukocytes and prostaglandins

What are the side effects of Cu-IUDs?

Heavy periods and increased risk of ectopic pregnancy

How do LNG-IUDs work?

Atrophy of endometrium

What are the permanent sterilisation options for female and male?

Female = Tubal Ligation and Male = Vasectomy

What happens during a Vasectomy?

Ligation of Vas Deferens tube

What are the natural methods of contraception?

Coitus interruptus/withdrawal, Rhythm method, Fertility Awareness method Natural family spacing and Abstinence

What is the UKMEC?

Guidance to providers of contraception - who can use contraceptive methods safely