QUIZ 2 SUMMARY TABLE 1

Placenta.

What is the source of Placental Growth Hormone?

Regulates fetal growth & uterine blood flow.

What is the function of Placental Growth Hormone?

Inversely related to growth restriction; Proportional to fetal weight.

How does Placental Growth Hormone relate to fetal growth and weight?

Low levels leading to hypertension and poor placentation.

In preeclampsia, what happens to the levels of Placental Growth Hormone and what does it lead to?

Increases insulin resistance.

In gestational diabetes, what effect does Placental Growth Hormone have?

Anterior pituitary.

What is the source of Prolactin?

Breast gland development & lactation.

What is the function of Prolactin?

10x increase by term; Estrogen stimulates lactotrophs; Decreases post-delivery.

What changes occur to Prolactin levels during pregnancy?

Dopamine.

What inhibits Prolactin?

Posterior pituitary.

What is the source of Oxytocin?

Uterine contractions & lactation letdown.

What is the function of Oxytocin?

No change in pregnancy; Increases during labor & breastfeeding.

What changes occur to Oxytocin levels during pregnancy?

Helps uterus return to normal size post-pregnancy.

What role does Oxytocin play post-pregnancy?

Posterior pituitary.

What is the source of Antidiuretic Hormone (Vasopressin)?

Maintains blood volume & homeostasis.

What is the function of Antidiuretic Hormone (Vasopressin)?

Needed throughout pregnancy for blood volume.

Why is Antidiuretic Hormone (Vasopressin) needed during pregnancy?

ADH deficiency leading to polyuria, polydipsia, low BP, tachycardia.

What does ADH deficiency lead to?

Hypothalamus releases TRH.

What is the first step in Thyroid Physiology?

Stimulates anterior pituitary.

What does Thyrotropin Releasing Hormone (TRH) do?

Anterior pituitary releases TSH.

What is the second step in Thyroid Physiology?

Stimulates thyroid gland.

What does Thyroid Stimulating Hormone (TSH) do?

Thyroid gland produces T3 & T4.

What is the third step in Thyroid Physiology?

Increases metabolism.

What effect do T3 (Triiodothyronine) & T4 (Thyroxine) have?

High T3 & T4 inhibit TRH & TSH.

What happens during the negative feedback step in Thyroid Physiology?

TRH crosses placenta.

What happens during the fetal stimulation step in Thyroid Physiology?

Helps fetal thyroid development.

What role does TRH play in fetal thyroid development?

Needed for T3 & T4 synthesis.

What role does Iodine play in Thyroid Physiology?

Estrogen & progesterone increase TBG.

What increases Thyroid Binding Globulin (TBG)?

Transports T3 & T4, prevents hyperthyroidism.

What is the function of Thyroid Binding Globulin (TBG)?

Placenta.

What is the source of hCG (Human Chorionic Gonadotropin)?

Stimulates corpus luteum, supports pregnancy.

What is the function of hCG (Human Chorionic Gonadotropin)?

Peaks at weeks 5-8; Stimulates thyroid gland.

When do hCG (Human Chorionic Gonadotropin) levels peak and what gland does it stimulate?

Shares α-subunit with TSH; Increases metabolism.

What does hCG (Human Chorionic Gonadotropin) share with TSH and what effect does it have?

Hypothalamus.

What is the source of TRH (Thyrotropin-Releasing Hormone)?

Stimulates pituitary to release TSH.

What is the function of TRH (Thyrotropin-Releasing Hormone)?

No rise during pregnancy; Crosses placenta to fetal pituitary.

What changes occur to TRH (Thyrotropin-Releasing Hormone) during pregnancy?

Anterior pituitary.

What is the source of TSH (Thyroid-Stimulating Hormone, Thyrotropin)?

Stimulates thyroid to produce T3 & T4.

What is the function of TSH (Thyroid-Stimulating Hormone, Thyrotropin)?

Suppressed due to high T4 & hCG; Decreases in 80% of first-trimester women.

What changes occur to TSH (Thyroid-Stimulating Hormone, Thyrotropin) during pregnancy?

Can mimic hyperthyroidism; Shares α-subunit with hCG.

What can TSH (Thyroid-Stimulating Hormone, Thyrotropin) mimic and what does it share with hCG?

Thyroid gland.

What is the source of T3 (Triiodothyronine) & T4 (Thyroxine)?

Regulates metabolism & fetal brain development.

What is the function of T3 (Triiodothyronine) & T4 (Thyroxine)?

First weeks: only maternal supply; Fetal thyroid develops after 5 weeks.

When does the fetal thyroid develop?

Maternal thyroid doubles production to support fetus.

What does the maternal thyroid do during pregnancy?

Liver.

What is the source of TBG (Thyroid-Binding Globulin)?

Binds and transports T3 & T4.

What is the function of TBG (Thyroid-Binding Globulin)?

Peaks at 20 weeks; Doubles & stabilizes until term.

When does TBG (Thyroid-Binding Globulin) peak?

Prevents free T3/T4 excess.

What does TBG (Thyroid-Binding Globulin) prevent?

Adrenal cortex.

What is the source of Cortisol?

Regulates metabolism & stress response.

What is the function of Cortisol?

Increases in late pregnancy; Bound to CBG due to ↑ estrogen.

What changes occur to Cortisol during pregnancy?

Helps maintain blood pressure & glucose levels.

What does Cortisol help maintain?

Adrenal cortex (zona glomerulosa).

What is the source of Aldosterone?

Maintains fluid & electrolyte balance.

What is the function of Aldosterone?

Increases from 15 weeks; Peaks in 3rd trimester.

What changes occur to Aldosterone during pregnancy?

Counters natriuretic effects of progesterone & ANP.

What does Aldosterone counter?

Adrenal cortex & kidneys.

What is the source of Deoxycorticosterone?

Supports blood volume expansion.

What is the function of Deoxycorticosterone?

Increases progressively; 15-fold rise in last trimester.

What changes occur to Deoxycorticosterone during pregnancy?

Produced in kidneys due to estrogen.

Where is Deoxycorticosterone produced due to estrogen?

Adrenal glands & ovaries.

What is the source of Androgens (Androstenedione & Testosterone)?

Converted to estrogens via placenta.

What are Androgens (Androstenedione & Testosterone) converted to?

Increased due to ↑ androgenic activity & SHBG.

What changes occur to Androgens (Androstenedione & Testosterone) during pregnancy?

SHBG slows clearance; Placenta prevents fetal androgenization.

What slows the clearance of SHBG and what prevents fetal androgenization?

Maintains hydration, supports circulation.

What is the function of Water Metabolism?

↑ ADH secretion, ↓ plasma osmolality, ↑ water retention.

What changes occur in Water Metabolism during pregnancy?

Prevents dehydration, supports fetal circulation.

What are the key effects of Water Metabolism during pregnancy?

Conserves protein for fetal & maternal tissues.

What is the function of Protein Metabolism?

Proteins prioritized for fetus, placenta, uterus, blood.

How are proteins prioritized during pregnancy?

↓ Maternal blood protein, ↑ placental screening.

What changes occur in Protein Metabolism during pregnancy?

Ensures glucose supply for fetus.

What is the function of Carbohydrate Metabolism?

↓ Fasting glucose, ↑ postprandial glucose, hyperinsulinemia.

What changes occur in Carbohydrate Metabolism during pregnancy?

Ensures fetal energy, risk of gestational diabetes.

What are the key effects of Carbohydrate Metabolism during pregnancy?

Fat accumulation.

What happens during Early Pregnancy in Maternal Hyperlipidemia?

↑ Lipid synthesis, ↑ food intake.

What changes occur during Fat accumulation?

Maternal fat stores increase.

What are the key effects of Fat accumulation?

Fat as primary energy source.

What happens during Late 2nd - 3rd Trimester in Maternal Hyperlipidemia?

↑ Triacylglycerols, cholesterol, VLDL, LDL, HDL, leptin, ghrelin.

What changes occur during Fat as primary energy source?

Spares glucose & amino acids for fetus.

What are the key effects of Fat as primary energy source?

Hyperlipidemia.

What happens during the Breakdown of fat stores stage in Maternal Hyperlipidemia?

↑ Free fatty acids, potential endothelial dysfunction.

What changes occur during the Breakdown of fat stores stage?

May contribute to CVD risk.

What are the key effects of the Breakdown of fat stores stage?

Endothelial function changes.

What Vascular Effects occur in Maternal Hyperlipidemia?

↑ HDL-C inhibits LDL oxidation.

What changes occur during Vascular Effects?

Protects endothelium, improves vasodilation.

What are the key effects of Vascular Effects?

2-4x ↑ in pregnancy.

What happens to Leptin levels during pregnancy?

Secreted by adipose & placenta.

Where is Leptin secreted from?

Regulates fat, metabolism, insulin sensitivity.

What is the function of Leptin?

Chronic ↑ leads to leptin resistance.

What does chronic elevation of Leptin lead to?

Inhibits insulin synthesis, ↓ adiposity.

What does Leptin resistance inhibit?

Can cause glucose metabolism imbalance.

What can Leptin resistance cause?

↑ until mid-pregnancy, then ↓.

What happens to Ghrelin levels during pregnancy?

Secreted by stomach parietal cells.

Where is Ghrelin secreted from?

Increases hunger, food-seeking behavior.

What is the function of Ghrelin?

Works with leptin.

What does Ghrelin work with?

Modulates energy homeostasis.

What does Ghrelin modulate?

Maintains balance of body weight & appetite.

What does Ghrelin maintain?

Retained (Na⁺: 1000 mEq, K⁺: 300 mEq).

What happens to Sodium & Potassium during pregnancy?

Enhanced kidney reabsorption.

How are Sodium & Potassium retained during pregnancy?

Maintains homeostasis.

What does Sodium & Potassium retention maintain?