Week 7 Study Guide2

Week 7 Study Guide2 - Lecture #12: Tuesday, 2/16/10...

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Lecture #12: Tuesday, 2/16/10 Endocrinology of Pregnancy Symptoms of Pregnancy Placental Hormones Relaxin Human Chorionic Gonadotropin (hCG) Human Placental Lactogen (hPL) Progesterone Estrogen Corticotropin Releasing Hormone (CRH) Fetal Hormones Androgens Adrenocorticotropin Hormone (ACTH) Oxytocin Maternal Hormones Prolactin (PRL) Thyroid Hormones: T 3 , T 4 Parathyroid Hormone Insulin Glucocorticoids Signals of Parturition Signs and Symptoms of Pregnancy Though an adaptive mechanism necessary to maintain proper growth and development of the fetus, pregnancy often results in the maternal exaggeration of hormonal effects, which may mimic symptoms found in pathologies such as hyperthyroidism, Cushing’s disease, and diabetes mellitus. Approximately twelve to sixteen days after menses, ovulation results in the ejection of a secondary oocyte, which remains viable for only 24-48 hours, into the oviduct. Approximately five to ten minutes post-coitus, 100-200 sperm can be found in the oviduct, allowing fertilization to occur in the oviduct ampulla. Implantation of the conceptus occurs about eight to ten days after fertilization. Note that gestational age is calculated from the first day of the last menstrual cycle, so that, the age of the conceptus is always two weeks less than the gestational age since ovulation, and thus a possible pregnancy, occurs during the second week of gestation. Human chorionic gonadotropin hormone (hCG) , the first hormone secreted by the conceptus, is secreted within 24 hours after implantation or within three weeks of gestation and it is at this point that the signs and symptoms of pregnancy appear. Breast tenderness, galactorrhea, fatigue, nausea, amenorrhea, softening of the uterus, continued elevated basal body temperature, increased pigmentation of the face and nipples, and the increased frequency and urgency of urination are all associated with pregnancy. Breast tenderness results as a consequence of increased estrogen and progesterone levels in addition to cortisol, prolactin, and growth hormone, which promote the growth and development of the mammary glands. Although galactorrhea is not a common sign during pregnancy since elevated estrogen and progesterone levels inhibit the effect of prolactin in synthesizing milk, some women may demonstrate this symptom, albeit during mid to late gestation. “Early Morning Sickness” or nausea that persists throughout the day and especially during the early morning hours is a consequence of activation of the nauseatory center of the medulla oblongata in response to high circulating levels of estrogen. Amenorrhea is due to
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the inhibition of GnRH and gonadotropin secretion by elevated levels of estrogen and progesterone, which act in a negative feedback manner. The softening of the uterus is a result of the placental hormone relaxin, which “ripens” or softens birth canal. Increased basal body temperature can be attributed to the thermogenic activity of progesterone, which begins at ovulation and continues through pregnancy. “The Mask of Pregnancy,” or increased
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This note was uploaded on 04/06/2012 for the course BICD 150 taught by Professor Fortes during the Winter '09 term at UCSD.

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Week 7 Study Guide2 - Lecture #12: Tuesday, 2/16/10...

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