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Explore the fascinating journey of fertilization, pregnancy, and lactation, from ovum fertilization to fetus development. Learn about placenta formation, hormonal control, and the physiology of parturition and lactation. Understand the crucial role of hormones and the process of milk production and ejection during lactation.
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Fertilization of the Ovum • Takes place in the fallopian tube. • Distally, the last 2cm remains spasmatically contracted – under the influence of estrogen for 3 days after ovulation. • Smooth muscle relaxes under the influence of progeterone – secreted by CL. • This allows the fertilized embryo to enter into the uterus.
Implantation of Zygote • Initially the embryo receives its nutrition from the uterus “milk”. • The trophoblastic cells then secrete proteolytic enzymes which digest the stromal cells of the endometrium. • The trophoblastic cells then forms the placenta. • Blood flows from the 16 day after fertilization • 6 weeks after fertilization – placenta takes over the fertilization of the fetus.
The Placenta • Foods cross the placenta by means of diffusion • Permeability of the placenta increases constantly – reaches a peak in the last month – sharp decrease in permeability. Permeability 0 8 20 40
Diffusion of O2 and CO2 • Gradient: Fetus – 30 mmHg Mother - 50 mmHg • Sufficient O2: ???? • Fetal Hb (increase ability to carry O2) • Fetal [Hb] > maternal [Hb] • Bohr effect: increase affinity for O2 in the fetus – decrease affinity in maternal blood. • CO2 gradient: Fetal CO2 – 48 mmHg • Maternal CO2 – 45 mmHg 20 mmHg gradient
Hormonal Control of Pregnancy • Initially the trophoblast cells secrete Human Chorionic Gonadotrophin (HCG) • Functions of HCG: • Prevents the degeneration of the corpus luteum • Stimulates the growth of the CL. • Increase secretion of both estrogen and progesterone • Prevents mestruation
Hormonal Secretion of the Placenta • Corpus luteum required until the 12th week of pregnancy – placenta secretion of hormones takes over completely. • Corpus luteum degenerates. • During pregnancy the placenta secretes: • HCG • Human chorionic somatomammotrophin (HCS) • Estrogen and progestrogen
Functions of Progesterone • Initially secreted by the Corpus Luteum in moderate quantities • Subsequently, secreted mostly by the placenta. • Action: • Development of the uterine endometrium – essential for the early nutrition of the embryo. • Decrease contractility of the gravid uterus • Contributes to the development of the ovum prior to implantation. • Prepares the breast for lactation.
Fetal Growth • Fetus • At 60 days embryo becomes a fetus • Fetal period • From day 60 to birth is rapid growth • Lanugo • Fine soft hair covering • Vernix caseosa • Waxy coat of protection
Parturition • Labor • First stage • Onset of regular uterine contraction until cervix dilates to fetal head diameter • Second stage • From maximum cervical dilation until baby exits vagina • Third stage • Expulsion of placenta from uterus • Parturition • Process by which a baby is born • In mother • Estrogens overcome inhibitory influence of progesterone • Oxytocin is released • In fetus • Adrenal gland is enlarged prior
Apgar Scores • Assessment of newborn baby • Appearance, pulse, grimace, activity, respiratory effect • Rated on scale of 0-2, 2 denotes normal function • Total Apgar score is sum from five characteristics
Parturition Physiology • Factors which initiate: • Ratio of estrogens/progesterone increase towards the end of pregnancy • Towards the end of term there is an increase responsiveness of the myometrium to oxytocin. • Increase fetal [oxytocin] towards end of term. • Mechanical stretch of the uterus: • Increase movements of the fetus • Increase size of the fetus • Stretch and/or irritation of cervix uterine – uterine reflex
Lactation: • Function of prolactin: prolactin Promotes the secretion of milk Estrogen and progesterone Birth Decrease [estrogen + progesterone Increase lactogenic effect (prolactin) Increase [milk] in the alveoli of the Breast – not the ducts!!!!!
Ejection of Milk: Oxytocin • Ejection of milk: • Neural reflex • Hormonal reflex spinal cord Suckling of breast Afferent conduction of APs Contraction of the myoepithelial cells Ejection of milk Oxytocin secretion hypothalamus Prolactin secretion Increase [milk] in the alveoli of the breast