PREGNANCY, PARTURITION, LACTATION
FERTILISATION PROCESSES
COAGULATION
OF SPERM
LYSIS
20´
CAPACITATION
1 – 3 hours
vagina
pH
viability of sp.
1-3 days
hysterosalpinx
cervix uteri
prostaglandines
hyaluronidase
Spermatozoa: 108
103
10
motility of sp.
3 mm/min
fertilization 1
1. Chemoattraction
2. Fixing of spermia on zona pellucida
3. Penetration and acrosomal reaction (acrosin)
4. Fusion (fertilin, membr. potential change)
Syncytiotrophoblast, cytotrophoblast; decidua; implantation
Immune changes in pregnancy
(polymorfic MHC genes of class I., II. vs. non-polymorfic HLA-G).
Ganong´s Review of Medicial Physiology
HORMONES IN GRAVIDITY
I. II. III. trimester
hCG
P E
PROL
Relaxin
hCS
OX
0 10 20 30 40 weeks of pregnancy
STH
TSH
ACTH
INS
KORT
ALD
T4
PTH
Placental – maternal - foetal
Placenta, corpus luteum graviditatis
hCG, hCS, E, P E, P, Relaxin
(8th week!!!)
luteinisation and luteotropic effects
inhibition of myometrial contractions
preparation of lactation
growth hormone in pregnancy
induction of delivery
RELATIONSHIP BETWEEN P:E
IN PREGNANCY
P E
P > E E > P
MOTHER PLACENTA FOETUS
cholesterol pregnenolone DHEAS
progesterone cortisol
aldosterone
DHEAS estradiol
Foetoplacental unit
Excretion of estriol in urine – index of foetal status
– 9 AA, differs from ADH in 3. a 8. AA
– Precursor molecule is synthetized in the same location as ADH (nucleus
paraventricularis)
– Stimulus for synthesis: dilatation of birth path caused by pressure of foetus
and stimulation of mechanoreceptors at breast nipple
– Reflex release: during breast-feeding, orgasm
– Main effects – on reproduction system:
• Uterokinetic effects (induction of parturition), milk ejection
• In men: probably increases contractions of smooth muscle in ductus
deferens
– Regulation of water and mineral metabolism – natriuretic effect, potentiation
of ADH effect
– Effect on memory: opposite to ADH effect – inhibits forming of memory
and its recollection
– Note: Melanocytes inhibiting factor – from oxytocin, modulates certain
types of receptors, modulation of melatonin effects (melatonin – epiphysis,
together with glomerulotrophin and DMT, circadian/circannual biorhythms,
controlled by hypothalamus, information from retina)
OXYTOCIN
INDUCTION OF BIRTH
P > E E > P
maternal
placental
foetal
CHOLESTEROL HT
ACTH OXYTOCIN
DHEA
PREGNENOLONE
CRH
EP
CORTISOL
PG
oxyt.rec.
conexin
gap-junctions
collagenase afferentation from mechanoreceptors
100x
Foetal respiratory insufficiency
Ganong´s Review of Medicial Physiology
LACTATION
GnRH PIF PSF OX.
GH
FSH
LH
PROL.
GCPH
UTERUS
involution
MAMMA
E HCSP
ejection
milk production
stop of
cycle
Composition of milk: water (88%), fat (3,5%), lactose (7%), proteins (1%)
trace minerals (Ca), vitamins, antibodies
(hyperprolactinaemia)
placental hormones
0,6-2 l/day
1 – 3 days after birth; initiated by decrease of estrogens concentrations after delivery
LEPTIN AND REPRODUCTIVE FUNCTIONS IN WOMEN
LEPTIN IN PREGNANCY
Synthesised by placenta from the 18th week of pregnancy.
Dramatic increase in maternal blood after the 34th week.
Synthesis in placenta, foetal adipose tissue and growing maternal adipose tissue.
BUT leptin plasmatic levels in non-pregnant women do not correspond to adipose
tissue amount (BMI).
Decrease after delivery down to the levels typical for non-pregnant women.
Leptin may play a role in proliferation and function of trophoblast, and thus affects
foetal growth.
LEPTIN IN NEWBORNS
Plasmatic levels of leptin correspond to newborn body mass and BMI.
Blood of newborn contains maternal and foetal leptin.
Girls have higher levels of leptin than boys.
It is supposed, that sex differentiation of plasmatic levels of leptin is already
genetically given, since it is not affected postnatally by sex hormones.