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Pregnancy Physiology 1

Prepared by:

Dr. Gehanath Baral


MBBS,DGO,MD
Senior Consultant Gynecologist & Obstetrician: Government of Nepal
Visiting Professor: CTGU
13rd March,2007
Pregnancy Hormones
1. hCG = Human Chorionic
Gonadotrophin

2. HPL = Human Placental Lactogen

3. P = Progesterone

4. E = Estrogen
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hCG: Source

1. From placental syncytiotrophoblast

2. Appears in 10 days of fertilization

3. Peaks at 9-10 weeks

4. Falls to plateau at 20-22 weeks


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hCG Structure:
1. Glycoprotein

2. 2 subunits

 Alfa- similar to LH,FSH,TRH

 Beta- specific to pregnancy

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hCG: Function
1. Maintains corpus luteum

2. Regulates steroid biosynthesis in


placenta & fetal adrenal

3. Stimulates testosterone production


in fetal male testes

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High: hCG: Level

1. Twin pregnancy

2. Hydatidiform mole

3. Choriocarcinoma

4. Embryonal carcinoma
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Low: hCG: Level

1. Ectopic pregnancy

2. Threatened abortion

3. Missed abortion

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HPL:
 Source: Placenta

 Structure Similar to: Growth


hormone & Prolactin

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HPL:
 Level: parallels placental growth,
rises throughout pregnancy

 Low level: threatened abortion, IUGR

 Effects: antagonises insulin action


decreases insulin utilization
glucose intolerance diabetes
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Progesterone:production
weeks Organ source

6-7 Corpus luteum

7-9 

9+ placenta

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Progesterone:function
 Structure: steroid
 Function:

1. Induces secretory changes


favourable for blastocyst
implantation
2. Induces immune tolerance for
pregnancy
3. Prevents myometrial contractions

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Estrogen (steroid hormone)
Forms Abbr. Site of
formation
Estradiol E2 Ovary

Estriol E3 Placenta

Estrone E1 Adipose tissue

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Age distribution of Estrogen types
Estradiol (E2) During non-pregnant
reproductive years

Estriol (E3) During pregnancy

Estrone (E1) During menopause

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Formation of estrogen:
E2 1. Theca cell cholesterolAndrogen
2. Granulosa cell Aromatase enzymeE2

E3 Fetal adrenalDHEA-S  placental


sulfatase enzymeE3

E1 Adrenal Androstenedione Peripheral


adipose tissue aromataseE1

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