Term
| What is the normal WBC for non-pregnant women? |
|
Definition
|
|
Term
| What is the normal WBC for pregnant women? |
|
Definition
|
|
Term
| What is the normal WBC for laboring women? |
|
Definition
|
|
Term
| What is the change in WBC in the postpartum period? |
|
Definition
| Gradually returns to normal values, 5-10k, by 4-7 days postpartum. |
|
|
Term
| What hormone probably causes the changes in WBC count? |
|
Definition
|
|
Term
| The increase in WBC in pregnancy is primarily due to increase in what hormone? |
|
Definition
| Polymorphonuclear neutrophils, monocytes, and granulocytes. |
|
|
Term
|
Definition
| Movement of neutrophils and other phagocytes in an organized fashion toward a site of antigenic invasion. |
|
|
Term
| Chemotaxis is ________ in pregnancy. |
|
Definition
|
|
Term
| Chemotaxis may delay ____________ responses to infection. |
|
Definition
|
|
Term
| Production of interleukin (IL)-4 and interferon-y (IFN-y) may be _________ in pregnancy. |
|
Definition
|
|
Term
| Monocyte and granulocyte activity is ________ in pregnancy. |
|
Definition
|
|
Term
| Monocyte and granulocyte activity is enhanced, resulting in ______ and more efficient ______. |
|
Definition
|
|
Term
| Enhanced monocyte and granulocyte activity may help protect the mother so she does not______________. |
|
Definition
| mount a cell-mediated immunity to the trophoblastic and fetal cells that appear in the maternal circulation. |
|
|
Term
| Natural killer (NK) cell activity is _______ during pregnancy. |
|
Definition
|
|
Term
| NK cell is down-regulated secondary to the effects of _________. |
|
Definition
|
|
Term
| Down-regulation of NK cell activity appears to induce formation of _________ that _________ lymphocyte proliferation and NK activity. |
|
Definition
| blocking factor; decreases |
|
|
Term
| Total WBC volume _________ slightly in pregnancy |
|
Definition
|
|
Term
| Total WBC count increases slightly beginning in the ________ month and levels off during ____ & _____ trimesters. |
|
Definition
|
|
Term
| PMN ______, ________, and __________ of Candida albicans have been found to be increased. |
|
Definition
| attachment, ingestion and digestion |
|
|
Term
| PMN function alterations are possibly secondary to ______. |
|
Definition
|
|
Term
| Pregnant women have higher rates of ________. |
|
Definition
|
|
Term
| Higher rates of fungal infections in pregnant women may be secondary to the effects of ________ on nutrient availability for fungal growth on the reproductive tract. |
|
Definition
|
|
Term
| Estrogens may alter __________ function, allowing adherence of pathogenic organisms and ________ the risk of colonization. |
|
Definition
| local mucosal barrier; increasing |
|
|
Term
| PMN antibody expression during pregnancy may enhance ___________ recognition and destruction of _____. |
|
Definition
| phagocyte; antigen-antibody complexes |
|
|
Term
| _____ &_______ are thought to be involved in regulating innate responses of the trophoblast to infections and tissue damage signals. |
|
Definition
| Toll-like receptors (TLR) and Nod-like receptors (NLR) |
|
|
Term
| Changes in ________ and ________ with tissue remodeling near parturition may release TLR and NLR as part of the cascade leading to labor onset. |
|
Definition
|
|
Term
| The maternal circulation is seeded with small particles from the _______ that function as antigens of fetal origin and stimulate a ________. |
|
Definition
| trophoblast; systemic inflammatory response |
|
|
Term
| The point of __________ activates endothelial cells and initiates an inflammatory response. |
|
Definition
| direct maternal contact with the placenta |
|
|
Term
| _________ is produced during pregnancy and has an inhibitory effect on the inflammatory response. |
|
Definition
| Pregnancy zone protein (PZP) |
|
|
Term
| PZP levels increase ______-________ fold during pregnancy. |
|
Definition
|
|
Term
| PZP inhibits ________ and ___________ inflammatory responses and IL-2 function near the decidua-trophoblast interface. |
|
Definition
|
|
Term
| Alterations in the function of the complement system during pregnancy begin at _______. |
|
Definition
|
|
Term
| There is an increase in the complement system during pregnancy due to ________ in both serum complement and specific proteins of the complement system. |
|
Definition
| greater hepatic synthesis |
|
|
Term
| The increase in the complement system is seen mainly in ____, ___, and _______. |
|
Definition
| C2, C3, and C3 split products |
|
|
Term
| In the complement system, the increase in C2, C3, and C3 split products enhance _______ and _________ through opsonization. |
|
Definition
| chemotaxis; actions of immunoglobulins |
|
|
Term
| C2, C3, and C3 split products augment ___________. |
|
Definition
| maternal defenses against bacterial infection. |
|
|
Term
| C1, C1a, B and D of the complement system are _______ in pregnancy. |
|
Definition
|
|
Term
| C1q is involved in activation of _______, _______, ________, and __________. |
|
Definition
| classic complement pathway, immune cell modification, cell processes and maintenance of immune tolerance. |
|
|
Term
| C1q is ______ and ________ by decidual epithelial cells during pregnancy. |
|
Definition
|
|
Term
| C1q is thought to have a role in changes in _______ and ________ between decidual and trophoblast cells. |
|
Definition
| decidual blood vessels; mediation of cell-to-cell interaction |
|
|
Term
| Activity of the ________ early in the immune response may be delayed during pregnancy. |
|
Definition
|
|
Term
| Th2 responses tend to enhance ________. |
|
Definition
| antibody-mediated responses |
|
|
Term
| Th1 responses enhance ___________. |
|
Definition
|
|
Term
| Th1 and Th2 have a _______ role in __________. |
|
Definition
| protective; maternal-fetal immune relationship |
|
|
Term
| __________ in the number of Th1 cytokines may decrease maternal resistance to the spead of ______ and ________ organisms |
|
Definition
| Decreases; bacterial, viral |
|
|
Term
| If Th1 predominates during pregnancy, inflammatory cytokine production increases and is associated with ___, _____, ____ and ______. |
|
Definition
|
|
Term
| ___________ is somewhat suppressed during pregnancy. |
|
Definition
|
|
Term
| In cell-mediated immunity lymphoctye and macrophage ________, _________ and _________ are altered slightly in pregnancy secondary to influences from estrogens, corticosteriods, progesterone, AFP, hCG, hPL, prostglandins, and serum proteins. |
|
Definition
| synthesis, activation, and function |
|
|
Term
| ________ suppress activation of T-cell lymphokines, phagocytic activity and lymphokine responsiveness of the macrophages. |
|
Definition
|
|
Term
| ________, especially PGE1 and PGE2, hPL, and AFP also appear to have an immunosuppressive role during pregnancy. |
|
Definition
|
|
Term
| _______ may induce production of regulatory T lymphocytes. |
|
Definition
|
|
Term
| A _______ in T-helper-to-T-suppressor (CD4+/CD8+) ratio occurs during pregnancy. |
|
Definition
|
|
Term
| The number of TCD4+ cells ______ progressively to term. |
|
Definition
|
|
Term
| The number of T-suppressor cells (TCD8+) tend to remain _________. |
|
Definition
|
|
Term
| A decrease in the number of TCD+4 cells may help protect the fetus from ___________. |
|
Definition
|
|
Term
| T-suppressor cell function may __________ in late pregnancy and ________ B-cell function. |
|
Definition
|
|
Term
| __________ T-lymphocyte function and efficiency may increase the risk of viral and mycotic infections. |
|
Definition
|
|
Term
| The antibody-mediated immune response is not _______ during gestation. |
|
Definition
|
|
Term
| A decrease in maternal levels of ____ has been attributed to hemodilution of pregnancy. |
|
Definition
|
|
Term
| There is an enhanced loss of ____ in the urine. |
|
Definition
|
|
Term
| The transfer of maternal _____ to the fetus occurs in the last trimester. |
|
Definition
|
|
Term
| A relative decrease in ____ along with alterations in ____ population may increase the risk of bacterial colonization with certain pathogens (ie streptococci). |
|
Definition
|
|
Term
| _______ remains stable or decreases during gestation. |
|
Definition
|
|
Term
| The slight _______ in IgA may reflect the increased levels of IgA found in _____ and ________. |
|
Definition
| decrease; saliva; other mucosal fluids |
|
|
Term
| ________ remains stable or may slightly decrease. |
|
Definition
|
|
Term
| ____ undergoes minimal or no change in levels. |
|
Definition
|
|
Term
| __________ increases until term; specific role is unknown. |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| It is a glycoprotein that has an inhibitory effect on the inflammatory response. |
|
|
Term
| PZP inhibits________ and ___________ inflammatory responses and _______ function near the decidua-trophoblast interface. |
|
Definition
| phagocytosis; suppresses; IL-2 |
|
|
Term
| Maternal serum IgG ________ during pregnancy. |
|
Definition
|
|
Term
| The function of maternal IgG in the fetus/neonate is ____ immunity against pathogens. |
|
Definition
|
|
Term
| IgG provides ________ of immunologic memory. |
|
Definition
|
|
Term
| There is _________, ____________, and ___________ because of maternal antibody IgG. |
|
Definition
| immunological imprinting, suppression of IgE responsiveness, and suppression of tumor develoment |
|
|
Term
| The components of the complement immunity system enhance chemotaxis and actions of immunoglobins through _____. |
|
Definition
|
|
Term
| Protection of the fetus from ______ seems to be predominantly a localized uterine response. |
|
Definition
|
|
Term
| There are systemic responses mediated primarily by ________ to help protect the fetus from rejection by the mother. |
|
Definition
|
|
Term
| The maternal immune system is aware of _______ and under normal circumstances are tolerant to these. |
|
Definition
|
|
Term
| Tolerance of the fetus by _____ is an active mechanism whereby fetal tissues are prevented from being recognized as being foreign and/or for being rejected by the cells of the system. |
|
Definition
|
|
Term
| During pregnancy, the _____ and _______ have a regulatory and supportive interaction that is critical for both pregnancy maintenance and protection against infectious organisms. |
|
Definition
| trophoblasts; maternal immune system |
|
|
Term
| Factors that are thought to have a role in maternal tolerace of the fetus include: |
|
Definition
| Trophoblasts; HLA-G Progesterone; Progesterone induced-blocking factor; altered NK cell function; Th1/Th2 balance that favors Th2 responses; indoIMINE 2,3 dehodrogenase (ido); FAS ligand-suppressor macrophages; lower complement activity; local immune response |
|
|
Term
| _________ is the first point of interaction between maternal and fetal tissues. |
|
Definition
|
|
Term
| Implantation involves an inflammatory process with ______ between the _____ and _______ that increases activity of the innate immune cells. |
|
Definition
| cross-talk (molecular dialogues); decidua, conceptus |
|
|
Term
| Increased activity of the innate immune system during implantation is mediated by ______, ________, __________, __________, ________, __________, and _________. |
|
Definition
| hormones, growth factors, cytokines, chemokines, adhesion molecules, extracellular matrix components, and matrix metalloproteins |
|
|
Term
| The inflammatory process at the ________ is most marked in the ____ and _____ trimesters. |
|
Definition
| maternal-placental interface; 1st and 3rd |
|
|
Term
| In the first trimester, the inflammatory process changes occur with the initial contact between the _____ and _________ with implantation and the remodeling of _______. |
|
Definition
| embryonic trophoblast, maternal tissues; maternal blood vessels |
|
|
Term
| In the 3rd trimester, inflammation is a critical component of _______ in prepartation for _______ and ______. |
|
Definition
| cervical changes; parturition, labor onset |
|
|
Term
| Beginning early in pregnancy, small quantities of _________ detach and enter the maternal blood through the uterine veins. |
|
Definition
|
|
Term
| Trophoblast cells form a minute ______ that eventually lodge in the pulmonary capillaries and are cleared by proteolysis. |
|
Definition
|
|
Term
| The formation of a minute emboli appears to be a _________ and does not lead to maternal inflammatory response or other respiratory distress in women experiencing a normal pregnancy. |
|
Definition
|
|
Term
| HLA-G does not stimulate__________. |
|
Definition
| the classic cytotoxic T-cell response |
|
|
Term
| HLA-G has a Fas/Fas ligand pathway for _______. |
|
Definition
| killing activated T cells |
|
|
Term
| HLA-G may help prevent ____________ by inducing ________. |
|
Definition
| maternal rejection of the fetus; apoptosis of activated maternal T-cells |
|
|
Term
| HLA-G inhibits _____ and _________. |
|
Definition
| NK cell cytotoxicity; dendritic cell maturation |
|
|
Term
| HLA-G systhesis may be stimulated by _______ from the placenta. |
|
Definition
|
|
Term
| HLA-G acts on cells of both _______ and ________ and has a major role in reprogramming maternal immune responses at the maternal-fetal interface. |
|
Definition
| innate; adaptive immune systems |
|
|
Term
| __________ molecules are found in the maternal plasma and increase from the 1st trimester on, peaking in the 3rd trimester. |
|
Definition
|
|
Term
| Decreased expression of HLA-G on the extravillous trophoblast are seen in women with _______ and _______ and alters conversion of the spiral arteries. |
|
Definition
| recurrent abortion; pre-e |
|
|
Term
| Decreased sHLA-G is found with _______, _______, and _______. |
|
Definition
| placental abruption, miscarriage, pre-e |
|
|
Term
| _________ are highly cytotoxic. |
|
Definition
|
|
Term
| _____________ produce cytokines that are beneficial for trophoblastic invasion and are critical for pregnancy maintenance. |
|
Definition
|
|
Term
| How does progesterone act to protect against preterm birth? |
|
Definition
| Protects the fetus from maternal immune response and rejection. |
|
|
Term
| Progesterone induces production of ___________ that alter the balance of ______ and _______ reponses. |
|
Definition
| anti-inflammatory cytokines; Th1, Th2 |
|
|
Term
| Toll-like receptors (TLR) are teh primary effector cell surfaces of _______. |
|
Definition
|
|
Term
| TRL are responsible for what? |
|
Definition
| Recognizing the molecular patterns of microbial products. |
|
|
Term
| All 10 TLRs are found in the ________, primarily in the ________. |
|
Definition
|
|
Term
| Each TLR is ____________. |
|
Definition
| specific for the molecular pattern of certain organism |
|
|
Term
| TLRs help the trophoblast _____________. |
|
Definition
|
|
Term
| TLR stimulation initiates __________ with up-regulation of __________, _________, ________, and __________. |
|
Definition
| an inflammatory response; cytokines, interferon, antimicrobial proteins and peptides |
|
|
Term
| Altered TLR __________ is seen with ____, ______, and ________. |
|
Definition
| signal transduction; PTL, Pre-E, IUGR |
|
|
Term
| ___________ are macrophages for primarily ________. |
|
Definition
| Hofbauer cells; placental defense |
|
|
Term
| Occasionally organsims may reach the fetus by _________. |
|
Definition
| directly infecting the placental tissue. |
|
|
Term
| Once an organism avoids _____ at the maternal-placental interface, it must interact with ________ to pass through the placental stroma and enter fetal blood. |
|
Definition
| cytokines; trophoblast receptors |
|
|
Term
| In breastmilk, _______ transport immunoglobulins and protect against ________, _________, _________, and ________. |
|
Definition
| leukocytes; necrotizing enterocolitis, Staph aureus, E. coli, and Candida albicans |
|
|
Term
| High ____&_____ cell concentrations produce ____, _______, and ______ and protect against gram negative organisms. |
|
Definition
|
|
Term
| ___________ is most abundant in breast milk. |
|
Definition
|
|
Term
| Secretory IgA protects against _______ in the baby's GI tract. |
|
Definition
|
|
Term
|
Definition
| A bacterial enzyme that lyses the cell walls of many baceteria and enhances Lactobacillus growth. |
|
|
Term
| Lysozyme limits the growth of _______ and __________. |
|
Definition
|
|
Term
| Lysozyme and lactoferrin transport ________ and protect against __________. |
|
Definition
| immunoglobulins; necrotizing enterocolitis |
|
|
Term
| Lysozyme cells have _______ activity against ________, _________, and ________ and may help regulate ______ function. |
|
Definition
| phagocytic; Staph aureus, E. coli, C albicans; T-cell |
|
|
Term
| List the immunologic factors that may cause SAB. |
|
Definition
1. Activation of immune response secondary to microbial infection (chlamydia, listerosis, parvovirus B19, toxoplasmosis)
2. Exagerrated maternal immune response to trophoblastic invasion (predominance of Th1 reactivity)
3. Cytokine induced failure of the ovary to produce sufficient progesterone
4. Presence of autoimmune antibodies such as antiphospholipid antibodies that interfere with placentation. |
|
|
Term
| Suppression of _______ may increase maternal susceptability to viruses and opportunistic pathogens. |
|
Definition
| Th1 cell-mediated immunity |
|
|
Term
| Genetic polymorphisms in the genes that encode __________ (IL6, IL8, TNF-alpha) may increase risk of _________. |
|
Definition
| modulators of innate mucosal immunity; altered vaginal microflora |
|
|
Term
| Alterations in neutrophil ________ and ______ also contribute to the persistance of infections during pregnancy. |
|
Definition
|
|
Term
| There is an ______ of fungal infections related to increased adherence of Candida albicans to vaginal mucous membranes, increased glycogen in the vagina, enhanced proliferation of Candida albicans under the influence of estrogen, and alterations in cell-mediated immunity. |
|
Definition
|
|
Term
| What mechanisms lead to inflammation? |
|
Definition
| Intrauterine infection, utero-placental ischemia or hemorrhage, uterine overdistention, cervical disease, stress, endocrine disorders. |
|
|
Term
| Inflammation can _______ the onset of _______. |
|
Definition
|
|
Term
| Both _________ & ________ infections can lead to preterm labor. |
|
Definition
|
|
Term
| Intrauterine infection leads to the activation of the ________. |
|
Definition
|
|
Term
| Inflammatory _________ & ________ increase PG production and release of matrix metalloproteases that lead to cervical ripening, fetal membrane rupture, and increased myometrial contractility. |
|
Definition
|
|
Term
| ________ have also been associated with PTL. |
|
Definition
|
|
Term
| Fever can lead to _______ which ________ uterine activity and may result in _______ initiation. |
|
Definition
| dehydration; increases; labor |
|
|
Term
| Actue infections with high temps may lead to release of _____ and ________ and increase uterine irritability. |
|
Definition
| catecholemines; corticotropin-releasing hormone |
|
|
Term
| There is evidence that ________ is an early event in the pathogenesis of pre-e. |
|
Definition
| vascular endothelial cell injury |
|
|
Term
| There is an increase in pre-e in __________. |
|
Definition
|
|
Term
| Multiparas with a ______ or _________ may cause increased incidence in pre-e. |
|
Definition
| new parter; new sperm donor |
|
|
Term
| There is an increase in pre-e in pregnancies with a _______ (ie multiple pregnancies) or hydatiform mole. |
|
Definition
|
|
Term
| There is a _____ in pre-e in ______ with the same father and consaguineous marriages even if the previous pregnancies ended in miscarriage. |
|
Definition
| decrease; repeat pregnancies |
|
|
Term
| There is a ___ in pre-e with longer _______ with the father before the pregnany and thus exposure to paternal antigens in semen. |
|
Definition
|
|
Term
| In women with pre-e, there is a presence of ________ in the ________ near the placental site that are similar to those with ______. |
|
Definition
| pathologic changes; uterine vessels; allograft rejection |
|
|
Term
| One of the theories of causation for pre-e is _____________. |
|
Definition
| failure of the maternal immune system to change fully in response to the conceptus |
|
|
Term
| A certain placental protein ________ will divert the ______ so that the fetus is accepted and grows. |
|
Definition
| PP13; mother's immune system |
|
|
Term
| PP comes from the ______ where the father's gene expression _______. |
|
Definition
|
|
Term
| The placenta is responsible for keeping _________ when it senses a _________ to the placenta. |
|
Definition
| the fetus alive; decrease in blood flow |
|
|
Term
| The placenta will cause an increase in ________ in an effort to save the fetus, leading to pre-e. |
|
Definition
|
|
Term
| When there is not enough PP13 to divert the maternal immune system there is an _____________. |
|
Definition
| incomplete dilation of the uterine arteries |
|
|
Term
| The incomplete dilation of the uterine arteries leads to ____________ and result in increased ______ for the mother. |
|
Definition
| decreased blood flow to the fetus; BP |
|
|
Term
| Women with ________ may experience _______ in their symptoms due to the opposite effects of Th1 and Th2 during pregnancy. |
|
Definition
| autoimmune disorders; improvement |
|
|
Term
| 75% of women with ____ experience improvement during pregnancy which is associated with _______ Th1 mediators which are decreased in pregnancy. |
|
Definition
|
|
Term
| There tends to be a ______ of RA within the 1st ______ months postpartum. |
|
Definition
|
|
Term
| Some other factors in pregnancy that may lead to decrease in symptoms from RA are _______, ___________, ___________. |
|
Definition
| changes in plasma levels of maternal humoral factors; depression of cell-mediated immunity; suppression of inflammatory reactions |
|
|
Term
| Graves disease may be transmitted to the fetus because _______. |
|
Definition
| transplacental passage of thyroid-stimulating immunoglobulin results in transient neonatal hyperthyroidism that can persist up to 2-6 months |
|
|
Term
| Myasthenia gravis may be transmitted to the fetus because _________. |
|
Definition
| there may be passage of maternal IgG against acetylcholine receptors, resulting in transient myasthenia gravis in 10-20% of offspring; may last a few hours up to 3 months |
|
|
Term
| In RH previous exposure, ________ are not necessary because the mom has naturally occuring antibodies against fetal RBC antigens. |
|
Definition
|
|
Term
| The most common rH incompatability is ______. |
|
Definition
|
|
Term
| rH incompatability may occur with _____ but never with _______. |
|
Definition
|
|
Term
| The antibodies of the ABO system are primarily ______ which does not cross the ______. |
|
Definition
|
|
Term
| Antigens of the ____ group are the ones usually involved in incompatability between the fetus and mother. |
|
Definition
|
|
Term
| Rho (D) isoimmunization occurs when an Rho (D) ________ mother carrying an Rho (D) ______ fetus produces antibodies against the D antigen on the fetal RBC antigen. |
|
Definition
|
|
Term
| D antigens on the fetal RBC antigens include _____, ______, ______, ________, and ______. |
|
Definition
| Kell, Duffy, Kidd, MNS, ABO group |
|
|
Term
| The type O mother has naturally occuring ______ and ________ antibodies in her serum that can react against ___ and ____ antigens in the fetal RBCs. |
|
Definition
|
|
Term
| _______ incompatabititly can also occur with an _______ infant but never with an ___ infant. |
|
Definition
|
|
Term
| ____________ is mild compared to ________ because the antibodies of the ABO system are primarily ______ which does not cross the placenta. |
|
Definition
| ABO incompatability; Rho (D); IgM |
|
|
Term
| Since the risk of __________ is increased during pregnancy, ________ are recommended for all pregnant women during ______ season, regardless of gestation. |
|
Definition
| influenza-related morbidity; influenza vaccines; flu |
|
|
Term
| The fetoplacental unit has different ____ because paternal antigens are expressed by the ______ cell stage of growth. |
|
Definition
|
|
Term
| The uterus may become an area safe to the fetus because of pregnancy hormones such as _______, ________, and _________. |
|
Definition
| hCG, progesterone, corticosteroids that reduce the immune resonse |
|
|
Term
| ______ cells are lower in the decidua. |
|
Definition
|
|
Term
| Neither ___________ or ____________ express Class I or Class II MCH antigens. |
|
Definition
| cytotrophoblasts; syncytiotrophoblasts |
|
|
Term
| Trophoblast cells that invade spiral arteries express ______ and _______ that may help fetal cells resist destruction by NK cells. |
|
Definition
|
|
Term
| Suppression of ________ and ______ decrease interleukin-2, interferon-gamma, and tumor necrosis factor beta (may explain remission of some autoimmune disorders). |
|
Definition
| T-helper (Th) and T-cytotoxic (Tc) |
|
|
Term
| Th2 increases and secretes more __, ___, and ____. |
|
Definition
|
|
Term
| Cervial mucous has higher levels of __________. |
|
Definition
| immunoglobulin A and G (IgA, IgG) |
|
|
Term
| _________ is 10x higher in pregnant women due to _____ and ______ effects. |
|
Definition
| Interleukin 1beta; estrogen, progesterone |
|
|
Term
| ___________ and ________ are depressed in the 2nd half of pregnancy increasing susceptability to some _______. |
|
Definition
| Chemotaxis, adherence functions; infections |
|
|
Term
| Overall, WBC count is ________ in pregnancy and may be as high as ______-______ during labor and delivery. |
|
Definition
|
|
Term
| C-reactive protein, complement factors C3 and C4 and erythrocyte sedimentation rates are _____ in pregnancy. |
|
Definition
|
|
Term
| _____ is the smallest of the immunoglobulins and is able to _______ giving the fetus protection against infections the mother has antibodies against. |
|
Definition
|
|
Term
| _____ may have been formed against the rhesus antigen. |
|
Definition
|
|
Term
| Possible maternal diseases that may be passed to the fetus via IgG are __________ and _______ and are transient in the newborn. |
|
Definition
| Grave's disease; Myasthenia gravis |
|
|
Term
| The nails may become ____ and _______ during pregnancy and will resolve soon after delivery. |
|
Definition
|
|
Term
| ________ and _________ to the scalp will cause increased numbers of anagen phase (growth phase) hairs during pregnancy causing hair to become thicker and more lusterous. |
|
Definition
| Estrogen; increased blood flow |
|
|
Term
| After delivery when estrogen is removed and blood flow returns to normal, most scalp hair enters the ______ phase and begin to shed. |
|
Definition
|
|
Term
| Hair loss after delivery is called _______ and is also seen after surgery, illness or other stressful events. |
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Definition
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Term
| Hair loss will resolve by about _____ months postpartum without treatment. |
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Definition
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Term
| Pigment changes occur due to stimulating effects of ____ and _____ on the _________ secretion from the anterior pituitary. |
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Definition
| estrogen; progesterone; melanocyte-stimulating hormone (MSH) |
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Term
| MSH will stimulate melanocytes to darken skin in certain areas such as ___, _____, _______ and _________. |
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Definition
| nipple, areola, midline of the abdominal area (linea negra) and the mask of pregnancy |
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Term
| ___________ appears as brown patches on the face and neck and is more prominent in women with darker complexions. |
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Definition
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Term
| Melasma may persist after birth in about ___ of women and increase when a woman uses _____. |
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Definition
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Term
| Vascular changes occur related to _____ caused by increased progesterone and a proliferation of capillaries at the skin surface due to ______. |
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Definition
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Term
| Vasodilation helps to _______. |
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Definition
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Term
| __________, _________, and _______ are all related to vascular changes and are frequently seen in pregnancy. |
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Definition
| Vascular spiders, telangiectasias, palmar erythema |
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Term
| Connective tissue changes are caused by increased _______, ________, and ________ along with stretching that occurs as the gravid uterus grows and maternal weight increases. |
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Definition
| estrogen, adrenocoriticoids, relaxin |
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Term
| Connective tissue changes are seen as ____ or ______ in the pregnant women. |
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Definition
| skin tags, stretch marks (striae gravidarium) |
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Term
| The hormones of pregnancy cause _______ to relax and ____ to separate. |
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Definition
| collagen adhesiveness; fibers |
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Term
| Skin tags are seen on the ______, ________, ______, and ___________. |
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Definition
| neck, axilla, groin, between and under the breasts |
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Term
| Stretch marks occur on the _____, __________, ________ and ______. |
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Definition
| abdomen, breasts, thighs, buttocks |
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Term
| Striae are more prevelent in __________. |
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Definition
| younger caucasian women in their first pregnancy |
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Term
| __________, ________, and _________ also contribute to the prevelance of stretch marks. |
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Definition
| Obesity, large babies, maternal family history |
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Term
| _______ and _______ become more active under the influence of increased androgen in pregnancy. |
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Definition
| Sebaceous, eccrine sweat glands |
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Term
| Sebaceous glands of the ___ hypertrophy (Montgomery's tubercules) and secrete more ______ to lubricate the nipple. |
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Definition
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Term
| ______ sweat glands cover the trunk and extremeties |
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Definition
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Term
| The increased activity of the eccrine glands help ________. |
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Definition
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Term
| What are the 5 dermatoses that occur only in pregnancy? |
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Definition
1. Pruritis gravidarium
2. Pruritic urticarial papules and plaques of pregnancy (PUPPPs)
3. Prurigo of pregnancy
4. Pruritic folliculitis of pregnancy
5. Herpes gestationis of pregnancy |
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Term
| What is pruritis gravidarium? |
|
Definition
| No primary lesions, associated with cholestasis and mild jaundice; associated with perinatal morbidity; recurs in future pregnancies |
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Term
| What is pruritic urticarial papules and plaques of pregnancy (PUPPPs)? |
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Definition
| onset in 3rd trimester; intense itching, no adverse effects; more common in white, primigravidas with a male or twins; seldom recurs in future pregnancies |
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|
Term
| What is prurigo of pregnancy? |
|
Definition
| pruritic papules on arms and legs; does not harm fetus; does not recur |
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Term
| What is pruritic folliculitis of pregnancy? |
|
Definition
| pustules, mucus membranes may be involved; maternal sepsis may occur, possibly pustular psoriasis; persists for weeks postpartum |
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Term
What is herpes gestationis or pemphigoid gestationis?
|
|
Definition
| Rare; severe itching, papules and plaques, vesicles and bullae; associated with preterm birth and transient neonatal lesions; autoimmune HLA related; recurrance is common |
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Term
| During pregnancy, ___________ and __________ decrease and there is a slight ______. |
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Definition
| intraoccular, corneal sensitivity; corneal edema |
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Term
| _________ may make wearing contact lenses uncomfortable. |
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Definition
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Term
| Pregnancy is not a good time to purchase new _______ or ___________. |
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Definition
| contact lenses or glasses |
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Term
| Unilateral _________ may occur during pregnancy and is thought to be due to ______ and ________ or stress. |
|
Definition
| ptosis; hormonal and fluid changes |
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Term
| ___________ of the eye may occur during second stage pushing. |
|
Definition
| Subconjunctival hemorrhage |
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Term
| Ear stuffiness and mild hearing loss may occur due to swelling of the _______ and changes in fluid pressure in the middle ear. |
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Definition
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Term
| Nasal congestion and pregnancy rhinitis may occur in pregnant women due to the effects of _____ and may decrease the sense of smell. |
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Definition
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Term
| Strong smells may trigger _____ and ______ of pregnancy. |
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Definition
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Term
| In the absence of mucosal swelling, many women experience an _____ . |
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Definition
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Term
| Epistaxis may occur when ____________ of the nasal mucosa break. |
|
Definition
| superficial blood vessels |
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Term
| ___________, _________, and __________ may be attributed to larynx changes of pregnancy and are due to the effects of estrogen and progesterone. |
|
Definition
| Hoarseness, deepening of the voice, and cough |
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Term
| Increased body and facial hair usually regresses by _____ postpartum. |
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Definition
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Term
| Thinning or regression of the hairline may not ______. |
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Definition
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Term
| Most postpartum women experience an increased hair loss beginning ___-______ weeks after delivery. |
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Definition
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Term
| Generally complete regrowth of hair occurs by ___ in 2/3 of women and by 15 months in the remainder. |
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Definition
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Term
| Experts recommend pregnant women don't make changes to their lenses during the ______ or for ____-____ months after delivery or stopping nursing. |
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Definition
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Term
| If the eye doctor changes the RX for glasses/contacts, ________ for return to pre-pregnancy vision. |
|
Definition
| keep your original contacts/glasses |
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