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Endocrine System DC - Prof DK
Endocrine System DC - Prof DK
IN PREGNANCY
Cortisol
Adrenal Aldosterone
Gland Deoxycorticosterone
PITUITARY GLAND
GH
TSH
Anterior LH
FSH
Prolactin
Oxytocin
Posterior
ADH
4
GROWTH HORMONE
Time Maternal Fetal
First Trimester GH secreted predominantly
from maternal pituitary
gland
8 weeks GH from placenta
pregnancy becomes detectable
Non
Pregnant
Pregnant
prolacti
n
prolacti prolacti
n n
prolacti prolacti
n n
PROLACTIN
To ensure lactation
and
weeks reac Prol
ha acti
nadi n
r con
Puls cent After
ratio
atil
e n delivery
decr
bur eas
st e
Res
pon
se
to
THYROID GLAND
Thyroid volume
increased from
12.1 mL in the first
trimester to 15.0
mL at delivery
Enlargement
caused by
Are not
glandular pathologic
hyperplasia and al
increased
vascularity
IODINE STATUS
Iodine
Increase in
requireme
Pregnancy
nts
Iodine Leads to
Deficien Cretinis
cy m
Parathyroid Glands - Vitamin D and Calcium
Vitamin D,
(a hormone that is
synthesized
in the skin or ingested)
the liver
25-hydroxyvitamin
D3
Facilitated by parathyroid hormone and by kidney, decidua,
low calcium and phosphate plasma levels and placenta
and opposed by calcitonin
1,25-dihydroxyvitamin D3
(increased during normal
pregnancy)
14
ADRENAL GLANDS
ADRENAL GLAND -
CORTISOL
ACTH decrease early
pregnancy
Pregnan
cy
ACTH & free cortisol progress
1. Resetting maternal
feedback mechanism
2. Tissue refractoriness to
cortisol
3. Progesteron (antagonis
mineralo corticoids)
15
MATERNAL PHYSIOLOGY
WILLIAMS OBSTETRICS 22ND
PAGE 143-145
16
ADRENAL GLANDS
ALDOSTERONE
Substrat
e
Angioten
sin II
17
http://www.webalice.it/alberto.frangini/Potassium-Sparing%20
Diuretics.jpg
18
ADRENAL GLANDS
DEOXYCORTICOSTERONE
Increase in pregnancy
(1500 g/ml, more than 15th fold)
Increased
kidney Estrogen
production stimulation
19
ADRENAL GLANDS
DEOXYCORTICOSTERONE
Concentration at fetus is bigger than it at mother
Transfer
deoxycorticosterone from
fetus to mother
20
ADRENAL GLANDS
21
TERIMA KASIH