ENDOCRINOLOGY OF PREGNANCY 2232021 SCNM PHYS 628 Endocrinology

Human Chorionic Gonadotropin • Produced by the syncytiotrophoblast • Glycoprotein • Binds to and

Placental Lactogen • Chorionic Somatomammotropin • Produced by the syncytiotrophoblast • Protein hormone –

Progesterone • Produced by the syncytiotrophoblast • Hormone necessary for the maintenance of pregnancy

Estrogen • Estriol secreted in the greatest quantity. 2/23/2021 SCNM, PHYS 628, Endocrinology of

Estrogen Biosynthesis by Fetoplacental Unit • Syncytiotrophoblast produces progesterone • Progesterone converted to DHEA-S

Other Hormones 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 7

Relaxin • Produced by the ovary • Similar to insulin in structure • Acts

Other pituitary hormones • Almost any other hormone • Fetus can manipulate maternal physiology

Releasing factors • Produced by the cytotrophoblast • Essentially all the releasing factors produced

Parturition • • Sex steroids Oxytocin Prostaglandins Catecholamines – -agonists stimulate uterine contraction –

Breast Development & Function E 2 Pubertal Prepubertal Weaning E 2, PRL, PL Lactation

Complications during Pregnancy • Gestational Diabetes • Preeclampsia 2/23/2021 SCNM, PHYS 628, Endocrinology of

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ENDOCRINOLOGY OF PREGNANCY 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 1

Human Chorionic Gonadotropin • Produced by the syncytiotrophoblast • Glycoprotein • Binds to and activates LH receptors – c. AMP is second messenger – Mimics the actions of LH • Stimulates Side-Chain Cleavage enzyme • Rescues the corpus luteum • Stimulates corpus luteum during 1 st trimester • Basis of the pregnancy test 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 2

Placental Lactogen • Chorionic Somatomammotropin • Produced by the syncytiotrophoblast • Protein hormone – Member of prolactin, growth-hormone family • Originally named for its lactogenic activity • Growth hormone for developing fetus. 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 3

Progesterone • Produced by the syncytiotrophoblast • Hormone necessary for the maintenance of pregnancy – Maintains the endometrium – Fall in progesterone results in miscarriage. 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 4

Estrogen • Estriol secreted in the greatest quantity. 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 5

Estrogen Biosynthesis by Fetoplacental Unit • Syncytiotrophoblast produces progesterone • Progesterone converted to DHEA-S by fetal adrenal • Syncytiotrophoblast metabolizes DHEA-S to estriol and estradiol 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy E 3 & E 2 Placenta P DHEA-S Fetal Adrenal Cortex 6

Other Hormones 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 7

Relaxin • Produced by the ovary • Similar to insulin in structure • Acts to ripen the cervix and to relax the pubic symphysis 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 8

Other pituitary hormones • Almost any other hormone • Fetus can manipulate maternal physiology for its own needs 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 9

Releasing factors • Produced by the cytotrophoblast • Essentially all the releasing factors produced by the hypothalamus 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 10

Parturition • • Sex steroids Oxytocin Prostaglandins Catecholamines – -agonists stimulate uterine contraction – -agonists inhibit uterine contractions • Corticosteroids – Lung maturation 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 11

Breast Development & Function E 2 Pubertal Prepubertal Weaning E 2, PRL, PL Lactation PRL, Oxytocin Pregnancy 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 12

Complications during Pregnancy • Gestational Diabetes • Preeclampsia 2/23/2021 SCNM, PHYS 628, Endocrinology of Pregnancy 13