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E d i l Endocrinology of fP Pregnancy

HUBS2107 Jon Hirst

Maternal recognition of pregnancy


The corpus luteum has a life span of approx 14 days and if implantation of a ovum does not occur, progesterone release is stopped and shedding of the endometrium lining occurs Implantation I l t ti 7-12 7 12 days d after ft fertilization f tili ti Embro derived human chorionic gonadotrophin (hCG) stimulates the CL to continue progesterone production

The menstrual cycle and uterine endometrial responses to the changing hormonal environment

Embryo derived gonadotrophin (hCG) Stimulate the CL to initiate pregnancy Implantation and recognition of pregnancy only ~2525 35% efficient
hCG = human chrionic gondadotrohic - acts like LH 3

Placental hCG Production


Human chorionic gonadotropin- similar to st uctu e LH in structure Secreted by chorion syncytiotrophoblast Peak levels in early pregnancy

terminal i l villus ill

Human chorionic gonadotropin


Maximum levels 40-50 days Presence in circulation means placenta present Basis of some pregnancy tests (caution why) h )

Maternal Progesterone and hCG

The menstrual cycle and uterine endometrial responses to the changing hormonal environment

Embryo derived gonadotrophin (hCG) Stimulate the CL to initiate pregnancy Implantation and recognition of pregnancy only ~2525 35% efficient
hCG = human chrionic gondadotrohic - acts like LH 8

Progesterone secretion
Maintain pregnancy suppresses uterine activity Human - Transition from corpus luteum to placental production ~ 50 days Placenta maintains high concentration in the maternal t l circulation i l ti until til birth bi th (syncytiotrophoblast) Loss of progesterone action causes termination

Maternal progesterone concentrations


hCG Progesterone

Human placantal lactogen (hPL)

Species differences in P secretion and roles

CL and placenta dependent species

Placental hPL biosynthesis


hPL- human placental lactogen Prolactin like activity Stimulates breast development - with progesterone & GH - lobulo-aveolar growth

Estrogens during pregnancy pregnancythe feto-placental feto placental unit


Estrogens
Estradiol Estriol Estrone

E Estradiol di l the h most potent estrogen Depentent p on adrenal p precurors Humans and higher primates

E Estrogens-the h feto-placental f l l unit i


Fetal adrenal glands Fetal zone produces DHEA Dehydropeiandrosteroney p estrogen precuror DHEA = dehydropeiandrosterone

E Estrogens-the h feto-placental f l l unit i


DHEA converted to 16OH deviative Then to estriol Or estrone by the placenta

placental p ce biosynthesis b osy es s of o steroids s e o ds


DHEA = dehydropeiandrosterone FETUS adrenal d l cortex adrenal zone pregnenolone cholesterol DHEA liver DHEA DHEAS 16OH-DHEAS progesterone DHEAS DHEA estrogens Estriol & estrone cholesterol progesterone PLACENTA MOTHER

Role of estrogns in human pregnancy: regulation of receptor expression


Estrogen -- ER ER expression

Estrogen action

+
PR expression P action

Maternal cortisol fetal protection p


DHEA = dehydropeiandrosterone FETUS adrenal d l cortex cortisone adrenal zone cholesterol pregnenolone DHEA progesterone liver DHEA DHEAS 16OH-DHEAS DHEAS DHEA estrogens PLACENTA MOTHER adrenal cortex Stress cortisol cholesterol

Cortisol in the fetus


Promotes growth and other changes at key times near birth Cortisol or potent than cortisol Placental enzymes convert cortisol to cortisone i Protects the fetus from high cortisol levels from the mother at times of maternal stress

C i l/DHEA changes Cortisol/DHEA h at birth bi h

Key points
Role of hCG Progesterone placental production hPL and its role in breast development Fetal adrenal androgen production (DHEA) Role in estrogen production and the fetoplacental unit Control of fetal cortisol levels

Other species
Horse late pregnancy maintain by unique placental estrogens equilin equilin Pregnant mares serum gonadotrophin (PMSG) maintains early pregnancy instead of hGC

Short gestation species- rats


Gestation 21 days y CL dependent p Mating leads to pseudopregnancy 19days Prolactin P l i secrection i by b the h pituitary i i maintain i i CL function Presence of fetus maintain prolactin secretion to term (21 days) ?

Steroid hormone receptors and their regulation


Estrogens Progesterone Testosterone and 5HDHT Glucocorticoids (cortisol) GR Mineralocorticord aldosterone ER and ER PR AR androgen R MR

END
Textbooks: F Martini Fundamental of Anatomy and Physiology 7th ed d

R Harding and A Bocking Fetal Growth and Development 2001 Cambridge University press