SITI MARIAM BINTI MOHD HAMZAH

Hormonal and Metabolic changes

during Pregnancy

HORMONAL CHANGES

essential to maintain the early pregnancy as it secretes progesterone (40mg/day)

after implantation, human chorionic gonadotropin(hCG) and placental lactogen(hPL) (syncytiotrophoblast cells) maintain the growth and function of corpus luteum.

MAINTENANCE OF CORPUS LUTEUM AFTER FERTILIZATION

The placenta acts as an endocrine organ, producing several important hormones during pregnancy. These hormones work together

To control the growth and development of the placenta and the fetus

and act on the mother to support the pregnancy and

prepare for childbirth. Placenta produces a variety of hormones of which protein and steroid hormones.

PLACENTA

HORMONES FUNCTIONhuman chorionic gonadotropin (hCG)

• First hormone to be released from the developing placenta

• As stimulus for secretion of progesterone by corpus luteum up till 6 weeks of pregnancy (major function)

• Got immunosuppressive activity• Stimulates both adrenal and placental

steroidogenesis• Promotes secretion of relaxin from corpus luteum• Disappears from the circulation within 2 weeks

following deliveryhuman placental lactogen (hPL) • Also known as human chorionic

somatomammotropin• Antagonises insulin action• Helps to develop fetal vasculature• Promote growth of breasts for lactation

PROTEIN HORMONES

HORMONES FUNCTIONprogesterone • maintain pregnancy by supporting the lining of the uterus which

provides the environment for the fetus and the placenta to grow• prevents the shedding of this lining, which would result in

pregnancy loss• suppresses the uterine wall’s ability to contract, which is

important in preventing labour from occurring before the end of pregnancy.

estrogen • acts to stimulate the growth of the uterus to accommodate the growing fetus

• allows the uterus to contract by countering the effect of progesterone

• stimulates the growth and development of the mammary glands during pregnancy

STEROID HORMONES

METABOLIC CHANGESTotal metabolism is increased due to the needs of

the growing fetus and the uterus. It increased to the extent of 30% higher than that of the average

for the non-pregnant women.

CARBOHYDRATE METABOLISM

Glucose is much needed from mother to

fetus throughout pregnancy

Insulin secretion is increased (hyperplasia

and hypertrophy of beta cells of pancreas)

Sensitivity to insulin is decreased

Plasma insulin increased, thus ensures continuous supply of glucose to fetus

Increased in insulin secretion also favors

lipogenesis (fat storage).

During maternal fasting, there is hypoglycemia,

hypoinsulinemia and hyperlipidemia

Lipolysis takes action and generates fatty

acids for gluconeogenesis and

fuel supply.

Total iron requirement during pregnancy is estimated 1000mg

The amount of the iron absorbed from the diet and that mobilized from the store is inadequate to meet the demand

Absorption through the gut is enhanced during pregnancy

Absence of iron supplementation can cause drop in haemoglobin, serum iron and serum ferritin concentration

However, placenta transfers adequate iron to the fetus, despite severe maternal iron deficiency

IRON METABOLISM

PROTEIN METABOLISM Total concentration of serum proteins decreases by about 0.1g/dl during

pregnancy It is related to increased excretion and utilization

FAT METABOLISM Average 3-4 kg of fat is stored during pregnancy mostly in the abdominal

wall, breasts, hips and thighs.

LIPID METABOLISM HDL level increases by 15%. LDL is utilized for placental steroid synthesis

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