Manual Endocrinology of Pregnancy

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At this early stage, progesterone has many diverse functions which are vital to the establishment of pregnancy, including:. As the placenta forms and grows, it develops the ability to produce hormones. Between weeks of pregnancy, the placenta takes over from the ovariesas the main producer of progesterone. As well as being vital to the establishment of pregnancy, progesterone also has many functions during mid to late pregnancy, including:.

Although progesterone dominates throughout pregnancy, oestrogen is also very important. Many of the functions of progesterone require oestrogen and in fact, progesterone production from the placenta is stimulated by oestrogen. Oestrogen is made and released by the corpus luteum of the ovaries and then later, the fetal-placental unit, where the fetal liver and adrenal glands produce the hormone oestriol an oestrogen often used to determine fetal wellbeing in pregnancy , that is passed to the placenta where it is converted into other oestrogens.

Levels of this hormone increase steadily until birth and have a wide range of effects, including:. The placenta also produces several other hormones including human placental lactogen and corticotrophin-releasing hormone. The function of human placental lactogen is not completely understood, although it is thought to promote the growth of the mammary glands in preparation for lactation. Corticotrophin-releasing hormone is thought to regulate the duration of pregnancy and fetal maturation.

For example, when pregnant women experience stress, particularly in the first trimester of pregnancy, the placenta increases the production of corticotrophin-releasing hormone. Later in pregnancy, it improves the blood flow between the placenta and fetus. In the last weeks of pregnancy corticotrophin-releasing hormone levels climb even higher — a rise which coincides with a major spike in cortisol levels.

High levels of progesterone and oestrogen are important for a healthy pregnancy but are often the cause of some common unwanted side-effects in the mother, especially as they act on the brain.

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The majority of women will experience morning sickness — a feeling of nausea, any time of day, which may lead to vomiting. The exact cause of morning sickness is unknown but it is likely to be because of the rapid increase in: oestrogen and progesterone; human chorionic gonadotrophin; or a closely related thyroid hormone called thyroid stimulating hormone which decreases during early pregnancy, although it is probably caused by a combination of all these hormonal changes.

Morning sickness usually starts around week of pregnancy and should subside by week , although some women suffer throughout pregnancy. Many women experience pain and discomfort in the pelvis and lower back during the first trimester. This is mostly due to a hormone called relaxin. Relaxin becomes detectable by week and is produced throughout pregnancy.

Endocrinology of Pregnancy - Abstract - Europe PMC

The effects of relaxin are most concentrated around the pelvic region; softening the joints of the pelvis can often lead to pain in the area. The joints being softer can also decrease stability and some women may notice it is harder to balance. There is also an increase in constipation associated with reduced gut motion because of the relaxin and the growth of the fetus.

Although uncomfortable and frustrating at times, all these side-effects will usually lessen or even subside by the end of the first trimester. The exact events leading up to the onset of labour are still not fully understood. For the baby to arrive, two things must happen: the muscles in the womb and abdominal wall have to contract and the cervix needs to soften, or ripen, allowing passage of the baby from the womb to the outside world.

The hormone oxytocin plays a key role in labour.

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  7. This is also true of another hormone released during labour called prolactin. Oxytocin levels rise at the onset of labour, causing regular contractions of the womb and abdominal muscles. Oxytocin-induced contractions become stronger and more frequentwithout the influence of progesterone and oestrogen, which at high levels prevent labour.

    Female Reproductive System - Menstrual Cycle, Hormones and Regulation

    The cervix must dilate open to around 10cm for the baby to pass through. Oxytocin, along with other hormones, stimulates ripening of the cervix leading to successive dilation during labour. Oxytocin, with the help of the high levels of oestrogen, causes the release of a group of hormones, known as prostaglandins , which may play a role in ripening of the cervix. Levels of relaxin also increase rapidly during labour. As labour contractions become more intense, natural pain relief hormones are released.

    Known as beta-endorphins, they are similar to drugs like morphine and act on the same receptors in the brain. As well as pain relief, they can also induce feelings of elation and happiness in the mother. A sudden rush of these hormones just before birth causes a surge of energy in the mother and several very strong contractions which help to deliver the baby. When the baby is born, oxytocin continues to contract the womb in order to restrict blood flow to the womb and reduce the risk of bleeding and to help detach the placenta which is delivered shortly afterwards.

    Synchrony between the development of the early embryo and establishment of a receptive endometrium is necessary to allow implantation and subsequent progression of pregnancy.

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    The endocrinology of human pregnancy involves endocrine and metabolic changes that result from physiological alterations at the boundary between mother and fetus. Known as the feto-placental unit FPU , this interface is a major site of protein and steroid hormone production and secretion. Many of the endocrine and metabolic changes that occur during pregnancy can be directly attributed to hormonal signals originating from the FPU. The initiation and maintenance of pregnancy depends primarily on the interactions of neuronal and hormonal factors.

    Proper timing of these neuro-endocrine events within and between the placental, fetal, and maternal compartments is critical in directing fetal growth and development and in coordinating the timing of parturition. Maternal adaptations to hormonal changes that occur during pregnancy directly affect the development of the fetus and placenta.

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    Gestational adaptations that take place in pregnancy include establishment of a receptive endometrium; implantation and the maintenance of early pregnancy; modification of the maternal system in order to provide adequate nutritional support for the developing fetus; and preparation for parturition and subsequent lactation. For complete coverage of this and related areas in endocrinology,visit www. How does Europe PMC derive its citations network? Protein Interactions.

    Protein Families. Nucleotide Sequences. Functional Genomics Experiments.