Predict which hormone is required more than other hormones in the first trimester more than horomes in the first trimester of pregnancy on the basic of relationship.
Answers
Progesterone and oestrogen have a great role along with other hormones. ... Supportive care in early pregnancy is associated with a significant beneficial effect on ... by very high b-hCG levels (3-100 times higher than normal pregnancy ).
Answer:
The endocrinology of human pregnancy involves endocrine and metabolic changes that result from physiological alterations at the boundary between mother and fetus. Progesterone and oestrogen have a great role along with other hormones. The controversies of use of progestogen and others are discussed in this chapter. Progesterone has been shown to stimulate the secretion of Th2 and reduces the secretion of Th1 cytokines which maintains pregnancy. Supportive care in early pregnancy is associated with a significant beneficial effect on pregnancy outcome. Prophylactic hormonal supplementation can be recommended for all assisted reproduction techniques cycles. Preterm labor can be prevented by the use of progestogen. The route of administration plays an important role in the drug's safety and efficacy profile in different trimesters of pregnancy. Thyroid disorders have a great impact on pregnancy outcome and needs to be monitored and treated accordingly. Method of locating review: Pubmed, scopus
Keywords: Oestrogen, hormones, progesterone,
Progesterone is largely produced by the corpus luteum until about 10 weeks of gestation.1 A study in ovarian failure and Assisted reproduction it was shown that one hundred mg of P were probably a supraphysiological dose to support pregnancy 6 to 8 weeks after conception. The fetoplacental unit was competent from 10 to 12 weeks’ gestation.2 When the pregnancy reaches term gestation, progesterone levels range from 100-200 ng/ml and the placenta produces about 250 mg/day. Almost all of the progesterone produced by the placenta enters the placenta, contrast to oestrogen. Progesterone production is independent of he precursor available, fetal status including the wellbeing.
In early pregnancy, the maternal levels of 17 a-hydroxyprogesterone rise, marking the activity of the corpus luteum. By the tenth week of gestation, this compound has returned to baseline levels, indicating that the placenta has little 17a hydroxylase activity. However, beginning about the 32nd week there is a second, more gradual rise in 17a-hydroxyprogesterone due to placental utilization of fetal precursors. This is relevant to understand prevention of preterm labor. Progesterone is also important in suppressing the maternal immunologic response to fetal antigens, thereby preventing maternal rejection of the trophoblast. And, of course, progesterone prepares and maintains the endometrium to allow implantation earlier. Studies have shown that the human corpus luteum makes significant amounts of estradiol, but it is progesterone and not oestrogen that is required for successful implantation.3
Oestrogen
The placenta does not have all the necessary enzymes to make oestrogens from cholesterol, or even progesterone. Human trophoblast lack 17-hydroxylase and therefore cannot convert C21-steroids to C19-steroids, the immediate precursors of oestrogen. To bypass this deficit, dehydroisoandrosterone sulfate (DHA) from the fetal adrenal is converted to estradiol-17ί by trophoblasts. In its key location as a way station between mother and fetus, placenta can use precursors from either mother or fetus to circumvent its own deficiencies in enzyme activities. Hormones act as catalysts for chemical changes at the cellular level that are necessary for growth, development and energy. Fetus lacks 3 B hydroxysteroid dehydrogenase-hence unable to produce progesterone-borrows from placenta. In return, fetus give placenta what it lacks (19 Carbon compounds)-precursor of oestrogen.
Protein hormones
Protein hormones are: Human placental lactogen (hPL), Human chorionic gonadotropin (hCG), Adrenocorticotropic (ACTH), Growth hormone variant (hGH-V), Parathyroid hormone-related protein (PTH-rP), Calcitonin, Relaxin, Inhibins Activins, Atrial natriuretic peptide, Hypothalamic-like releasing and inhibiting hormones, Thyrotropin releasing hormone (TRH), Gonadotropin releasing hormone (GnRH), Corticotropin-releasing hormone (CRH), Somatostatin, Growth hormone-releasing hormone (GHRH), alpha fetoprotein, prolactin, relaxin and other decidual proteins. Due to the comprehensiveness of the choices to describe hormones, clinical importance of hCG relevant for therapy is discussed in this chapter.
Human chorionic gonadotropin
The most widely studied trophoblast hormone product is hCG. In pregnancy this glycoprotein is critical since it rescues the corpus luteum from involution, and this maintains progesterone secretion by the ovarian granulosa cells. Its usefulness as a diagnostic marker of pregnancy stems from the fact that it may be one of the earliest secreted products of the conceptus. In pregnancy, placental production of hCG is at its peak between the eighth to the tenth week of gestation, and tends to plateau at a lower level for the remainder of pregnancy.