Which of the following are hormonal changes that support pregnancy? Select all that apply.
Increased human chorionic gonadotropin
Increased human placental lactogen
Decreased estrogen
Increased progesterone
Decreased thyroid hormone production
Correct Answer : A,B,D
Hormonal changes in pregnancy are critical for maintaining implantation, fetal growth, and maternal adaptation. hCG maintains the corpus luteum for early progesterone secretion, progesterone relaxes uterine smooth muscle and prevents contractions, while hPL induces insulin resistance and promotes fetal glucose supply. Estrogen rises progressively, stimulating uterine growth and increasing blood flow. Normal total estrogen levels increase 10–100 fold, progesterone rises from 10–44 ng/mL in the first trimester to >100 ng/mL at term, and hCG peaks around 100,000 IU/L by 10 weeks.
Rationale for correct answers
1. Increased hCG supports the corpus luteum in early pregnancy, ensuring continuous progesterone production until placental steroidogenesis becomes sufficient.
2. Increased hPL promotes maternal insulin resistance, sparing glucose for fetal use and enhancing maternal lipolysis for alternative energy sources.
4. Increased progesterone maintains uterine quiescence by reducing myometrial excitability, while also contributing to smooth muscle relaxation in other systems.
Rationale for incorrect answers
3. Estrogen does not decrease; it significantly increases during pregnancy, stimulating uterine growth, breast development, and increasing uteroplacental perfusion.
5. Thyroid hormone production does not decrease; in fact, mild increases occur due to hCG’s thyrotropic effect, with free thyroxine (T4) levels slightly rising in early pregnancy. Normal maternal free T4 range is 0.7–1.9 ng/dL.
Take home points
• hCG, hPL, estrogen, and progesterone all increase during pregnancy.
• Progesterone prevents uterine contractions and supports smooth muscle relaxation.
• hPL induces insulin resistance, sparing glucose for fetal development.
• Thyroid activity slightly increases due to hCG stimulation, not decreases.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Human placental lactogen (hPL)is a placental hormonestructurally related to growth hormoneand prolactin. Its primary action is to induce insulin resistancein maternal tissues, ensuring continuous fetal glucose availability. hPL also stimulates maternal lipolysis, increasing free fatty acids as an alternate maternal energy source. Normal maternal serum hPL levels rise steadily during pregnancy, reaching 5–7 mg/L at term.
Rationale for correct answer
3.hPL increases maternal insulin resistance, which decreases maternal glucose utilization and increases circulating glucose for fetal transport. This adaptive mechanism ensures that fetal energy needs are prioritized, especially during the second and third trimesters.
Rationale for incorrect answers
1.Relaxation of uterine smooth muscle is mediated by progesterone, not hPL. Progesterone maintains uterine quiescence by reducing myometrial excitability and preventing premature contractions.
2.Maintenance of the corpus luteum is the role of human chorionic gonadotropin (hCG), which supports progesterone production in early pregnancy. hPL has no direct function in corpus luteum support.
4.Cervical softening is mediated by prostaglandins and relaxin, which remodel collagen in cervical tissue. hPL does not directly influence cervical ripening.
Take home points
• hPL primarily induces maternal insulin resistance to increase glucose availability for the fetus.
• Progesterone relaxes uterine smooth muscle, preventing contractions.
• hCG maintains the corpus luteum and progesterone secretion in early pregnancy.
• Cervical softening is mainly regulated by prostaglandins and relaxin, not hPL.
Correct Answer is B
Explanation
Human placental lactogen (hPL)is a peptide hormonesecreted by the syncytiotrophoblast. It modifies maternal metabolismby increasing insulin resistance, thereby reducing maternal glucose uptake and ensuring fetal glucose supply. hPL also promotes lipolysis, increasing free fatty acids for maternal energy use. Normal maternal serum hPL levels rise progressively to 5–7 mg/L at term.
Rationale for correct answer
2.hPL promotes insulin resistance by antagonizing insulin action in maternal tissues. This spares glucose for the fetus while shifting maternal metabolism toward lipolysis. The physiologic insulin resistance peaks in the second and third trimesters, helping maintain fetal growth.
Rationale for incorrect answers
1.Human chorionic gonadotropin (hCG) maintains the corpus luteum in early pregnancy and supports progesterone secretion. It does not influence insulin sensitivity or glucose regulation.
3.Estrogen promotes uterine growth, increases uteroplacental blood flow, and enhances myometrial oxytocin receptor expression. It does not play a significant role in maternal insulin resistance.
4.Progesterone relaxes smooth muscles, maintaining uterine quiescence and reducing gastrointestinal motility. While it indirectly affects glucose metabolism, it is not the primary hormone responsible for insulin resistance in pregnancy.
Take home points
• hPL is the main hormone that promotes insulin resistance in pregnancy.
• Insulin resistance spares glucose for the fetus and shifts maternal metabolism to fat utilization.
• Excessive insulin resistance may contribute to gestational diabetes mellitus.
• Estrogen, progesterone, and hCG serve other reproductive roles without directly altering insulin sensitivity.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.