Endocrinology of Pregnancy

A coordinated sequence of events must occur in order to establish and successfully maintain a healthy pregnancy. Synchrony between the development of the early embryo and establishment of a receptive endometrium is necessary to allow implantation and subsequent progression of pregnancy. 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. 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.endotext.org , our free web-book,