Key Points continued

has both growth-hormone-like and prolactin-like activities.

• The placenta constitutively synthesizes large amounts of progesterone from cholesterol taken up from the maternal circulation.

• Although the placenta cannot synthesize 19-carbon steroids, it produces large amounts of estrogens by aromatizing androgens secreted by the maternal and fetal adrenal glands.

• Corticotropin-releasing hormone (CRH) produced by the placenta stimulates the fetal pituitary to secrete ACTH and also acts directly on the fetal adrenal cortex to stimulate production of dehydroepiandrosterone-sulfate which serves as a precursor for placental estrogen production.

• Estrogens drive their own production and the production of progesterone by increasing placental uptake of cholesterol and conversion to pregnenolone, which serves as a precursor for placental production of progesterone and fetal adrenal production of dehydroepiandro-sterone-sulfate.

• Parturition is initiated by convergence of self-amplifying effects of CRH, cortisol, prostaglandins, mechanical stretching of the myometrium, and perhaps other factors that are not fully understood.

• Oxytocin promotes uterine contractions and speeds up parturition but is not secreted until parturition has been initiated.

• Estrogen and progesterone promote growth and branching of the mammary duct system.

• Prolactin and hCS in the presence of estrogen and progesterone during pregnancy stimulate growth of the mammary alveolar tissue.

• Tactile stimulation of the nipples or sensory input related to nursing signal release of oxytocin.

• Oxytocin stimulates myoepithelial cells surrounding the mammary alveoli and ducts to contract and deliver pressurized milk to the lactiferous ducts.

• Suckling stimulates prolactin secretion.

• Prolactin is secreted in response to suckling and stimulates milk synthesis in preparation for the next episode of suckling.

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