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OBSTETRICS 1.0 > 1.3 Placenta, Fetal membranes, Placental Hormones > Flashcards

1.3 Placenta, Fetal membranes, Placental Hormones Flashcards

1
Q

signals the start of cascade of events that will ensure the nourishment and growth of the product of conception

A

Fertilization

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2
Q

What is the product of conception

A

zygote

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3
Q

what day after fertilization where zygote is cleaved into blastomeres?

A

day 0-2

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4
Q

day when morulla is formed and enters uterine cavity

A

Day 3

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5
Q

What is formed during day 4-5?

A

Blastocyst

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6
Q

what is the fate of:

a) inner cell mass
b) outer cell mass

A

a) embryo

b) trophoblast

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7
Q

this event is signalled by the disappearance of the zona pellucida

A

implantation of blastocyst

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8
Q

the adhesion to the endometrial epithelium of the blastocyst (commonly at he upper posterior wall of uterus)

A

Apposition

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9
Q

Apposition occurs when?

A

day 5-6

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10
Q

at this day (a), the blastocyst is completely enveloped by maternal endometrium which is called (b)

A

a) day 9

b) decidua capsularis

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11
Q

at this day,the trophoblast is contiguous with the endometrium forming a syncytium

A

day 10

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12
Q

what are the 2 distinguishable layers of trophoblast and categorize to which side (maternal, embryonic)

A

Syncytiotrophoblast (Maternal side)

Cytotrophoblast (Embryonic side)

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13
Q

when does the layers of trophoblast become distinguishable?

A

Day 12

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14
Q

this provide the attachment of blastocyst to the decidua

A

trophoblast

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15
Q

trapped to form lacunae which soon become filled with blood

A

Spiral arteries (maternal)

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16
Q

subdivision of extravillous trophoblasts

A

Endovascular

Interstitial

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17
Q

invade and transform spiral arteries during pregnancy to create low resistance blood flow

A

Endovascular Trophoblasts

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18
Q

what do interstitial trophoblast invade specifically?

A

invade DECIDUA and SPIRAL ARTERIES

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19
Q

it is a period where the lacunae join together to form a complicated labyrinthem partitioned by solid trophoblastic columns

A

Lacunar Period

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20
Q

Lacunae will soon become the?

A

intervillous spaces

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21
Q

What are the cascade of events that happens during the 12th day of conception? (5)

A
  1. distinguished trophoblast (Syncytio and Cyto)
  2. distinguished embryonic poles (outer and inner)
  3. Trophoblastic invasion of the spiral arteries
  4. division of trophoblast outside the villus
  5. Lacunar period
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22
Q

characterized by the formation of primary and secondary villi (days)

A

13-19

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23
Q

what is the origin of primary villus?

A

solid cellular columns (from lacunar period)

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24
Q

What is the origin of the secondary villus?

A

when solid stalks (primary villus) are invaded by mesenchymal chord

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25
Q

what is the fate of the body stalk?

A

forms the Umbilical cord

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26
Q

the fetal membrane closest to the heart

A

Amnion

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27
Q

when does maternal blood enter the intervillous space?

A

day 14-15

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28
Q

this phenomenon is necessary for the intrauterine oxygen exchange. manner by which blood enters the intervillous space via the spiral arteries

A

Fountain-like burst

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29
Q

what are the cascade of events during the 13-19 post fertilization?

A
  1. Primary villus formation
  2. secondary villus formation
  3. Body stalk formation
  4. Amnion formation
  5. maternal blood enters intervillous space in a fountain like burst manner
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30
Q

what is formed when there is angiogenesis in the mesenchymal cores

A

tertiary villus

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31
Q

What is the pathology when there is absence of angiogenesis (failure of tertiary villus to form)

A

Hydatid mole (H. mole)

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32
Q

What are the clinical features of H.mole?

A

Ectopic pregnancy
Bleeding
Abortion

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33
Q

when does the fetoplacental circulation establishes itself?

A

day 17

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34
Q

What are the events that occur during 19-21 days postfertilization?

A
  1. formation of tertiary villi
  2. formation of fetal capillaries
  3. fetoplacental circulation
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35
Q

what completes the formation of fetoplacental circulation?

A

connection of blood vessels of the embryo to the chorionic blood vessels

36
Q

what happens during days 21-40?

A
  1. formation of Chorionic frondosum
  2. roof and floor formation of the intervillous space
  3. formation of placental septa
37
Q

the proliferation of chorionic villi that is in contact with the decidua basalis forms?

A

Chorionic frondosum

38
Q

what is the other term for chorionic frondosum?

A

Leafy chorion

39
Q

the roof and floor components of the intervillous spaces are composed of?

A

Roof: chorionic plate
Floor: cytotrophoblasts from the cell column

40
Q

it consists of decidual tissue encasing trophoblastic elements with fetal and maternal componnets

A

Placental Septa

41
Q

Day 40-50 events

A
  1. cotyledon formation

2. fromation of chorion laeve

42
Q

which of the following forms the placental cotyledon?

a) stem villi
b) anchoring villi

A

Stem villi

43
Q

blood supply and venous nature of the chorion frondosum at the endometrial cavity is lost which forms the?

A

Chorion Laeve

44
Q

Decidua capsularis + decidua parietalis

A

Decidua Vera

45
Q

time frames of Early pregnancy and Late pregnancy clinically.

A

Early pregnancy 8weeks

46
Q

Describe the following in the Early pregnancy

  1. Syncytial layer
  2. Cytotrophoblast
  3. Hobauer cells
  4. Chronic stroma
  5. Fetal capillaries
A
  1. thick
  2. increase prominence, volume
  3. increase prominence, volume
  4. increase Abundance, loose
  5. decrease prominent, number

*typically LATE PREGNANCY has the opposite findings.SO MEMORIZE!

47
Q

the fetal surface of the placenta is covered by the

A

Amnion

48
Q

there is no connection between maternal circulation and fetal circulation. T/F

A

True

49
Q

a low resistance unit that allows the exchange of oxygen as blood stays in the placenta

A

Placental Circulation

50
Q

this organ ensures blood supply to the fetus during labor

A

Placenta

51
Q

what is the course fetal circulation

A 
Umbilical artery
Mother
oxygenated blood
umbilical vein
deoxygenated blood
52
Q

when does end diastolic flow appear in the umbilical artery?

A

week 10

53
Q

deoxygenated blood from the fetus course through the _____ to the mother

A

2 umbilical arteries

54
Q

what are the charateristics of the amnion at term/birth?

A

Tough
pliable
tenacious

55
Q

T/F.the amnion is vascularized.

A

False

56
Q

it provides most of the tensile strength of fetal membranes

A

Amnion

57
Q

the amnion is identifiable at what day of pregnancy?

A

7th-8th day

58
Q

the acellular outer layer of the amnion is called

A

Zona spongiosa

59
Q

which of the following is the composition of the fetal membrane when there is twin pregnancy?

a) 2 amnions, 1 chorion
b) 1 amnion, 1 chorion
c) 1 amnion, 2 chorions

A

All are possible.

60
Q

this structure extends from the fetal umbilicus to the fetal surface of the placenta or chorionic plate

A

Umbilical cord

61
Q

average length of the umbilical cord

A

55cm

62
Q

average diameter of the umbilical cord

A

0.6-2.0 cm

63
Q

the extra cellular matrix of the umbilical cord is called the

A

wharton’s jelly

64
Q

the umbilical cord is composed of what 3 main vessels?

A

2 umbilical arteries

1 umbilical vein

65
Q

the oxygenated blood form the umbilical vein empties into the IVC via what fetal bypass?

A

Ductus venosus

66
Q

true or false. both Placenta and trophoblast cells are endocrine organs

A

true

67
Q

earliest hormonal signal for pregnancy

A

human chorionic gonadotropin (HCG)

68
Q

when is HCG detected in the maternal circulation?

A

8-9 days post ovulation

69
Q

hcg ca be synthesized by the kidney. T/F.

A

True

70
Q

the doubling time of hCG

A

1.7-2 days

71
Q

what are the characteristics of the subunits of hCG:

a) alpha
b) Beta

A

Alpha: shared with LH, TSH and FSH
Beta: unique thus it is the one being detected

72
Q

when does hCG reaches its peak concentration?

A

@ 10 weeks (50000-100000 mIU/mL)

*responsible for vomiting

73
Q

hCG is secreted by what cells and produced by what cells?

A

Produced by: Trophoblasts
Secreted by: Syncytiotrophoblasts
*before 5 weeks, it is secreted by both Cyto and Syncytio

74
Q

when does hCG becomes (+) for PT?

A

at 5 weeks

75
Q

Biological functions of the hCG

A

stimulates fetal testis
stimulates maternal thyroid activity
rescues the corpus lutem
promotes uterine vasculature VD, relaxin scretion by corpus luteum

76
Q

a high hCG level may mean that:

A

there is multiple pregnancy
GTD (gestational trophoblastic disease)
ex: H.mole/chorecarcinoma

77
Q

what are the functions of the human placental lactogen (hPL)

A 
Anti-insulin
(+) maternal lipolysis
Angiogenic hormone
ensure nutrient supply to the fetus
Tumor marker
78
Q

relaxin can be secreted by?

A

Corpus luteum
Decidua
Placenta

79
Q

serves as the parathyroid of fetus

A

Parathyroid hormone-related protein

80
Q

aka placental growth homone

A

Growth hormone variant (hGH-V)

81
Q

stimulates the secretion of hCG

A

GnRH

82
Q

when does the placenta assume progesterone secretion?

A

at 8th week

83
Q

little progesterone is secreted by the ovary after?

A

after 6-7 weeks of gestation

84
Q

surgical removal of the corpus luteum at 7th-10th week is extremely lethal for pregnancy. T/F

A

False. at 8th week, the placenta assumes progesterone secretion

85
Q

what is the substrate for progsterone

A

Cholesterol

86
Q

hormone that provides placental quiescence

A

progesterone

87
Q

production of both progesterone and estrogen in the maternal ovaries decreases significantly by the 7th week. at this time placenta will assume progesterone secretion around the 8th week. this is called the?

A

Luteal-Placental Transition

OBSTETRICS 1.0 (6 decks)

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