Chapter 6: Fetal Membranes Flashcards
Fetal membranes
Structures developed from the zygote but do not share in the formation of the embryo:
1. Chorion and placenta.
2. Amnion.
3. Umbilical cord.
4. Yolk sac.
Chorion
Chorion is the wall of chorionic vesicle.
Formation of chorion
- At the 12th day, extra embryonic mesoderm is formed on the inner aspect of the cytotrophoblast.
- Chorionic vesicle is formed when spaces in the extra embryonic mesoderm fuse to form extra-embryonic coelom (chorionic cavity).
The extra-embryonic coelom is divided into
- Somatic mesoderm: lines cytotrophoblast and covers amniotic cavity.
- Splanchnic mesoderm: covers yolk sac.
Layers of chorion
Composed of layers (external to internal):
1. Synctiotrophoblast.
2. Cytotrophoblast.
3. Extraembryonic somatic mesoderm.
Placenta
Organ through which the exchange of materials occurs between maternal and fetal blood.
Placenta shape
Disc shape
Placenta weight
500-600 gm.
Placenta diameter
15-20 cm
Placenta thickness
3 cm
Placenta site
Mostly in the upper segment of the posterior wall of the uterine cavity near fundus.
Placenta surfaces
- Fetal surface.
- Maternal surface.
Fetal surface
- Surface that faces the fetus.
- Smooth and covered with transparent amnion.
- Umbilical cord is attached near its center.
Maternal surface
- Surface that lies in contact with internal surface of uterine wall.
- It shows presence of 15-20 elevations named cotyledons, separated from each other by grooves.
- Covered by thin layer of Decidua basalis.
Formation of placenta
Formed by the union of two main parts:
1. Maternal part: decidual plate (basalis).
2. Fetal part: chorionic plate (frondosum).
Structure of placenta
Composed of:
1. Chorionic plate.
2. Decidual plate.
3. Chorionic villi.
4. Intervillous space.
5. Placental (decidual) septa.
Chorionic plate (external to internal)
- Amnion.
- Extra-embryonic somatic mesoderm
- Cytotrophoblast.
- Syncytiotrophoblast.
Decidual plate (internal to external)
- Syncytiotrophoblast which lines the intervillous space.
- Cytotrophoblastic shell.
- Decidua basalis.
Chorionic villi
Tertiary villi of the chorion frondosum composed of the following layers:
1. Syncytiotrophoblast (outer layer).
2. Cytotrophoblast.
3. Somatic extraembryonic mesoderm.
4. Epithelium of fetal blood vessels.
Parts of chorionic villi
- Stem (anchoring) villi.
- Floating (free or absorbing) villi.
Stem (anchoring) villi
Main part of the villous that extends between chorionic and decidual plates.
Floating (free or absorbing) villi
Side branches from the stem villi that float in maternal blood in the intervillous spaces to allow exchange of food materials and gases between fetal and maternal blood.
Intervillous space
Formed of intercommunicating spaces that separate between stem villi and extend from chorionic plate to decidual plate. Maternal arterioles and venules open into the spaces through the decidual plate.
Placental (decidual) septa
- Septa that extend from decidual plate to the cavity of intervillous spaces.
- Appear during 4th to 5th months.
- Incomplete septa that do not extend to the chorionic plate.
- Each septum is composed of core Decidua basalis covered with cytotrophoblast and syncytiotrophoblast.
- Cotyledons on the maternal surface are separated by grooves that correspond to inwards extension of the placental septa.
Placental circulation
Circulation of blood inside the placenta composed of:
1. Maternal part (circulation of maternal blood).
2. Fetal part (inside fetal blood vessels).
Maternal blood (circulation of maternal blood)
- Arterial blood flows to the intervillous space through 80-100 decidual arterioles.
- Full term placenta contains about 150 ml of maternal blood which is changed 3-4 times/min.
- Maternal blood flows back towards decidual plate to leave through maternal venules.
Fetal part (inside fetal blood vessels)
- Umbilical arteries leave the the abdomen of the fetus through the umbilical cord.
- They reach the fetal surface of the placenta where they branch to enter the tertiary villi inside the placenta.
- After the exchange between fetal and maternal blood, the fetal blood is carried through left umbilical veins to the fetal heart where it is distributed to the body of fetus.
Placental barrier (membrane)
Membrane that separates between fetal blood (inside the tertiary villi) and maternal blood (in the intervillous spaces).
Early placental barrier
- Endothelium of fetal blood vessels.
- Somatic extraembryonic mesoderm.
- Cytotrophoblast.
- Syncytiotrophoblast.
Late placental barrier (from 4th month)
- Endothelium of fetal blood vessels.
- Syncytiotrophoblast.
Why does the placental membrane become thinner in the second half of pregnancy?
To allow rapid exchange of nutrition and gases to give adequate supply to the larger fetus.
Functions of placental barrier
- Separates between fetal and maternal blood.
- Permits gaseous, nutritive, and waste products exchange.
- Prevents passage of bacteria and most viruses except:
- HIV.
- Poliomyelitis.
- Rubella.
- Cytomegalovirus.
- Measles. - Prevents passage of most toxic materials and most maternal hormones except some synthetic hormones:
- Progestin.
- Diethylstilbestrol.
Functions of the placenta
- Exchange of metabolic products.
- Exchange of gases.
- Transmission of maternal antibodies to the fetus.
- Endocrine function.
- A protective role.
- Excretory function.
Placenta: exchange of metabolic products
Allows transmission of nutritive substances from maternal to fetal body and in the opposite direction, waste products are transmitted from fetal to maternal blood.
Placenta: exchange of gases
Giving oxygen to fetus and receiving CO2 from fetal blood.
Placenta: transmission of maternal antibodies to the fetus
Starting from 14th week. Fetus will gain immunity since then.
Placenta: endocrine function
- Progesterone hormone.
- Estrogen hormone.
- Human chorionic gonadotropins (HCG).
- Somatomammotropin.
Endocrine: progesterone hormone
Maintains the endometrium of pregnancy.
Endocrine: estrogen hormone
Stimulates uterine growth and development of mammary gland.
Endocrine: estrogen
Stimulate uterine growth and development of mammary gland.
Endocrine: human chorionic gonadotropins (HCG)
Maintains corpus lutes till the 4th month. It is used to detect pregnancy.
Endocrine: somatotropin
Gives fetus the priority on maternal blood glucose. It also promotes breast development.