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3- Reproduction > Fetal Physiology > Flashcards

Fetal Physiology Flashcards

1
Q

Placenta

A

vital connecting organ between maternal uterus and foetus

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2
Q

pre-implantation

A

development of placenta begins during implantation of blastocyst

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3
Q

blastocyst embryonic cell types

A

outer trophoblast cells (form placenta)

inner cell mast (form foetus and foetal membranes)

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4
Q

Site of normal implantation

A

anterior or posterior wall of the body of the uterus

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5
Q

Most common ectopic implantation site

A

ampulla of fallopian tubes

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6
Q

Implantation: 6th day

A

zone pellucid disintegrates and blastocyst hatches allowing implantation to take place.
Trophoblast cells interact with endometrial decidual epithelia to enable invasion into maternal uterine cells.

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7
Q

Implantation: 8th day

A

trophoblast cells differentiate into outer multinucleate synctiotrophoblast and inner mono nucleated cut-trophoblast

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8
Q

Outer multinucleate synctiotrophoblast

A

erodes maternal tissue by sending out projections

Responsible for producing hormones such as HCG

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9
Q

Inner mono nucleated cut-trophoblast

A

Actively proliferating

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10
Q

Post-implantation

A

Takes place 9th day Lacunae spaces form within synctiotrophoblast. Erodes maternal tissues allowing maternal blood from uterine special arteries to enter lacunar network

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11
Q

what is established by week 2

A

early uteroplacental circulation

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12
Q

3rd week post-implantation

A

Extra-embryonic mesoderm grows into villi, forming a core of loose connective tissue
By end of week embryonic vessels begin to form in embryonic mesoderm of secondary chorionic villi
Anchoring and branching villi form

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13
Q

Purpose of branching villi post-impkantation

A

provide surface area for the exchange of metabolites between mother and foetus

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14
Q

establishment of circulation

A

Maternal spinal arteries undergo remodelling to produce low resistance, high blood flow condition in order to meet demands of the foetus

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15
Q

What cells invade maternal spinal arteries

A

Cytotrophoblast cells

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16
Q

Pre-eclampsia

A

trophoblastic disorder related to failed or incomplete differentiation of cytotrophoblastic cells during epithelial to endothelial transformation

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17
Q

Placenta barrier

A

Not a true barrier as it allows many substances to pass between maternal and foetal circulation.

18
Q

Separation of maternal and foetal blood

A

maternal blood in intervillous specs is separated from the foetal blood by chorionic derivatives.
Human placenta: haemochorial type.

19
Q

Placenta barrier in first trimester

A

0-13 weeks

Surface of chorionic villi formed by synctiotrophoblst. Cells rest on a layer of cytotrophoblstic cells that cover a vascular endothelium

Barrier relatively thick

20
Q

placenta barrier in Second and third trimester

A

Chorion frondosum formed was more villi develop on embryonic pole.
On foetal surface, placenta is covered by chorionic plate.
On maternal side, it is bordered by decide basalis

Decidual plate most intimately incorporated into placenta

21
Q

Compartments of placenta

A

Cotyledons

Placenta divided by septa

Cotyledons receive blood supply through 80-100 spiral arteries that pierce decidual plate.

22
Q

Full term placenta

A

Discoid in shape
Diameter: 15-25cm
Approx: 3cm thickness
Weight: 500-600g

23
Q

Maternal side of full term placenta

A

15-20 bulging areas (cotyledons) covered by a thin layer of decider basalis.
Fully grown placenta contains intervillous lakes
Hold approx 150 ml of maternal blood

24
Q

Placenta changes: End of pregnancy

A

Aim: reduce exchange between maternal and foetal circulations

Increase in fibrous tissue in core of villus
Thickening of foetal capillary basement membranes
Obliterative changes in small capillaries of villi
Deposition of fibrinoid on surface of villi in junctional zone and in chorionic plate. (leads to infarction of intervillous lake -> turns whitish)

25
Q

placental abruption

A

part, or all of, the placenta separates prematurely from uterine wall.
Occurs following aa rupture of maternal vessels within basal layer of endometrium.
Blood accumulates and causes placenta to split from basal layer.
Detached portion us unable to function and can lead to rapid foetal compromise.

26
Q

Placental abruption risk factors

A 
previous placental abruption 
Pre-eclampsyia 
Abnormal lie of foetus 
Polyhydramnios
Smoking
multiple pregnancy
underlying thrombophilia
abdo traum
27
Q

Presentation and exam of placental abruption

A

Painful vaginal bleeding

Uterus may be woody (tense) and painful on palpation

28
Q

Foetal heart structure

A 
Umbilical Vein 
Umbilical Arteries
Ductus venous 
Ductus Arteriosus 
Foramen Ovale
29
Q

umbilical vein

A

delivers oxygenated blood from the placenta to the foetus, providing oxygen and nutrients

30
Q

umbilical arteries

A

transport deoxygenated blood away from the fetal tissue and back towards placenta for re-oxygenation

31
Q

ductus venous

A

allows blood for placenta to bypass liver (highly demanding but relatively inactive

32
Q

ductus arteriosus

A

fusion of primitive pulmonary artery to the aorta, allowing blood to pass straight from right ventricle into aorta and bypass inactive lungs

33
Q

foramen ovale

A

creates a shunt between right atrium and left atrium so oxygenated blood from placenta can move to left atrium. allows oxygenated blood to pass through left ventricle and into ascending aorta, oxygenating the brain

34
Q

partial pressure of O2 in foetal circulation

A

4kPa (comparison to adult-13kPa_

35
Q

How does foetus maintain adequate oxygen delivery to tissue

A

Shunt
Reltive polycythaemia
Properties of Fetal haemoglobin

36
Q

Fetal haemoglobin

A

2 alpha subunits and 2 gamma subunits
Change in structure of protein mean foetal haemoglobin can bind more readily to oxygen from maternal circulation.
Allows for adequate oxygenation of tissues.

37
Q

Adaptation of fetal heart to neonatal heart

A

First breath causes a rise in partial pressure of O2.
Increase in O2 pressure causes pulmonary vasodilation
Leads to drop in right heart pressure.
Simultaneously placental circulation ceases, causing left heart pressure to rise.
Combined factors -> formane ovale shuts

Pulmonary and systemic circulations become separate.

Final step: closure of ductus arterioles, occurring 2-3 days after birth

38
Q

Structural remnants of fetal circulatory structures

A

Fossa Ovalis- Foramen Ovale

Ligamentum Arteriosum - Ductus arteriosus

Ligamentum Venosum - Ductus venous

39
Q

patent ductus arteriosus

A

If ductus arteriosus remains open beyond

  • 3 months of life (pre-term)
  • 1 year (full term)
  • -> Persistent patent ductus arteriosus

Prostaglandin E2 is responsible for keeping PDAs open

40
Q

Recognition of Patent Ductus Arteriosus

A

Continuous, machinery murmur over upper left sternal border.
Generally asymptomatic

3- Reproduction (15 decks)

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