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Physiology 2 > Implantation, Placentation And Hormone Changes In Pregnancy > Flashcards

Implantation, Placentation And Hormone Changes In Pregnancy Flashcards

1
Q

What is a blastocyst?

A

Embryo that is ready for implantation

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2
Q

How old is a blastocyst?

A

5/6 days post fertilisation

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3
Q

What are the two definitive cell lines in a blastocyst?

A

Embryoblast and trophoblast

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4
Q

What does the trophoblast give rise to?

A

Placenta

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5
Q

What does the embryoblast give rise to?

A

Foetus

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6
Q

What is another name for the embryoblast?

A

Inner cell mass

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7
Q

What is the fluid filled cavity of the blastocyst called?

A

Blastocoel

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8
Q

What is the embryoblast end called?

A

Embryonic pole

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9
Q

What is the end that doesn’t have the embryoblast called?

A

Abembryonic pole

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10
Q

What do you need for implantation to occur?

A

A fully developed blastocyst and a receptive endometrium

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11
Q

What is special about the endometrium that allows implantation to happen?

A

Thick endometrial lining and expression of embryo receptivity markers

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12
Q

What are the factors that mean the blastocyst is ready to be implanted?

A

Fully expanded and hatched out of the zona pellucida

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13
Q

What do you get before the blastocyst stays fully expanded?

A

Expansions and contractions that allow it to exit the zona pellucida

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14
Q

What happens at the abembryonic end when the blastocyst is still in the zona pellucida?

A

Digestive enzymes are released to break down the zona pellucida

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15
Q

What are the stages of implantation?

A

Apposition, attachment and invasion

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16
Q

What is apposition?

A

Positioning of the embryo so its ready to attach to the endometrium

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17
Q

What is the surface of the endometrial wall called?

A

Decidua basalis

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18
Q

What happens at days 7-8?

A

Blastocyst attaches to the decidua basalis and the trophoblast cells assemble to form a synctiotrophoblast

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19
Q

Why do the trophoblast cells form a synctotrophoblast?

A

To facilitate invasion of the decidua basalis

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20
Q

What happens at days 9-11?

A

The synctiotrophoblast further invades the decidua basalis and by day 11 its almost completely buried in the decidua

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21
Q

What happens at day 12?

A

Decidualisation happens and is taken up by the synctiotrophoblast

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22
Q

What is decidualisation?

A

Progesterone causing the enlargement and coating of the decidual cells in glycogen and lipid rich fluid

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23
Q

Why is the decidual fluid taken up by the synctiotrophoblast?

A

Helps to sustain the blastocyst before placental formation

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24
Q

What happens around day 14?

A

Synctiotrophoblast cells branch out to form primary villi.
Decidual cells between the primary villi clear out leaving spaces
Maternal vessels grow into the decidua basalis
Blood filled lacunae merge into a single large pool of blood

25
Q

What is the junctional zone?

A

The large pool of blood formed when the blood filled lacunae merge

26
Q

What is the junctional zone the foundation for?

A

The placenta formation

27
Q

What are lacunae?

A

Spaces left by the evacuation of decidual cells

28
Q

What does the foetal placenta take up?

A

Oxygen and glucose, immunoglobulins, hormones and some toxins

29
Q

What does the foetal placenta drop off?

A

CO2 and waste products

30
Q

What happens at day 17?

A

Foetal mesoderm cells start to form blood vessels in the villi, which grow larger in size

31
Q

What is formed from the villi cells at day 17?

A

Chorionic plate

32
Q

When do capillaries connect with the umbilical cord blood vessels?

A

Week 5

33
Q

What is a cotyledon?

A

Sections of the placenta formed by the decidual septum

34
Q

What are the functions of the placenta?

A

Maternal provision of nutrients, metabolism, barrier to pathogens and drugs, removal of foetal waste products and endocrine secretion

35
Q

What hormones does the placenta secrete?

A

Oestrogen, progesterone, hPL, hCG and cortisol

36
Q

Why is the placenta good at its job?

A

Huge maternal uterine blood supply at a low pressure, high SA in contact with maternal blood

37
Q

What are the risk factors for pre-eclampsia?

A

First pregnancy, multiple gestation, >35 yrs maternal age, hypertension, diabetes, obesity and family history

38
Q

What is eclampsia?

A

Pre-eclampsia and seizures

39
Q

What is pre-eclampsia characterised by?

A

Narrowing of the maternal spiral arteries supplying blood to the placenta

40
Q

What does pre-eclampsia cause?

A

New onset maternal hypertension and proteinuria

41
Q

What does pre-eclampsia result in?

A

Placental insufficiency

42
Q

What is placental insufficiency?

A

Not enough maternal blood flow to the placenta

43
Q

Why do seizures happen in eclampsia?

A

Higher pressure of blood flow to brain

44
Q

What is a placental abruption?

A

Premature separation of all or part of the placenta

45
Q

What are the risk factors for placental abruption?

A

Blunt force trauma, smoking and recreational drug use, multiple gestation, high maternal age and a previous placental abruption

46
Q

What is placental abruption caused by?

A

The degeneration of maternal arteries supplying blood to the placenta, causing vascular rupture and haemorrhage

47
Q

What are the symptoms of a placental abruption?

A

Vaginal bleeding and pain in the back and abdomen

48
Q

What are the maternal complications of placental abruption?

A

Hypovolemic shock, Sheehan syndrome, renal failure and disseminated intramuscular coagulation

49
Q

What is disseminated intravascular coagulation and what causes it?

A

Blood clots throughout circulation, caused by the release of thromboplastin

50
Q

What is Sheehan syndrome?

A

Perinatal pituitary necrosis

51
Q

What does Sheehan syndrome cause?

A

Loss of secondary sexual characteristics (body hair, breast shrinkage and irregular menstural cycles)

52
Q

What are the foetal complications of placental abruption?

A

Intrauterine hypoxia and asphyxia and premature birth

53
Q

What is placenta previa?

A

When the placenta implants into the lower uterus, fully or partially covering the internal cervical os

54
Q

What is placenta previa associated with?

A

Increased chances of pre-term birth and foetal hypoxia

55
Q

What are the risk factors for placenta previa?

A

Previous c-section, uterine/endometrial surgery or uterine fibroids, previous placenta previa, smoking and recreational drug use, multiple drug use, multiple gestation and a high maternal age

56
Q

What happens hormonally once implantation of the blastocyst has occurred?

A

hCG production

57
Q

What does oestrogen cause in pregnancy?

A

Increased blood volume, shallow breathing, increased urinary output

58
Q

What does progesterone cause in pregnancy?

A

Mood changes, nausea and taste changes, loosened ligaments, breast changes and darkened skin

Physiology 2 (38 decks)

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