Implantation,placentation +early embryonic development Flashcards
Define gestational age
- used clinically
- time zero=first day of last menstrual period
- expressed in completed weeks plus days
Define embryonic age
-used in embryolohy
-Time zero is fertilisation (day 14=ovulation)
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What is implantation?
-Begins day 6/7
Complete by day 10 (4 days prior to expected period)
-Three stages: 1.) Apposition 2.) Attachment 3.)penetration
When is the endometrium receptive?
During the implantation window(3 day period) which is from day 7-10
What are the different phases of the menstrual cycle?
- ) proliferative phase
- ) Secretory phase split into
- pre-receptive
- receptive
- refractory
Describe the primitive trophoblast
- Rapidly differentiates into two layers
1. ) Inner layer composed of mono nuclear cells cytotrophoblastic layer
2. )Synctiotrophobolast outer layer composed of multinucleated cells
Lacunae (inter-communicating fluid filled spaces appear in the rapidly enlarging trophoblastic mass from the 8th day after fertilisation
What is haemochorial placentation characterized by?
- This is part of development of the placenta
- differentation of the endometrium into decidua: enlarged stromal cells and uterine natural killer cells
- Transformation and opening of the uterine spiral arteries
Explain the development of the placenta and early embryo as characterized by the end of the second week
- The end of the 2nd week is characterized by the first appearance of chorionic villi
- Primary villous stems have a central core of cells derived by the proliferarion of the cytotrophoblast
- The primary villi gradually develop mesenchymal cores,which convert them into secondary villi
- The mesenchyal cells within the villi differentiate into blood capillaries, thus forming the tertiary villi
- The vessels from the villi soon become connected with the embryonic heart via vessels that differentiate in the mesenchyme of the chorion and in the connecting stalk
Describe the transition from a primary to tertiary villus, the time duration and characteristics of each.
- A primary villus is present at 2 weeks, this has a cytotrophoblast core
- At 3 weeks a secondary villus is present. This has a mesoderm core (has a smaller cytotrophoblast layer)
- At 4 weeks a tertriary villus is present which contains blood vessels (villous capillary)
Note that they all have cytotrophoblast & synctiotrophoblast
What is the significance of haemochorial placentation?
- Hemochorial placentation is the time that the fetus has an independent circulation making it an independent being
- The fetus is still not totally independent, as it is still dependent on the mother for oxygen, sugar, some amino acids, and basic nutrient supply
Explain the development of the placenta and early embryo beyond the 4th week.
- As the growth continues, the villi on the decidua capsularis (abembryonic) pole degenerate to form the chorion leavae.
- Villi adjacent to the decidual plate rapidly grow and expand to form the chorion frondosum
- The chorion frondosum forms the placenta together with the decidual plate
What is visible on an USS of a placenta, 6 weeks post conception?
- Chorion laevae: this will be away from the definitive placenta and this bit of the placenta is thin
- Chorion frondosum: The definitive placenta forms here so this bit of the placenta is thick.
What makes up the outer layer of fetal placenta?
-Chorion leavae & chorion frondosum
Why must the spiral arteries be dilated?
- Early on, the maternal spiral arteries start to be dilated bu they’re plugged by synctiotrophoblast cells in the centre
- This protects the embryo from the maternal blood pressure
- We can use Doppler screening to see if the spiral arteries are open, using ultrasound and looking at the wave forms which are upstream from the spiral arteries
What are the characteristics of the uterine arteries of a non-pregnant woman?
- A lot of elastic recoil
- The arteries are narrow
What are the characteristics of the uterine artery blood flow of a non-pregnant woman?
- Continuous flow throughout the cardiac cycle
- There’s a systolic peak but continuous flow in diastole