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The Reproductive System > Lecture 6.1: Placental Development and Pregnancy > Flashcards

Lecture 6.1: Placental Development and Pregnancy Flashcards

1
Q

What does the Trophoblast differentiate into? (2)

A
  • Syncytiotrophoblast
  • Cytotrophoblast
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2
Q

What does the Embryoblast differentiate into? (2)

A
  • Epiblast
  • Hypoblast
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3
Q

Which trophoblast differentiate invades the uterine wall? On what day?

A
  • Syncytiotrophoblast
  • Day 6
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4
Q

Degraded contents of uterine cells engulfed by the trophoblast are used to feed the embryo until….?

A

links with maternal capillaries are made

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5
Q

What day does the bilaminar disk form?

A

Day 7-9

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6
Q

By the end of week 2: what are the 2 cavites surrounding the embryo?

A
  • Amniotic Cavity
  • Yolk Sac
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7
Q

What is the supporting sac at the end of week 2 called?

A

Chorionic Cavity

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8
Q

What is the role of the yolk sac?

A

Provides nutrients until placenta ready to take over

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9
Q

What does the Chorion go on to form? What is its role?

A
  • Placenta
  • Provide Nutrition for Embryo
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10
Q

What does the Allantois go on to form? What is its role?

A
  • Umbilical Chord
  • Waste Disposal
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11
Q

What is the Amnion?

A

Membrane surrounding amniotic fluid

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12
Q

Twins: When are there 2 chorions and 2 amnions?

A
  • 2 morulas and 2 blastocytes
  • Could be 2 separate eggs or 1 egg splits into 2 at
    zygotic stage
  • Separate implantation sites
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13
Q

Twins: When are there 2 amnions but a shared chorion?

A
  • 1 morula but 2 ICMs and bilaminar disks
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14
Q

Twins: When are there is shared amnions and a shared chorion?

A
  • 1 blastocyte and bilaminar disk but 2 primitive streaks
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15
Q

The human placenta is haemomonochorial, what does this mean?

A

Only one layer of trophoblast ultimately separates maternal blood from foetal capillary wall

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16
Q

Why does the placental membrane get thinner?

A

To fulfil the needs of the foetus as they increase

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17
Q

What are the aims of the implantation of a foetus? (3)

A
  • Establish the basic unit of exchange (villi)
  • Anchor the placenta
  • Establish maternal blood flow within the placenta
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18
Q

What are Primary Villi?

A

Early finger-like projections of trophoblast

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19
Q

What are Secondary Villi?

A

Invasion of mesenchyme into core

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20
Q

Tertiary Villi

A

Invasion of mesenchyme core by foetal vessels

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21
Q

What is Decidualisation?

A

Functional and morphological changes that occur within the endometrium to form the decidual lining into which the blastocyst implants

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22
Q

What hormone signals to the endometrium to prepared
for implantation each month?

A

Progesterone

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23
Q

What do endometrial stromal cells do?

A

Secrete growth factors and signalling molecules

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24
Q

What do uterine natural killer cells do?

A

Regulate the immune response against the non-self embryo

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25
Q

What happens in remodelling of the spiral arteries?

A

Modifies the arteries from low-flow, high-resistance to high-flow, low-resistance vessels

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26
Q

Why does remodelling of the spiral arteries occur?

A

Maintains the high flow required to meet foetal demand

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27
Q

What happens to the cytotrophoblast layer of the placenta as pregnancy progresses?

A

It is lost, as placenta becomes thinner so that nutritional needs of foetus can be better met

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28
Q

What structure links placental blood vessels with developing foetus?

A

Umbilical Chord

29
Q

What vessels does the umbilical chord contain?

A
  • Two umbilical arteries (deoxygenated blood from
    foetus to placenta)
  • One umbilical vein (oxygenated blood from placenta to
    foetus)
30
Q

What are the 3 ways the placenta allows transport of materials from mother to foetus?

A
  • Simple Diffusion
  • Active Transport
  • Facilitated Diffusion
31
Q

What materials are transported via Simple Diffusion between mother and foetus? (4)

A
  • Water
  • Electrolytes
  • Urea & uric acid
  • Gases (foetal O2 stores are small so maintenance of
    adequate flow is essential)
32
Q

What materials are transported via Facilitated Diffusion between mother and foetus?

A

Glucose

33
Q

What materials are transported via Active Transport between mother and foetus? (3)

A
  • Specific “transporters” expressed by the
    syncytiotrophoblast
  • Amino Acids
  • Iron
  • Vitamins
34
Q

How is Passive Immunity passed from mother to foetus? What Ig specifically?

A
  • Receptor-mediated transport process
  • IgG
35
Q

The Placenta is also involved in metabolism, what substances does it synthesis? (3)

A
  • Glycogen
  • Cholesterol
  • Fatty acids
36
Q

Why does the placenta synthesise glycogen?

A

Storage of maternal glucose for transfer to foetus later as necessary

37
Q

Why does the placenta synthesise cholesterol?

A

It is a precursor for oestrogen and progesterone

38
Q

What steroid hormones does the placenta produce? (2)

A
  • Oestrogen
  • Progesterone
39
Q

What protein hormones does the placenta produce? (4)

A
  • Human Chorionic Gonadotrophin (hCG)
  • Human Chorionic Stomatomammotrophin
  • Human Chorionic Thyrotrophin
  • Human Chorionic Corticotrophin
40
Q

What is a molar pregnancy (hydatidiform mole)?

A
  • A gestational trophoblastic disease (GTD), which
    originates from the placenta and can metastasise
  • It is unique in that the tumour originates from
    gestational tissue rather than from maternal tissue
41
Q

What is a choriocarcinoma?

A

A malignant, fast-growing tumour that develops from trophoblastic cells

42
Q

What effect does placental progesterone have on maternal metabolism?

A

Causes increased appetite

43
Q

What effect does hCS/hPL have on maternal metabolism?

A

Increases glucose availability to foetus by switching mother from glucose to fatty acid metabolism

44
Q

What effects does Relaxin have on the mother? (4)

A
  • Increases flexibility of pubic symphysis
  • Increases size of pelvis
  • Suppresses oxytocin release thereby preventing
    premature labour
  • Causes dilation of cervix before delivery
45
Q

Dysfunctions in Implantation: Ectopic Pregnancy

A

Implantation at site other than uterus (most commonly fallopian tubes)

46
Q

Dysfunctions in Implantation: Complication of Lower Uterine Implantation (3)

A
  • Placenta Praevia (placenta attaches in the lower part
    of your uterus, sometimes completely covering the
    cervix)
  • Haemorrhage in Pregnancy or during Birth
  • Require C-section
47
Q

Dysfunctions in Placental Invasion

A

Inadequate invasion of trophoblasts to reach the maternal vessels

48
Q

What teratogens can access the foetus via the placenta? (5)

A
  • Thalidomide
  • Alcohol
  • Therapeutic drugs
  • Drugs of abuse
  • Maternal smoking
49
Q

What is haemolytic disease of the newborn?

A

Occurs when the immune system of the mother sees a baby’s RBCs as foreign, Rhesus blood group incompatibility of mother and foetus

50
Q

What maternal systems/physiological change during pregnancy? (6)

A
  • Cardiovascular System
  • Urinary System
  • Respiratory System
  • Metabolic Changes
  • Gastrointestinal System
  • Immune System
51
Q

What happens to blood volume during pregnancy?

A

It Increases

52
Q

Is BP affected by pregnancy?

A

Systolic BP is never normally increased in pregnancy

53
Q

What is Pre-eclampsia?

A

Having high blood pressure (hypertension) and protein in your urine (proteinuria) during pregnancy

54
Q

How is Pre-eclampsia treated?

A

Deliver the baby

55
Q

What is Eclampsia?

A

Eclampsia is unexplained generalised seizures in patients with preeclampsia

56
Q

What changes occur in the urinary system during pregnancy? (7)

A
  • Glomerular filtration rate (GFR) increases
  • Renal plasma flow increases
  • Filtration capacity intact
  • Functional renal reserve decreases as GFR increases
  • Increased kidney volume
  • Ureter dilation
  • Increased bladder capacity
57
Q

What happens to cardiac output, stroke volume,
heart rate in pregnancy?

A

Increases

58
Q

What happens to systematic vascular resistance and
blood pressure in pregnancy?

A

Decreases

59
Q

What happens to the subcostal angle during pregnancy?

A

Increases

60
Q

What increases in the respiratory system during pregnancy? (3)

A
  • Subcostal Angle
  • Anterior-Posterior and Transverse Diameters of the
    Chest Wall
  • Chest Wall Circumference
61
Q

What provides substrate for maternal metabolism, leaving glucose for the foetus?

A

Free fatty acids

62
Q

What is Gestational Diabetes?

A

Occurs when your body can’t make enough insulin during your pregnancy, thus increased blood sugar levels

63
Q

Effects of Gestational Diabetes on Baby

A
  • Baby being very large
  • Being born early
  • Having low blood sugar after birth
64
Q

Effects of poorly controlled Gestational Diabetes on Baby (3)

A
  • Congenital Defects
  • Developing type 2 diabetes later in life
  • Having low blood sugar after birth (baby will have
    hyperinsulin due to mother’s diabetes)
65
Q

Pregnancy is a pro-thrombotic state, what does this increase risk of? (4)

A
  • VTE/DVT
  • PE
  • Heart Attack
  • Stroke
66
Q

Why can Anaemia occur in Pregnancy?

A

If you don’t have enough iron stores or folate, you could develop iron deficiency anaemia

67
Q

Effects of pregnancy related anaemia on foetus (2)

A
  • Increases the risk of premature birth
  • Baby may not grow as much as it should
68
Q

What are the diagnostic criteria for pre-eclampsia (3)

A
  • Thrombocytopenia
  • Proteinuria
  • Hypertension

The Reproductive System (19 decks)

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