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Embryology > Placenta > Flashcards

Placenta Flashcards

1
Q

Human placenta is hemochorial, which means-

A

Maternal blood comes in direct contact with the chorion

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2
Q

What is the fetal and maternal component of the placenta?

A

fetal- villous chorion

Maternal- decidua basalis

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3
Q

The fetal surface of the placenta is characterized by

A

vascular chorionic plate covered by amnion; appears smooth and grayish

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4
Q

The umbilical cord contains

A

2 umbilical arteries and 1 umbilical vein

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5
Q

What are the umbilical arteries and vein surrounded by?

A

Wharton’s jelly (mucous connective tissue)

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6
Q

Since umbilical vessels are longer than the cord, they twist around each other and bend forming

A

false knots

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7
Q

What is the decidua

A

endometrium of the uterus in a pregnant woman

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8
Q

What are the 3 regions of the decidua

A

Decidua basalis- part deep to the conceptus that forms the maternal part of placenta
Decidua capsularis- superficial part overlying conceptus
Decidua parietalis- all the reamining parts

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9
Q

Maternal side of the placenta has 15-20 compartments called

A

cotyledons separated by placental septa

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10
Q

Fetal component of the placenta is derived from the

A

trophoblast and extraembryonic mesoderm, forming the villous chorion

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11
Q

What are the 3 stages of chorionic villi development

A

primary villi, secondary villi, and tertiary villi

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12
Q

Cytotrophoblast cells penetrate through the synctiotrophoblast and reach the decade and form

A

the cytotrophoblast shell

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13
Q

What does the cytotrophoblast shell do

A

firmly attaches chorion to the endometrium.

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14
Q

What are villi that extend from the chorionic plate to the decidua basalis

A

Stem (anchoring) villi

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15
Q

What branches from the sides of the stem villi and represent sites where nutrient and gas exchange will occur?

A

Terminal (free; branch) villi

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16
Q

What is the placental membrane?

A

It separates the maternal blood from fetal blood

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17
Q

By month 4, what are the 4 layers of the placental membrane

A

Synctiotrophoblast, cytotrophoblast, extraembryonic mesoderm, and fetal endothelium

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18
Q

At the beginning of month 4, the cytotrophoblast degenerates leaving what 2 layers

A

Synctiotrophoblast and fetal endothelium

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19
Q

In the 3rd trimester, what becomes very thin

A

syncytiotrophoblast

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20
Q

What covers the surface of the chorion prior to week 8

A

Villi

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21
Q

As pregnancy progresses, the villi proliferate to form the

A

chorionic frondosum (bushy chorion)

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22
Q

Chorionic villi on the ab-embryonic pole degenerate and form __ by the end of month 3.

A

smooth chorionic laeve

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23
Q

When can you conduct chorionic villus sampling

A

10-12 weeks

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24
Q

What cells spread and form the lining of the amnion

A

epiblast cells

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25
Q

The amnion encloses the entire embryo by

A

week 8

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26
Q

The amnion becomes continuous with the skin at the attachment of the umbilical cord to the fetus to

A

cover the umbilical cord and placenta

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27
Q

What are the functions of the amniotic fluid?

A 
allows for fetal movements;
Prevents adherence between amnion and embryo;
shock absorber;
barrier to infection;
promotes lung development.
28
Q

What is the amniotic fluid volume at 10 weeks vs term

A

10 weeks- 30mL

37 weeks- 1000 mL

29
Q

What is the “water-bag” that breaks prior to delivery of the baby?

A

amnio-chorionic membrane

30
Q

How is the amnio-chorionic cavity formed?

A

The amnion pushes against the chorion and the chorionic cavity is obliterated so the amnion lies against the chorionic laeve

31
Q

What is an amniocentesis

A

hollow needle is inserted through the mothers abdomen into the uterus and amniotic fluid is drawn for analysis

32
Q

What is amniotic band syndrome

A

There are tears in the amnion that may result in amniotic bands that encircle fetal limbs or digits resulting in deformations

33
Q

What is polyhydramnios and what is it correlated with

A

excess amniotic fluid; maternal diabetes and disorders of the central nervous system and GI tract that prevents fetus from swallowing.

34
Q

What is oligohydramnios and what is it linked to

A

too little amniotic fluid; may result from failure of the kidneys to form.

35
Q

What is oligohydramnios a risk factor of

A

lung hypoplasia (lung underdevelopment)

36
Q

What are the functions of the placenta?

A 
Acts as an organ of exchange between maternal and fetal tissues;
Produces hormones (progesterone, hCG, human placental lactogen=somatomammotropin)
Serves as an immunological barrier
37
Q

What beneficial substances can cross the placenta?

A 
Oxygen and CO2
glucose, amino acids, etc.
Water, ions, etc.
Urea, uric acid, bilirubin
Maternal serum proteins
unconjugated steroid hormones
IgG, IgA
38
Q

What harmful substances can cross the placenta?

A

Viruses (rubella, CMV, herpes simplex type 2, measles, polio), toxoplasma gondii, and troponema pallidum (only bacteria that can cross).
Category X drugs (absolute contraindication in pregnancy; thalidomide, coumadin, alcohol, etc.)
Category D drugs (definite risk to fetus; tetracycline, valium, etc.)
Carbon monoxide, mercury, lead, cocaine, heroin, rubella virus vaccine, anti Rh antibodies)

39
Q

What substances do not cross the placenta

A

Maternally derived cholesterol, triglycerides, phospholipids.
Protein hormones- insulin
IgD, IgE, IgM

40
Q

Umbilical arteries and veins carry what

A

arteries: deoxygenated blood toward placenta
Vein: oxygenated blood toward fetus

41
Q

What is a newborns blood volume?

A

300 cc/mL

42
Q

The inner sac is the __ and outer sac is the __

A

amnion; chorion

43
Q

After 10 weeks amnion pushes out and

A

fuses with chorion

44
Q

What is delivery en caul?

A

sac is intact

45
Q

What are the metabolic functions of the placenta?

A

glycogen for fetus and cholesterol

46
Q

When is Rh disease a problem

A

Rh - mom and Rh + baby

47
Q

How to prevent Rh disease?

A

Give rhogam at 28 weeks, after baby is born if its Rh +, and after any bleeding in pregnancy

48
Q

Up to how many hours does rhogam work after bleeding?

A

72 hours

49
Q

What can cause postpartum hemorrhage?

A

leaving cotyledons behind after delivery

50
Q

What does marginal insertion (battledore) placenta cause

A

fetus may be small

51
Q

What occurs in membranous or velamentous insertion

A

cells can be kink, may result in non reassuring fetal heart tracing

52
Q

What is vasa previa

A

accessory placental lobe has vessels running across the internal opening of the cervix

53
Q

Why should you deliver vasa prevue babies early

A

If water breaks, vessels may rupture and baby can rapidly exsanguinate

54
Q

What is placenta previa?

A

Whole placenta is covering the opening of the cervix

55
Q

What is placenta accreta

A

placenta attaches too strongly to uterine muscle, or myometrium

56
Q

What is placenta increta

A

placenta invades into myometrium

57
Q

What is placenta percreta

A

placenta invades through myometrium to bowel, bladder

58
Q

What is abruption

A

Premature separation; babys oxygenation ceases and blood lost is fetal blood

59
Q

What causes abruption

A

cocaine, high BP, trauma

60
Q

Cleavage of morula in days 1-3 results in

A

dichorionic/diamniotic

61
Q

Cleavage of blastocyst in days 4-8

A

monochorionic/diamniotic

62
Q

Cleavage of implanted blastocyst in days 8-13

A

Monochorionic/monoamniotic

63
Q

Cleavage of formed embryonic disc in days 13-15

A

conjoined twins

64
Q

What is twin-twin transfusion syndrome?

A

if monochorionic, artery of one fetus can connect to vein of other, and blood from one baby flows to the other

65
Q

What happens to the fetuses in twin-twin transfusion

A

Donor: growth restricted, minimal fluid
Recipient: fluid overload

Embryology (5 decks)

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