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Reproduction, Development and Ageing > Placenta > Flashcards

Placenta Flashcards

1
Q

What is pre-eclampsia?

A

A hypertensive disorder affecting only human pregnancies.

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2
Q

Why is pregnancy history important in evaluating risk of CVD?

A
  • Pre-eclampsia ~20 weeks inc. chance of death by cardiovascular complications
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3
Q

What are the five functions of the placenta?

A
  • Self maintenance/renewal
  • Exchange/transport/transfer
  • Separation
  • Protection from maternal infections
  • Protection from maternal immune system
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4
Q

___% of conceptions are lost

A

70

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5
Q

The villous _____ is a trophoblast is a trophoblast progenitor cell type found mainly in the first trimester underlying the ______

A

Cytotrophoblast

Syncitiotrophoblast

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6
Q

How is the syncitiotrophoblast formed?

A

Fusion of the villous cytotrophoblast

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7
Q

What is the extravillous cytotrophoblast?

A

Differentiated cells that have migrated out of the villous placenta towards the maternal tissues

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8
Q

What are the components of the chorion?

A
  • Extraembryonic mesoderm
  • Cytotrophoblast
  • Syncytiotrophoblast
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9
Q

What changes occur in the lacunar period of placental development?

A
  • Lacunae formation

- Trophectoderm protrusions extend into lacunae forming trabeculae

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10
Q

What changes occur in the villous period of placental development?

A
  • Primitive syncytium disappears
  • Primary villi formed (proliferation and invasion by cytotrophoblasts)
  • Lacunar system forms intervillous space
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11
Q

Around what day do secondary villi form in the placenta?

A

Day 14

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12
Q

Tertiary villi are formed in around days ____

A

18-20

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13
Q

What are the cell types present in a secondary villus?

A
  • Syncitiotrophoblast
  • Cytotrophoblast
  • Extraembryonic mesoderm
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14
Q

The intervillous space is the area between the ____ and the _____ of the placenta.

A

Chorionic plate

Decidua basalis

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15
Q

Conception happens around day ___ of the cycle

A

14

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16
Q

What is the chorion laeve?

A

Smooth chorion formed by regression of villi that lie to the sides and towards the uterine lumen

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17
Q

What is the chorion frondosum?

A

Definitive placenta formed by villi at the base of the implantation site

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18
Q

What is the difference between floating and anchoring villi?

A
  • Floating villi do not have contact with maternal tissues but are suspended in intervillous space
  • Anchoring villi attach placenta to uterus
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19
Q

Spiral arteries do not empty directly into the uterine cavity, they are connected by capillaries to _____.

A

Draining veins

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20
Q

Around mid-gestation spiral arteries are lined by ______

A

Endovascular trophoblasts

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21
Q

Which inadequate physiological changes may cause placental malperfusion?

A
  • Inadequate depth of trophoblast invasion

- Reduced number of vessels transformed

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22
Q

Small for Gestational Age babies are more likely to be born ____ or ____

A

Prematurely or still born

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23
Q

When does plugging of the spiral arteries occur?

A

Prior to mid-gestation

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24
Q

What is histiotrophic nutrition?

A

Nourishment of the foetus by glandular ‘milk’ during the first trimester

25
What is a missed miscarriage?
When a woman give signs that she is likely to have an impending miscarriage, but the condition resolves
26
Plugs in spiral arteries also stop _____ to prevent placental damage)
Pulsatile flow (of maternal blood)
27
What is a common finding in women with missed miscarriage?
Increased blood flow to the placenta (at weeks 7-9 or 10-11)
28
What structural changes occur in the placenta with gestational age? - Early pregnancy - Second trimester - Third trimester - Villi - Size
- Early pregnancy: stroma more cellular and more vascularised - Second trimester: villous cytotrophoblast thins down - Third trimester: villous cytotrophoblast is sparse - Villi: branching increases - Size: increases
29
What are the three anatomical components of the decidua?
- Decidua basalis - Decidua capsularis - Decidua parietalis
30
The amnion is a vascular/avascular membrane that covers the _____
Avascular | Back of placenta and umbilical cord
31
The umbilical cord is formed from the ___ and ____
Yolk sac and allantois
32
Wharton's jelly is a network of contractile ______ interspersed with _____
Myofibroblasts | Mucopolysaccharides
33
What is the difference between a false and true knot?
False knot = varicosity/ballooning of vessel True knot = occlusion of vessels
34
What is a nuchal cord?
When the umbilical cord becomes wrapped around the foetal neck 360 degrees
35
When are umbilical cord knots pathologic?
When Wharton's jelly is not functioning properly
36
How is the placenta adapted to maximise surface area for exchange?
1. Villous structure tortuous with a large SA 2. Syncytiotrophoblast has a microvillous surface 3. Third trimester most villi are small tertiary villi 4. Third trimester most foetal capillaries closely apposed to syncytiotrophoblast
37
Foetal blood has a greater affinity for ____ due to Hbf (foetal haemoglobin)
Oxygen
38
(Bohr Effect) Foetal metabolites picked up by maternal blood cause pH to ____ therefore ____ affinity for oxygen
Lower | Decrease
39
(Haldane effect) Loss of oxygen from maternal blood causes ____ capacity for CO2
Increased
40
What are the five functions of amniotic fluid?
1. Buoyant medium for symmetrical growth 2. Cushion for embryo/foetus 3. Prevent adhesions of foetus with membranes 4. Foetal movement -> muscle development 5. Development of respiratory and GI tracts
41
Amniotic fluid is initially an ____ of ____ but then becomes predominantly ____
Ultrafiltrate of maternal plasma | Foetal urine
42
Fluid leaves amniotic cavity mainly by ____ (500-1000mls/day)
Foetal swallowing
43
Fluid can move across foetal skin (prior to keratinisation at ____ weeks)
24
44
What is polyhydraminos?
Excessive amniotic fluid possibly due to loss of swallowing (found in many cases of diabetic pregnancy)
45
What is oligohydraminos?
Lack of amniotic fluid (potentially due to kidney problems)
46
Amniocentesis usually occurs at ___ weeks gestation whereas CVS usually occurs at ___ weeks
14-16 | 10
47
After breaking off the placenta, where to syncytiotrophoblasts tend to deposit?
Lungs
48
What is cell-free foetal DNA?
A short piece of DNA that comes from the trophoblast
49
The placenta prevents the transmission of which infections?
- Hepatitis B - Rabies - Measles - Malaria
50
What preventative measure is taken with babies that have mothers who are Hep B positive?
- Administered antiglobulin | - Hep B can be transmitted intrapartum
51
The placenta permits transmission of which infections?
- HIV - CMV - Smallpox and other related viruses - Rubella - Toxoplasmosis
52
What is the critical period of organogenesis?
20-70 days after last menstrual period
53
What consequence can thalidomide have in pregnancy?
Limb reduction defects
54
What consequence can diethylstilbestrol have in pregnancy?
Clear cell adenocarcinoma in vagina or cervix of adults after in utero exposure
55
What consequence can ethanol have in pregnancy?
Foetal alcohol syndrome
56
What consequence can recreational drugs have in pregnancy?
Intrauterine growth restriction and developmental delay
57
In pregnancy warfarin is swapped to ____
Aspirin
58
What is betamethasone?
A glucocorticoid given to prevent respiratory distress syndrome

Reproduction, Development and Ageing (26 decks)

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