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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
Q

What is a missed miscarriage?

A

When a woman give signs that she is likely to have an impending miscarriage, but the condition resolves

26
Q

Plugs in spiral arteries also stop _____ to prevent placental damage)

A

Pulsatile flow (of maternal blood)

27
Q

What is a common finding in women with missed miscarriage?

A

Increased blood flow to the placenta (at weeks 7-9 or 10-11)

28
Q

What structural changes occur in the placenta with gestational age?

  • Early pregnancy
  • Second trimester
  • Third trimester
  • Villi
  • Size
A
  • 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
Q

What are the three anatomical components of the decidua?

A
  • Decidua basalis
  • Decidua capsularis
  • Decidua parietalis
30
Q

The amnion is a vascular/avascular membrane that covers the _____

A

Avascular

Back of placenta and umbilical cord

31
Q

The umbilical cord is formed from the ___ and ____

A

Yolk sac and allantois

32
Q

Wharton’s jelly is a network of contractile ______ interspersed with _____

A

Myofibroblasts

Mucopolysaccharides

33
Q

What is the difference between a false and true knot?

A

False knot = varicosity/ballooning of vessel

True knot = occlusion of vessels

34
Q

What is a nuchal cord?

A

When the umbilical cord becomes wrapped around the foetal neck 360 degrees

35
Q

When are umbilical cord knots pathologic?

A

When Wharton’s jelly is not functioning properly

36
Q

How is the placenta adapted to maximise surface area for exchange?

A
  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
Q

Foetal blood has a greater affinity for ____ due to Hbf (foetal haemoglobin)

A

Oxygen

38
Q

(Bohr Effect)

Foetal metabolites picked up by maternal blood cause pH to ____ therefore ____ affinity for oxygen

A

Lower

Decrease

39
Q

(Haldane effect)

Loss of oxygen from maternal blood causes ____ capacity for CO2

A

Increased

40
Q

What are the five functions of amniotic fluid?

A
  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
Q

Amniotic fluid is initially an ____ of ____ but then becomes predominantly ____

A

Ultrafiltrate of maternal plasma

Foetal urine

42
Q

Fluid leaves amniotic cavity mainly by ____ (500-1000mls/day)

A

Foetal swallowing

43
Q

Fluid can move across foetal skin (prior to keratinisation at ____ weeks)

A

24

44
Q

What is polyhydraminos?

A

Excessive amniotic fluid possibly due to loss of swallowing (found in many cases of diabetic pregnancy)

45
Q

What is oligohydraminos?

A

Lack of amniotic fluid (potentially due to kidney problems)

46
Q

Amniocentesis usually occurs at ___ weeks gestation whereas CVS usually occurs at ___ weeks

A

14-16

10

47
Q

After breaking off the placenta, where to syncytiotrophoblasts tend to deposit?

A

Lungs

48
Q

What is cell-free foetal DNA?

A

A short piece of DNA that comes from the trophoblast

49
Q

The placenta prevents the transmission of which infections?

A
  • Hepatitis B
  • Rabies
  • Measles
  • Malaria
50
Q

What preventative measure is taken with babies that have mothers who are Hep B positive?

A
  • Administered antiglobulin

- Hep B can be transmitted intrapartum

51
Q

The placenta permits transmission of which infections?

A
  • HIV
  • CMV
  • Smallpox and other related viruses
  • Rubella
  • Toxoplasmosis
52
Q

What is the critical period of organogenesis?

A

20-70 days after last menstrual period

53
Q

What consequence can thalidomide have in pregnancy?

A

Limb reduction defects

54
Q

What consequence can diethylstilbestrol have in pregnancy?

A

Clear cell adenocarcinoma in vagina or cervix of adults after in utero exposure

55
Q

What consequence can ethanol have in pregnancy?

A

Foetal alcohol syndrome

56
Q

What consequence can recreational drugs have in pregnancy?

A

Intrauterine growth restriction and developmental delay

57
Q

In pregnancy warfarin is swapped to ____

A

Aspirin

58
Q

What is betamethasone?

A

A glucocorticoid given to prevent respiratory distress syndrome

Reproduction, Development and Ageing (26 decks)

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