- cells of the endometrial connective tissue which swell because of the accumulation of glycogen and lipid in their cytoplasm (provide nutrition for the early embryo)

Placenta & Fetal Membranes Flashcards by asope sokan

What are the Fetal Membranes?

Chorion
- Amnion
- Umbilical Vesicle
- Allantois

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The placenta is the primary site for what process?

nutrient and gas exchange between mother and fetus

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What are the 2 parts of the placenta?

What do they develop from?

A fetal part = develops from the chorionic sac
A maternal part = derived from the endometrium

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What are the functions of the placenta?

Protection
Nutrition
Respiration
Excretion
Hormone Production
Metabolism
Endocrine secretion (hCG)

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What is the functional layer of the endometrium that separates from the rest of the uterus at birth called?

gravid endometrium

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what is the process of seperating the gravid endometrium from the rest of the uterus called?

parturition

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What is the decidua?

cells of the endometrial connective tissue which swell because of the accumulation of glycogen and lipid in their cytoplasm
(provide nutrition for the early embryo)*

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What are the 3 regions of the decidua and what do they form?

*Decidua basalis** = forms the maternal placenta.
*Decidua capsularis** = overlies the conceptus.
*Decidua parietalis** = all the remaining parts of the decidua

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As the fetus grows, which 2 decidual layers will eventully fuse together?

What is this called?

- capsularis will eventually fuse with **parietalis **

they form the “decidua vera”

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decidual cells are large pale-staining connective tissue cells.

What do they form in response to?

increasing progesterone levels in the maternal blood

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The decidual reaction, refers to ….?

cellular and vascular changes in the endometrium as the blastocyst implants

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Development of the placenta is characterized by what 3 things?

fast proliferation of the trophoblast
development of the chorionic sac
development of chorionic villi

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By the end of week 3, what structures are established?

the anatomic structures needed for physiological exchanges between mother and embryo

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What (structure) is evident by the end of week 4?

a complex vascular network

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Chorionic villi cover the entire chorionic sac until the beginning of what week?

week 8

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As the chorionic sac grows, what area forms?

Why/how does this occur?

the** smooth chorion** forms

As the sac grows the villi associated with the decidua capsularis are compressed, reducing the blood supply to them, causing them to degenerate

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Chorionic villi associated with what decidua layer increase in number, branch profusely, and enlarge?

What area does this form?

decidua basalis

this forms the villous chorion

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How many hormones are produced by the placenta?

Name at least 1 and its function.

7 - 8 hormones

relaxin = helps cervix relax during vaginal delivery

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Where do the primary chorionic villi begin forming?

in syncytotrophoblast and surrounding the embryo

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The placenta grows in size and thickness until week ______?

week 20

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What is the weight of a fully developed placenta?

300 to 700 grams

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When is the decidua basalis is replaced by the fetal part of the placenta?

By the end of the fourth month

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At the time of birth, the placenta will usually detach within ___________ after the baby is delivered.

The maximun time should be up to __________.

20 minutes
1 hour

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What 4 things should a physician note about the placent upon delivery?

its weight
its measurements
length of umbilical cord
implantation of umbelical cord (should be central)

What attaches the fetal part of the placenta to the maternal part?

cytotrophoblastic shell ## Footnote *(external layer of trophoblastic cells on the maternal surface of the placenta)*

What happens as the chorionic villi invade the decidua basalis?

- decidual tissue is eroded to enlarge the intervillous space - this erosion produces wedged-shaped areas of decidua

wedged-shaped areas of decidua are called...?

**placental septa**

The placental septa divide the fetal part of the placenta into **irregular convex areas **called what?

**cotyledons**

the decidua basalis is replaced by the cotyledons by what time?

the end of **month 4**

By 22 to 24 weeks the blood supply to the decidua capsularis is reduced. What does this cause?

causes the decidua capsularis to degenerate and disappear

After the decidua capsularis is gone, what 2 structures fuse together?

the **smooth part of the chorionic sac** fuses with the **decidua parietalis**

How is the fusion between the chorionic sac and the decidua parietalis separated?

- separated when blood escapes from the intervillous space. - collection of blood **(hematoma)** pushes the chorionic membrane away from the decidua parietalis.

What happens when a hematoma occurs that seperates the baby form the placenta in-utero?

- the baby will die - must remove the placents/conceptus to stop the bleeding - focus is to save mother

How much blood loss is normal after a full delivery (birth)?

approximately 1 Litre, or 1 pad every 3-4 hours

What happens if the membranes remain inside the mother after delivery?

- heavy bleeding can continue - hemmoraging can occur - potential **maternal death** if bleeding isn't stopped

What do the Intervillous spaces of the placenta contain? When were these formed?

- **maternal blood** derived from the **lacunae** - formed in the syncytiotrophoblast **during week 2**

How/where does the maternal blood enter the intervillous space?

through **spiral endometrial arteries** in the _decidua basalis_ *(spiral arteries pass through gaps in the cytotrophoblastic shell and discharge blood into the intervillous space)*

Endometrial veins...

... help drain the intervillous space ## Footnote *(penetrate through the cytotrophoblastic shell)*

branched chorionic villi...

... are showered with maternal blood ## Footnote *(circulates through the intervillous space)*

The maternal blood contains...

**- oxygen and nutritional materials** *(important for fetal growth and development)* ** - fetal waste products** *(i.e. carbon dioxide, salts, and products of protein metabolism)*

**Primary chorionic villus** 1. time of development 2. structures 3. surrounded by...

1. during **week 2** 2. consists of a core of **cytotrophoblastic cells** 3. surrounded by **syncytiotrophoblast**

**Secondary chorionic villus** 1. time of development 2. structures 3. surrounded by...

1. during the start of **week 3** 2. Consists of a core of **extraembryonic mesoderm** 3. surrounded by **cytotrophoblastic cells and syncytiotrophoblast**

**Tertiary chorionic villus** 1. time of development 2. structures 3. surrounded by...

1. end of **week 3** 2. Consists of a core of **villous (fetal) capillaries** 3. surrounded by **cytotrophoblastic cells and syncytiotrophoblast**

Chorionic Villi Classifications

Primary, Secondary, Tertiary

Which 2 structures fuse to form the amniochorionic membrane? What happens to this during labor?

**amnion** and **smooth chorion** fuse - membrane ruptures during labour - "water breaking"

Preterm rupture of the amniochorionic membrane (amniotic cavity) is the most common cause of what?

**premature labor** (amniotic fluid escapes through the cervix and vagina0

What is the usual dialation present at the normal rupture of the amniotic cavity? "water breaking"

9 cm dialated

What position should the mother be in after her water breaks? Why?

**Supine (laying down)** to avoid trauma from the baby's head hitting the pelvic bone

How does poorly oxygenated blood leave the fetus?

_passes through the umbilical arteries to the placenta_ (when the **umbilical cord joins the placenta**, these **arteries divide** into several chorionic arteries that **branch in the chorionic plate** before **entering the chorionic villi**)

What side of the fetal heart has a higher pressure? When does this change?

**right side** - changes to left side after birth (once baby breathes on its own)

Describe the maternal blood flow into the intervillous space from the spiral arteries.

- very fast - pulsatile - propelled in jetlike fountains - spurts toward the chorionic plate - flows **slowly over the branch villi **(metabolic gas exchange) - return to the maternal circulation through the endometrial veins

What is caused by a reduction in uteroplacental circulation?

**- fetal hypoxia**** ** ## Footnote **- intrauterine growth restriction (IUGR)**

**Placental Metabolism:** What is synthesized here?

nutrients for the embryo/fetus ## Footnote **- glycogen** **- cholesterol** **- fatty acids**

How are most materials transported across the placental membrane?

- Simple diffusion - Facilitated diffusion - Active Transport - Pinocytosis

What are Substances That Do Not Cross The Placental Membrane?

- Maternally-derived cholesterol, triglycerides, and phospholipids - Protein hormones (e.g., insulin) - Drugs (e.g., succinylcholine, curare, heparin, methyldopa, drugs similar to amino acids) - IgD, IgE, IgM - Bacteria in general

Each branched chorionic villi has \_\_\_\_\_\_\_\_\_\_\_\_?

- a venous and artery pair

What happens to the baby's heart rate suring vaginal delivery?

- during uterine contractions blood vessels in placents collapse/constrict - **baby’s HR changes (increases or decreases)** _need to monitor this_

What happens to the baby when the mother is **Rh negative** and the father is **Rh positive**?

1st pregnancy: Rh positive baby; nothing abnormal **2nd pregnancy**: Rh positive baby; **maternal immune system attacks fetus**