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Antepartum > Placenta Physiology and Development > Flashcards

Placenta Physiology and Development Flashcards

1
Q

Functions of the Placenta

A

Metabolic- metabolizes glycogen, cholesterol, and fatty acids for energy

Endocrine- uses precursor molecules such as cholesterol, estrogen, or protein to synthesize both peptide and steroid hormones

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2
Q

Peptide hormones produced by placenta

A 
hCG
human placental lactogen (HPL)
ACTH
corticotrophin releasing hormone
relaxin
inhibin
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3
Q

Steroid hormones produced by placenta

A

estrogen

progesterone

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4
Q

What does relaxin do?

A 
quiets the myometrium
facilitates decidual reaction
remodels collagen
helps soften cervix
affect cartilage of maternal skeletal system
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5
Q

What does DHEA-S do?

A

essential precursor to placental synthesis of estrogen

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6
Q

What role does estrogen play in gestation?

A
  • Prepares the endometrium for pregnancy
  • stimulates phospholipid synthesis
  • enhances prostaglandin production
  • promotes uterine vasodilation
  • prepares breasts for breastfeeding
  • increases fetal lung surfactant production
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7
Q

What role does progesterone play in gestation?

A
  • Essential for preparation of the endometrium for implantation
  • maintains quiescent uterus
  • inhibits prostaglandin development
  • inhibits maternal cell-mediated immune system
  • reduces CO2 sensitivity in maternal resp. center
  • Inhibits prolactin secretion
  • relaxes maternal smooth muscle
  • causes increase in maternal temp
  • increases cervical mucus and formation of mucus plug
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8
Q

role of hCG

A

maintain corpus luteum
promotes vasodilation and relaxation of uterus
stimulates the male testicle to secrete testosterone
stimulates maternal thyroid
promotes secretion of relaxin

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9
Q

role of hPL

A

maternal lipolysis
increases maternal insulin resistance
angiogenesis
increases synthesis of lipids

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10
Q

role of Human Chorionic Adrenocorticotropin (ACTH)

A

promotes fetal lung maturation

plays role in timing of labor

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11
Q

role of corticotrophin-releasing hormone

A
  • Acts to increase ACTH secretion from trophoblast
  • causes smooth muscle relaxation in blood -vessels and uterus
  • facilitates maternal immunosuppression
  • near term contributes to genesis of labor
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12
Q

role of inhibin

A

acts with other hormones to decrease release of FSH, which stops ovulation

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13
Q

role of syncitiotrophoblast

A

the outer layer of blastocyst. sends out fingerlike extensions that take in uterine cells as it invades the endometrium

The syncytiotrophoblast cells secrete both peptide and steroid hormones important to the maintenance of pregnancy

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14
Q

role of cytotrophoblast

A

inner layer, secretes peptide hormones need for the pregnancy;
In early development, contains the embryo, amnion, and yolk sac

After the end of the 2nd wk, small projections of the cytotrophoblast extend into the syncytiotrophoblast to form primary chorionic villi

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15
Q

what are villous trophoblasts?

A

they give rise to the chorionic villi, which primarily transport oxygen, nutrients, and other compounds between the fetus and mother

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16
Q

what are extravillous trophoblasts?

A

migrate into the decidua and myometrium and also penetrate maternal vasculature, thus coming into contact with various maternal cell types

17
Q

Four main modes of transport for substances across the placental membrane

A

simple diffusion
facilitated diffusion
active transport
pinocytosis

18
Q

simple diffusion

A

movement from higher to lower concentration

  • gases
  • drugs
  • steroids
  • electrolytes
19
Q

facilitated diffusion

A

movement that needs a transporter but no energy

  • glucose
  • cholesterol
20
Q

active transport

A

movement against a concentration gradient that requires energy

  • amino acids
  • vitamins
  • transferrin
  • calcium
  • iodine
21
Q

pinocytosis

A

carrier molecule is required to engulf the molecule and move it across the placental barrier

igG

22
Q

Immunological status of placenta

A

Fetal semi-allograft survival may be explained by immunological neutrality

immunologically inert and therefore unable to create a maternal immune response

Villous trophoblast cells lack MHC class I and II antigens

23
Q

utero-placental circulation

A

two arteries and a vein
umbilical cord goes from fetus umbilicus to placenta

Deoxygenated venous-like fetal blood flows to the placenta through two umbilical arteries

Umbilical vein brings oxygenated blood, nutrients back to the fetus from the placenta

The umbilical vessels are contained with the cord and surrounded by wharton’s jelly, a gelatinous connective tissue

24
Q

What is aerobic metabolism?

A

energy production in the presence of oxygen

fetus uses glucose to convert to ATP

25
Q

What are the end products of aerobic metabolism?

A

CO2 and H2O

They rapidly diffuse across the placenta

26
Q

What is anaerobic metabolism?

A

energy production in the absence of oxygen or with insufficient oxygen
fetus converts glucose to ATP

27
Q

What is the end product of anaerobic metabolism?

A

lactic acid

slow to cross the placenta –> acidosis –> brain damage and damage to other organs in fetus

28
Q

Where does amniotic fluid come from?

A

Early gestation- secretions from the surface of the body of the embryo through intramembranous and transmembranous flow

Mid gestation- fetal urine begins to enter the amniotic sac and fetus begins to swallow AF. The fetal lungs also begin to secrete liquid into the AF

Late gestation- AF production from fetal urine and fetal lung liquid. Clearance comes from fetal swallowing and intramembranous pathway (pathway where water and solute exchange occurs directly between AF and fetal blood)

29
Q

What is normal amniotic fluid index (AFI)?

A

5-24 cm

30
Q

Volume of amniotic fluid throughout pregnancy

A 
30ml at 10wks  
200ml by 16 wks
400ml between 22-30wks
Reaches 800 ml by the mid-third trimester
Decline by 8% per week after 40 wks
31
Q

maintenance of amniotic fluid

A

Fetal Urine production

Fetal lung liquid secretion
(Approximately 50 percent of this fluid (170 mL/day) is swallowed and the remainder enters the AF compartment, which is the basis for fetal lung maturity testing)

Fetal swallowing

Intramembranous flow

Oral-nasal secretions

Transmembranous flow

32
Q

Functions of amniotic fluid

A

Protects the embryo/fetus from trauma to the maternal abdomen

Is a barrier to most bacteria; has some antibacterial properties

Provides the necessary fluid, space, and growth factors to permit normal development of the fetal lungs and musculoskeletal and GI systems

Allows for fetal movement and growth

Reflects fetal kidney function

Provides thermoregulation

It serves as a reservoir of fluid and nutrients for the fetus

Cushions the umbilical cord from compression between the fetus and uterus

Antepartum (2 decks)

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