PLACENTAL AND FETAL MEMBRANES Flashcards
Remant of follicle
corpus luteum
-granulosa cell
-theca cell
maintains pregancy that is less than 8 weeks
corpus luteum
Process wherein the corpus luteum develops from the remains of the graafian follicle.
LUTEINIZATION
endometrium in pregnancy
DECIDUA
ensures success of the pregnancy semi allograft.
- Estrogen
- progesterone
- androgens
- NK cells
If the pregnancy continues, the lining of the endometrium continues to thicken to ___ and is seen in ultrasound.
1 cm
This is where the placenta is formed
○ Decidua directly beneath the implanted blastocyst modified by trophoblast
DECIDUA BASALIS
Overlies the enlarging blastocyst and
initially separates the conceptus from the
rest of the uterine cavity
DECIDUA CAPSULARIS
remainderof the uterus
DECIDUA PARIETALIS
composed of zonacompacta and zona spongiosa
ZONA FUNCTIONALIS
A middle portion or spongy zone
- Has remnants of glands and
numerous small blood vessels
ZONA SPONGIOSA
Basal zone
- Remains after delivery and gives
rise to new endometrium
- Not sloughed off.
ZONA BASALIS
contributes to formation of the placental basal plate
- becomed the bed of placenta
DECIDUA BASALIS
- zone of fibrinoid degeneration in
which invading trophoblast meet the decidua basalis - important because if it’s not intact, the placenta will penetrate the uterine wall leading to placenta acute syndrome.
-After delivery, this wil detach from the decidua.
NITABUCH LAYER
placenta is adhered to the decidua
PLACENTA ACCRETA
placenta is adhered to the myometrium
PLACENTA INCRETA
placenta is adhered to the perimetrium
○ It causes postpartum hemorrhage.
○ CS hysterectomy will be performed to
deliver the placenta
PLACENTA PERCRETA
Must take place within a few hours, and no more than a day after ovulation.
FERTILIZATION
Thick glycoprotein layer surrounding the
oocyte membrane.
ZONA PELLUCIDA
A diploid cell with 46 chromosomes
ZYGOTE
zygote cells undergoes cleavage
BLASTOMERES
division reaches the 16 cell stage
MORULA
58cells
morula travel through a ciliary movement going to the endometriumand wil become ____
BLASTOCYST
Destined to form trophoblasts
○ Remaining 53 outer cells of the blastocyst
TROPHECTODERM
Immunomodulatory actions and proangiogenic actions required for implantation.
Colony-stimulating factor-1 (CSF-1)
Blastocyst implants into the uterine wall ______ DAYS after fertilization.
6-7
stages of Implantation
(H- A- A- I)
HATCHING
APPOSITION
ADHESION
INVASION
- a very important organ in pregnancy because this is the organ of transfer from the mother to the fetus.
- depends for depends on the placenta for pulmonary, hepatic, and renal functions.
PLACENTA
Human placental formation begins with the ______ which gives rise to a trophoblast cell layer encircling the blastocyst.
TROPHECTODERM
- outer mononucleated syncytium
and provides transport functions
of the placenta. - Has an amorphous cytoplasm
without cell borders.
Syncytiotrophoblast
- inner layer of primitive mononuclear cells.
- It has synctin which is an endogenous envelope protein which aids in cell fusion with the expanding outer layer of the syncytiotrophoblast.
Cytotrophoblast
Gives rise to the chorionic villi, which primarily transport oxygen, nutrients, and other compounds between the fetus and mother.
Villous trophoblast
Migrate into the decidua and myometrium and also penetrate maternal vasculature and directly contact various maternal cell types.
Extravillous trophoblasts
invade the decidua (endometrium of pregnancy) and eventually penetrate the myometrium to form placental-bed giant cells. Surround spiral arteries.
Interstitial trophoblast:
penetrate the spiral artery lumens.
Endovascular trophoblast:
Types of Extravillous trophoblasts
- Interstitial trophoblast
- Endovascular trophoblast
Group of isolated cells in the blastocyst cavity, which later on lines the cavity.
EMBRYONIC MESENCHYME
A chorionic cavity formed by spaces fused within the extraembryonic mesoderm.
EXTRAEMBRYONIC COELOM
Composed of trophoblast and mesenchyme.
CHORION
Formed from the stalk.
UMBILICAL CORD
When angiogenesis is not established in the mesenchymal cords.
HYDATIDIFORM MOLE
○ 3 distinguishing microscopic characteristics seen in HYDATIDIFORM MOLE
- Hyperplasia of trophoblastic cells
- Hydropic swelling of villi
- Absent vessels
○ Formed by the cytotrophoblast proliferation at the villous tips producing the trophoblastic cell columns
○ Not invaded by the fetal mesenchyme
○ Anchored to the decidua at the basal plate
(maternal oriented)
ANCHORING VILLI
mode of exchange/connection of baby and the mother.
PLACENTA
directly connects to the decidua/uterus
CHORION
chorion and amnion. Important
for the pregnancy to advance.
FETAL MEMBRANES
___Viewed from the maternal surface, slightly elevated convex areas vary from____
-PLACENTAL LOBES
-10 TO 38
● Fetal macrophages (very important because it increases the resistance of the baby).
● Nearly round with vesicular, often eccentric nuclei and very granular or vacuolated cytoplasm
● Important mediators of protection at the maternal-fetal interface
HOFBAUER CELLS
- Attacks Hofbauer cells allowing fetal transmission.
- Mosquito-borne flavivirus.
- Birth defects: fatal brain condition
and microcephaly.
ZIKA VIRUS
By __weeks’ gestation, the apparent continuity of the cytotrophoblast is lost.
16
carries oxygenated blood going to the ductus venosus
UMBILICAL VEIN
carries deoxygenated blood
UMBILICAL ARTERY
fetal circulation
AVA
2 - arteries
1 - vein
mechanisms of placental transfer
Molecular mass less than 500 Da-pass readily through placental tissue by
SIMPLE DIFFUSION
Most common source of environmental
cadmium
CIGARETTE SMOKE (cross placenta)
● A tough and tenacious but pliable membrane
● Provides almost all tensile strength of the fetal
membranes
AMNION
● Its resistance to rupture is vitally important to
successful pregnancy outcome..
● Lacks smooth muscle cells, nerves. lymphatics, and importantly, blood vessels.
AMNION
10 mL per week at 8 weeks
60 mL per week at 21 weeks
peaks at 34 weeks
AMNIOTIC FLUID FORMATION
1L - normal
● Serves to cushion the fetus, allowing musculoskeletal development and protecting it from trauma.
● Maintain temperature.
● Minimal nutritive function.
AMNIOTIC FLUID
Amnion tensile strength is regulated in part by fibrillar collagen assembly. This process is influenced by the interaction of fibrils with proteoglycans such as __ and __
BIGLYCAN
DECORIN
The _____ projects into the base of the body stalk from the caudal wall of the yolk sac and later, from the anterior wall of the hindgut.
ALLANTOIS
Produced in placenta
ESTROGENS
PROGESTERONES
produced by the maternal adrenal in response to the stimulus of angiotensin II.
ALDOSTERONE
production during pregnancy is not increased, even though the blood levels are elevated because of decreased clearance caused by increased cortisol-binding globulin.
CORTISOL
Maintains corpus luteum function
Regulates fetal testis testosterone secretion Stimulates maternal thyroid
Human chorionic gonadotropi n (hCG)
Aids maternal adaptation to fetal energy requirement s
Placental lactogen (PL)
Relaxes smooth muscle;
initiates parturition?
Promotes fetal and maternal glucocorticoid production
Corticotropin -releasing hormone (CRH)
Regulates trophoblast hCG production
Gonadotropi n-releasing hormone (GnRH)
Regulates transfer of calcium and other solutes; regulates fetal mineral homeostasis
Parathyroid- releasing protein (PTH-rp)
Regulates placental GnRH synthesis
ACTIVIN
Potentially inhibits FSH-mediat ed ovulation; regulates hCG synthesis
INHIBIN
combined hCG molecule is detectable in plasma of pregnant women _ to _ days after the midcycle surge of LH that precedes ovulation
7 to 9 days
Plasma levels rise rapidly, doubling every _days in the first trimester
two (2)
on _____, you may request plasma hCG to determine if you are pregnant. Plasma NOT Urine.
DAY 21
major precursor of estrogen in pregnancy
DHEA-S
- The process wherein the corpus luteum develops from the remains of the graafian follicle is referred to as
a. Ovulation
b. Luteinization
c. Zygote
d. Fertilization
b. Luteinization
- This is called the highly modified endometrium of pregnancy. a. Follicular Phase
b. Decidua
c. Luteal phase
d. Corpus Basalis
b. Decidua
- After delivery of the placenta, this layer remains and gives rise to new endometrium:
a. Zona compacta
b. Zona spongiosa
c. Zona functionalis
d. Zona basalis
d. Zona basalis
- This is a zone of fibrinoid degeneration in which invading trophoblasts meet the decidua basalis. It is usually absent in cases such as Placenta Accreta which can cause postpartum hemorrhage:
a. Rohr Stria
b. Decidua Vera
c. Nitabuch layer
d. Extravillous Trophoblast
c. Nitabuch layer
- Fertilization normally takes place in the fallopian tube lumen within:
a. Few hours and after a day of ovulation
b. Few hours and no more than a day after ovulation
c. Few hours and after 2 days of ovulation
d. Few hours and after 3 days of ovulation
b. Few hours and no more than a day after ovulation
- Fertilization is highly complex. Molecular mechanisms allow spermatozoa to pass between cumulus cells; through the _____________, which is a thick glycoprotein layer surrounding the oocyte cell membrane; and into the oocyte cytoplasm.
a. Zona compacta
b. Zona basalis
c. Zona pellucida
d. Zona vera
c. Zona pellucida
- Fertilization or fusion of the two nuclei and intermingling of maternal and paternal chromosomes creates the.
a. Blastomeres
b. Zygote
c. Morula
d. Blastocyst
b. Zygote
- After fertilization, a thick cell with 48 chromosomes undergoes cleavage, and cells produced by this division are called ___________; it undergoes slow cleavage for 3 days while still in the fallopian tube.
a. Blastomeres
b. Zygote
c. Morula
d. Blastocyst
a. Blastomeres
- As early as 4-5 days after fertilization, the 58-cell blastocyst differentiates into the inner cell mass and trophectoderm. The trophectoderm is destined to form the:
a. Embryo
b. Trophoblast
c. Amnion
d. Chorion
b. Trophoblast
- The blastocyst implants into the uterine wall 6 or 7 days after fertilization. This process can be divided into these phases in order.
a. Adhesion, Apposition, Invasion
b. Hatching, Adhesion, Apposition
c. Apposition, Adhesion, Invasion
d. Hatching, Adhesion, Invasion
c. Apposition, Adhesion, Invasion
- This is the organ of transfer from mother to fetus. The fetus depends on it for pulmonary, hepatic, and renal functions.
a. Umbilical Cord
b. Amniotic Fluid
c. Chorion
d. Placenta
d. Placenta
- Following implantation, trophoblasts differentiate along two main pathways that give rise to either Villous or extravillous trophoblasts. These trophoblasts generate chorionic villi, which primarily transport oxygen, nutrients, and other compounds between the fetus and mother.
a. Villous trophoblasts
b. Extra Villous trophoblasts
c. Interstitial trophoblasts
d. BandC
a. Villous trophoblasts
- Following implantation, trophoblasts differentiate along the main pathways that give rise to either villous or extravillous trophoblasts. These trophoblasts migrate into the decidua and endometrium and penetrate maternal vasculature:
a. Villous trophoblasts
b. Extra Villous trophoblasts
c. Interstitial trophoblasts
d. BandC
b. Extra Villous trophoblasts
- This is a tough and tenacious but pliable membrane. This innermost avascular fetal membrane is contiguous with amniotic fluid and provides almost all of the tensile strength of the fetal membranes. Its resilience to rupture is vital to successful pregnancy outcome
a. Chorion
b. Placenta
c. Amnion
d. Zona pellucida
c. Amnion
- This is a pathology of the chorionic villi when angiogenesis is not established in the mesenchymal cords.
a. Hydatidiform mole
b. Ectopic pregnancy
c. Spontaneous Abortion
d. Placenta Accreta
a. Hydatidiform mole
- What artery does the endovascular extravillous trophoblast invade to increase vessel diameter?
a. Arcuate Arteries
b. Radial Arteries
c. Basal Arteries
d. Spiral Arteries
d. Spiral Arteries
- The following consists the fetal membrane, EXCEPT:
a. Amnion
b. Umbilical Cord
c. Placenta
d. Chorion
b. Umbilical Cord
- The umbilical cord has:
a. 2 veins, 1 artery
b. 2 arteries, 2 veins
c. 1 artery, 1 vein
d. 2 arteries, 1 vein
d. 2 arteries, 1 vein
- In the fetal circulation, this vessel carries oxygenated blood to the fetus:
a. Umbilical Artery
b. Umbilical Vein
c. Both A & B carries oxygenated blood
d. Spiral Arteries
b. Umbilical Vein
- The umbilical cord extends from the fetal umbilicus to the fetal surface of the placenta. The fetal surface of the placenta is called:
a. Basal Plate
b. Decidua Basalis
c. Chorionic Plate
d. Amnion
d. Amnion
- Plasma b-Hcg is detectable in pregnant women _____________ after the midcycle LH surge preceding ovulation.
a. 7to9days
b. 14 days after ovulation
c. First day of missed menses
d. 4 weeks
a. 7to9days
- In intrauterine pregnancy, plasma b-Hcg levels rise rapidly, doubling approximately every ______________ during the first trimester:
a. Day
b. 2 days
c. 3 days
d. 4 days
b. 2 days
- This hormone maintains the corpus luteum function in the first trimester
a. Progesterone
b. HPL
c. CRH
d. b-HCG
d. b-HCG
- Maternal blood enters through the ___________ and is driven up toward the _________ by maternal arterial pressure and disperse laterally to bathe the chorionic villi.
a. Chorionic plate, basal plate
b. Basal plate, chorionic plate
c. Decidua, umbilical cord
d. Intervillous space, fetus
b. Basal plate, chorionic plate
- Oxygen, Carbon dioxide, anesthesia readily pass through placental tissue by
a. Simple Diffusion
b. Facilitated diffusion
c. Osmosis
d. Trophoblast receptor mediated esta
a. Simple Diffusion
