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GIGU > Placental and Fetal Membranes > Flashcards

Placental and Fetal Membranes Flashcards

1
Q

What is a fetomaternal organ?

A

placenta

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2
Q

What is the fetal part of the placenta?

A 
chorionic sac (outermost fetal membrane)
-->more specifically, villous chorion that projects into intervillous space where maternal blood is
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3
Q

What is the maternal part of the placenta?

A

Decidua basalis

–>endometrium deep to fetus

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4
Q

What are examples of fetal membranes?

A

chorion
amnion
umbilical vesicle
allanosis

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5
Q

What are the extraembryonic structures that develop from trophoblast of blastocyst?

A

amnion
umbilical vesicle
connecting stalk
chorionic sac

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6
Q

When does the blastocyst become a bilaminar embryonic disc?

A

when implantation occurs

–>10 days post-fertilization

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7
Q

What are the 2 cell lineages in the blastocyst?

A

blastocyst is TOTIPOTENT

–>embryoblast (embryo)

–>trophoblast (extraembryonic tissue)

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8
Q

What is the fxnl layer of endometrium that separates from the remainder of the uterus after childbirth?

A

decidua

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9
Q

What part of the endometrium is deep to the fetus and forms the maternal part of the placenta?

A

decidua basalis

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10
Q

What part of the endometrium is superficial and overlies the fetus?

A

decidua capsularis

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11
Q

What part of the endometrium makes up the remaining decidua?

A

decidua parietalis

–>between capsularis and basalis

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12
Q

What is the decidual reaction?

A

cellular and vascular changes as the blastocyst implants

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13
Q

What does the trophoblast differentiate into as the blastocyst implants?

A

-Cytotrophoblast (inner layer)

  • Syncytiotrophoblast
  • —–>will invade and displace decidual cells of the endometrium to embed
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14
Q

Where do lacunae appear?

A

syncytiotrophoblast layer

–>will eventually fuse together and fill with blood and uterine secretions

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15
Q

What is the primordial uteroplacental circulation?

A

oxygen and nutritive substances pass to embryo via diffusion through lacunar networks

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16
Q

Give the timeline for implantation

A
  • Zona pellucida degen (Day 5)
  • Blastocyst adheres to endometrial epithelium (Day 6)
  • Trophoblast diff (day 7)
  • Blood-filled lacunae appear in syncitiotrophoblast (day 9)
  • Lacunar networks form via fusion (days 10-11)
  • Syncytiotrophoblast erodes endometrial BV to establish uteroplacental circulation (days 11-12)
  • Primary chorionic villi develop (days 13-14)
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17
Q

What are sx of ectopic pregnancy?

A

ap
amenorrhea
vaginal bleeding
rupture of oviduct wall

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18
Q

Where do ectopic pregnancies take place?

A

implant outside of uterine cavity, most of the time in the oviduct
–>ampulla or isthmus

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19
Q

What makes up the chorionic sac?

A
  • extraembryonic somatic mesoderm
  • cytotrophoblast
  • syncytiotrophoblast
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20
Q

What surrounds the amnion and primary umbilical vesicle?

A

extraembryonic mesoderm

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21
Q

What mesoderm lines the trophoblast and covers the amnion?

A

extraembryonic somatic mesoderm

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22
Q

What mesoderm surrounds the umbilical vesicle?

A

extraembryonic splanchnic mesoderm

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23
Q

What is the fluid-filled cavity that surrounds the amnion and umbilical vesicle?

A

extraembryonic coelom

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24
Q

What is a thin, tough membrane that surrounds the fetus and amniotic fluid?

A

amnion/amniotic sac

–>amnioblast separates from epiblast to enclose amniotic cavity

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25
Q

What eventually obliterates the chorionic cavity and forms the epithelial covering of the umbilical cord?

A

amnion

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26
Q

What is amniotic fluid derived from?

A

maternal tissue and IF initially

  • ->fetal urinary system secretes @ 11 weeks
  • ->resp and GI tract contribute

exchange @ umbilical cord

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27
Q

Describe hydraminos

A

excessive amniotic fluid

  • ->genetic defect d/t CNS or blockage of GI tube
  • ->abd pain, sig swelling or bloating, breathlessness
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28
Q

Describe oligohydraminos

A

insufficient amniotic fluid (<400mL)

  • ->renal agenesis or pulmonary hypoplasia
  • ->d/t placental abnormality or maternal HBP

not enough cushion for fetus and umbilical cord

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29
Q

What obliterates the uterine cavity?

A

when the decidua capsularis (covering chorionic surface) bulges into the uterine cavity and fuses with the decidua parietalis on the opposite wall
–>amniochorionic membrane

30
Q

What forms from the decidua capsularis degeneration?

A

@ 22-24 weeks

makes smooth chorion that fuses with parietalis–>amniochorionic membrane

31
Q

Where is the amniochorionic membrane?

A

fusion with decidua capsularis and adheres to parietalis

–>formed d/t amniotic sac grows faster than chorionic sac and obliterates uterine cavity

32
Q

What forms chorionic villi?

A

proliferation and projection of cytotrophoblast into syncytiotrophoblast

33
Q

What is the cytotrophoblastic shell?

A

chorionic villi that attach to the decidua basalis

  • ->anchors chorionic sac to decidua
  • ->A/V pass freely through gaps in shell to enter intervillous space where exchange occurs
34
Q

What does placental development involve?

A

formation of chorionic villi from the chorionic sac

proliferation of cytotrophoblasts

35
Q

What makes up the placenta?

A

decidua basalis

villous chorion

36
Q

What are primary chorionic villi?

A

cytotrophoblasts that grow into syncytiotrophoblast layer

–>1st stage of placental development @ end of 2nd week

37
Q

What do villi that are assicated with the decidua capsularis become?

A

compressed–>degenerate to form smooth chorion (surrounds fetus except at villousu chorion)

38
Q

What do villi associated with the decidua basalis become?

A

rapidly increase and branch

–>forms villous chorion, a bushy area of the chorionic sac that connects with umbilical cord

39
Q

What surrounds the chorionic sac, attaches and erodes decidua basalis and creates an intervillous space?

A

cytotrophoblastic cell

–>lacuna b/t villi make intervillous space

40
Q

What divides villous chorion into irregular convex areas?

A

placental septa via decidual erosion

41
Q

What are irregular convex areas of the villous chorion called?

A

cotyledons

–>projections that contain chorionic villi, between decidua basalis and intervillous space

42
Q

What is in the intervillous space of the placenta?

A

maternal blood (11-14 weeks)

43
Q

What villi extend from the chorionic plate into intervillous space?

A

main stem villi

44
Q

What villi extend from the main stem villi to increase surface area?

A

Branch villi

45
Q

What villi attach to the maternal tissues through the cytotrophoblastic shell?

A

anchoring villi

46
Q

What do cotyledons contain?

A
  • 2+ main stem villi

- multiple branch villi

47
Q

What are secondary chorionic villi?

A

extraembryonic mesoderm grows into primary villi
–> NO BV

mesoderm core, cyto, syncytio

48
Q

What are tertiary chorionic villi?

A

extraembryonic mesoderm diff into capillary and RBC

  • ->capillary and CT coore
  • ->cyto
  • ->syncytio
49
Q

What villi are the main sites for exchange of maternal and fetal blood?

A

branch villi

50
Q

What is the difference in makeup of placental membrane before and after 20 weeks?

A

before 20: cytotrophoblast included with syncytio, CT in villi and capillary endotheliym

after 20: extremely diminished cytotrophoblast layer

51
Q

What does NOT cross the placenta?

A

protein hormones
–>insulin pituitary hormones

bacteria

drugs with AA-like structures
—>methyldopa

52
Q

Where is the umbilical cord attached?

A

near center of fetal surface of placenta

53
Q

What forms the umbilical cord?

A 
connecting stalk covered with amnion
--> 2 umbilical As
       DEOX
--> 1 umbilical V
      OX
54
Q

Describe absence of umbilical A

A

common
—>chromosomal and fetal abnormalities

detected via US

55
Q

Describe placenta previa

A

placenta implants in lower uterine segment or cervix

–>3rd trimester bleeding, most common type of abnormal placenta

56
Q

Describe placenta accrete

A

partial or complete absence of decidua, so villous chorion attaches directly to myometrium

–>placenta doesn’t separate at birth

–>severe postpartum bleeding

57
Q

Describe a partial hydatidiform mole

A

portion of normal villi become edematous

  • ->fetal tissue found
  • ->normal ovum via 2 sperm

triploid or tetrapliod karyotypes

58
Q

Describe complete hydatidiform mole

A 
all villi enlarged
no fetal tissue
fertilized empty ovum
--->all DNA paternal
--->fertilized by duplicated sperm

46XX or 46XY

59
Q

Describe an invasive mole

A

Complete mole penetrates or perforates uterine wall

  • ->HIGH blood levels hCG
  • ->can cause hemorrhaging d/t invasion
  • ->chemotherapy
60
Q

Describe gestational choriocarcinoma

A

Highly invasive, met tumor via trophoblast cells

–>50% of mole pregnancies

–>increasing hCG titer without uterine enlargement

–>combined chemotherapy

61
Q

What type of twin originates from 2 zygotes?

A

dizygoitc=fraternal

62
Q

What is the relationship between zygotic splitting of twins and membranes?

A

earlier the split, the more separate the membranes and placentas

63
Q

What are the membranes and placental relationships of dizygotic twins?

A

Separate amnion, chorion and placentas

64
Q

What membranes arise if monozygotic twins separate at the 2-8 cell stage (up to 72 hrs)?

A

Diamniotic
Dichorionic
–>fused or separate placenta

65
Q

What membranes arise if monozygotic twins separate at the blastocyst stage (4-8 days)?

A

Diamniotic

Monochorionic

66
Q

What membranes arise if monozygotic twins separate at the implant stage (9-12 days)?

A

Monoamniotic

Monochorionic

67
Q

Why do you have conjoined twins?

A

separate way late, past implant stage

68
Q

What are 65% monozygotic twins?

A

division of embryoblast of blastocyst

–>1 placenta, 1 chorionic sac, 2 amniotic sacs

69
Q

What are 35% monozygotic twins?

A

division of morula of blastocyst

–> 2 blastocysts with own amniotic and chorionic sacs

70
Q

What’s the difference between the smooth and villous chorion?

A

Villous chorion is the fetal side of the placenta where the umbilical cord is

Smooth chorion is the rest of the sac surrounding the fetus

71
Q

What ruptures during childbirth?

A

amniochorionic membrane

GIGU (37 decks)

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