Placental Physiology Flashcards

1
Q

What is the Decidua?

What are it’s (4) parts?

A

Decidua: The endometrium of the gravid (pregnant) Uterus

Four parts;

  1. Basalis: Maternal part of the placenta
  2. Capsularis: Covers conceptus
  3. Parietalis: rest of the endometrium
  4. Reflexa: Junction between capsularis & Parietalis
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2
Q

Around what day does the Chorionic Villi begin to develop?

A

Day 13

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3
Q

Until the 8th week, the entire chorionic sac is covered with Villi. What occurs that changes this?

A

The Chorionic Sac grows and compresses the villi of Decidua capsularis. Only the part associated with Decidua Basalis retain it’s villi.
This results in (2) types of chorion;

  1. Chorion Frondosum: Villous chorion
  2. Chorion Laeve: Bare (smooth) chorion
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4
Q

What are the (2) components of the Placenta?

A
  1. Fetal part; Develops from the Chorion Frondosum
  2. Maternal part; develops from the endometrium (functional layer decidua basalis)
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5
Q

What is the function of the placenta? (5)

A
  1. Protection
  2. Nutrition
  3. Respiration
  4. Excretion
  5. Hormone Production
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6
Q

At term, what are the (3) layers of the Placental membrane?

A
  1. Syncytiotrophoblast
  2. Connective Tissue
  3. Endothelium of the capillaries
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7
Q

What is vasculosyncytial placental membrane?

A

Sites of the placental membrane in which the syncytiotrophoblast is in direct contact with the endothelium of the capillaries.

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8
Q

What are the (4) mechanisms of Placental transport?

A
  1. Simple Diffusion
  2. Facilitated Diffusion
  3. Active Transport
  4. Pinocytosis
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9
Q

Describe the layers/structures of the placental barrier from maternal side to fetus side.

A
  1. Intervillous space (w/ blood)
  2. Syncytiotrophoblast
  3. Cytotrophoblast
  4. Basement Membrane
  5. Connective tissue
  6. Fetal capillary
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10
Q

What is preclampsia?

A

Preclampsia is a pregnancy complication due to underdeveloped arteriovenous shunts resulting in narrower uterine arteries (thus higher resistance). It is characterized by high blood pressure.

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11
Q

What are the (3) primary symptoms of preclampsia?

A
  1. High Blood Pressure
  2. Swelling of hands & feet
  3. Protein in Urine
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12
Q

What is the incidence of Preclampsia?

A

Preclampsia affects 2-8% of pregancies worldwide.

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13
Q

What other diseases may increase the risk of preclampsia?

A
  • Chronic Hypertension
  • Chronic Renal Disease
  • Collagen Vascular Disease
  • Pregestational Diabetes Mellitus
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14
Q

When does preclampsia usually occur?

What if it occurs earlier?

A

Usually, preclampsia occurs after 32 weeks. If it occurs earlier, it is associated with worse outcomes.

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15
Q

What are the Immunogenic risk factors for Preeclampsia?

A
  • Nulliparous (woman who has never given birth)
  • Previous preeclampsia
  • Multiple Gestation
  • Abnormal Placentation
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16
Q

What are the Maternal related risk factors of Preeclampsia?

A
  • Obesity
  • 35< age < 20
  • New Paternity
  • Cohabiliation < 1 year
  • African American
17
Q

Women who have had preeclampsia are at an increased risk of what conditions later in life?

A

Heart Disease

Stroke

18
Q

What complications may arise for the mother with Preeclampsia?

A

CNS:

  • seizures
  • Cerebral edema
  • Cerebral Hemorrhage
  • Stroke (thrombosis)

Hepatic:

  • Hepatic Failure
  • Hepatic Rupture
  • Subcapsular Hemorrhage

Hematological:

  • Disseminated intravascular Coagulation (DIC)
  • HELLP: Hemolysis, Elevated Liver enzymes, Low Platelet count.

Renal:

  • Renal failure
  • Oliguria
  • Proteinuria

Lungs:

  • Pulmonary Edema
19
Q

What complications may arise for the Fetus with preeclampsia?

A
  • Preterm delivery
  • Stillbirth (Intrauterine Fetal Death)
  • Intrapartum Fetal Distress
  • Placental Abruption (placenta separates from the uterus early)
  • Uteroplacental Insufficiency;
    • Hypoxic Neurological Injury
    • Intrauterine Growth Restriction (IUGR)
    • Oligohydramnios
20
Q
A