Session 6 - Placental Function & Dysfunction Flashcards

1
Q

Which structure does the placenta come from?

A

Placenta is formed from the syncytiotrophoblast, in the week of 2s.

It is a specialisation of the chorionic membrane (outer)

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2
Q

When does implantation begin?

A

Day 6 trophoblast contacts endometrium.

Day 9 embedded in endometrium.

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3
Q

What happens to the yolk sac and chorionic cavity as the embryo continues to develop?

A

The yolk sac is no longer needed, so regresses.

The chorionic cavity reduces as the amniotic sac grows and ‘fills’ its space.

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4
Q

What does implantation of the embryo and the syncytiotrophoblast achieve?

A
  • Exchange between the mother and embryo. (Villi) finger like projections of trophoblast.
  • Anchors the placenta.
  • establishment of maternal blood flow through structure.
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5
Q

What happens to the placental membrane as development progresses? Why is it important?

A

Membrane becomes thinner, ultimately one cell layer (trophoblast).

In order to reduce the diffusion pathway for higher rate of oxygen, and nutrient diffusion for an increased demand from the foetus.

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6
Q

How are the mother and foetal circulation separated?

A

At placenta by one layer of trophoblast, ensures circulations don’t mix.

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7
Q

What is a chorionic villus?

A

A finger like projection of the trophoblast with inner connective tissue core.
Has foetal vessels, for exchange with maternal blood.

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8
Q

What are two major implantation defects and their process? What are the risks?

A

Ectopic Pregnancy
- Implantation at site other than uterine body (most common Fallopian tube ampulla)

Risk: Bleeding into pelvic cavity

Placenta Praevia
- Implantation in the lower uterine segment (sometimes over birth canal)

Risk: Haemorrhage in pregnancy
(C-section)

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9
Q

In the presence of the embryo what happens to the endometrium of the uterus?

A

Becomes the decidua.

The uterine lining during pregnancy, promoted by progesterone

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10
Q

What is the decidual reaction?

A

The set of changes in endometrium in preparation for embryo implantation.
Embryo implantation may be unsuccessful without this reaction happening properly.

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11
Q

What are the cotyledons of the placenta?

A

The separations of the decidua containing a main stem of a chorionic villus and its branches, which form the placenta.

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12
Q

What is the structure of a chorionic villus?

A
  • Main stem containing syncytiotrophoblast cells on the outer layer, and some cytotrophoblast cells deep to this.
  • Has branches, and terminal branches, containing vessels with foetal blood.

Thin layer for diffusion.

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13
Q

How do nutrients and oxygen from maternal blood diffuse into the foetal circulation?

A

The chorionic villi of the foetal placenta are surrounded by flow of maternal blood.

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14
Q

Which vessels from the foetus carry blood too and from the placenta?

A

Two umbilical arteries: deoxygenated blood from foetus to placenta.

One umbilical vein: brings oxygenated blood back to foetus.

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15
Q

What is the function of human chorionic somatomammotrophin from the placenta?

A

Peptide hormone

  • Has anti insulin properties in the mother, to reduce glucose use by mother.
  • To allow higher glucose concentration and to be used more by the foetus.
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16
Q

What is an important endocrine function of the placenta?

A

Secretes progesterone and oestrogen.
Takes over from corpus luteum.
Important in preparation of pregnant state, increasing hunger (Progesterone maintaining endometrium)
- Increases breast size and preparation for lactation. (Oestrogen)

17
Q

Where is Human chorionic gonadotropin secreted from? Why is its function?

A
  • Secreted from syncytiotrophoblast of the placenta.
  • Thus secreted in the pregnant state.
  • Supports the secretory function of the corpus luteum.
18
Q

Which hormone present in urine is used in pregnancy tests?

A

Human chorionic Gonadotrophin (hCG)

19
Q

By which week do the placental hormones take over the corpus luteum?

A

11th week

20
Q

What is the reason for limit of oxygen diffusion at the placenta?

A

Flow limited, not diffusion limited

21
Q

How are molecules that aren’t passively diffused moved through the placenta into foetal blood stream?

A

By specific ‘transporters’ on the syncytiotrophoblast.

Amino acids, iron, vitamins

22
Q

How is transfer of maternal immunity achieved to the foetus?

A

IgG from the mother are transported through a receptor mediated process. (Higher concentration in foetus than mother - against gradient)

23
Q

Which dangerous substances can pass the placental barrier?

A

Teratogens

24
Q

Name some harmful teratogens that can cross the placental membrane, and their effects.

A

Thalidomide
- Limb defects

Alcohol
- Foetal alcohol syndrome FAS, and ARND

  • Anti-epileptic drugs
  • Warfarin (can cause foetal bleeding)
  • Drug abuse - can cause adiction
  • Maternal smoking (placenta changes)
25
Q

What are the effects of teratogens in the pre-embryonic, embryonic, and foetal stages.

A

Pre-embryonic
- Lethal effects, loss of pregnancy

Embryonic
- Most sensitive period
(Narrow window for some systems)

Foetal
- Not as sensitive, fewer denovo structures developing.

After embryonic period, low risk except CNS.