Podcast
Questions and Answers
Where does the amniotic fluid go after being swallowed by the fetus?
Where does the amniotic fluid go after being swallowed by the fetus?
What is the primary function of amniotic fluid in fetal development?
What is the primary function of amniotic fluid in fetal development?
What happens to the excess water in the fetal blood?
What happens to the excess water in the fetal blood?
What is a key component of amniotic fluid in late pregnancy?
What is a key component of amniotic fluid in late pregnancy?
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Which of the following is NOT a function of amniotic fluid?
Which of the following is NOT a function of amniotic fluid?
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What is the approximate length of the umbilical cord at full term?
What is the approximate length of the umbilical cord at full term?
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What is the primary function of the umbilical cord?
What is the primary function of the umbilical cord?
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Where does one end of the umbilical cord attach to the fetus?
Where does one end of the umbilical cord attach to the fetus?
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What occurs about 6 days after fertilization?
What occurs about 6 days after fertilization?
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Which layer of the trophoblast is highly invasive?
Which layer of the trophoblast is highly invasive?
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What is a key transformation that occurs in the endometrial stromal cells during the decidua reaction?
What is a key transformation that occurs in the endometrial stromal cells during the decidua reaction?
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Which hormone is secreted by the syncytiotrophoblast after implantation?
Which hormone is secreted by the syncytiotrophoblast after implantation?
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By day 11 to 12, what happens to the blastocyst during implantation?
By day 11 to 12, what happens to the blastocyst during implantation?
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What is the primary role of the chorionic villi during placentation?
What is the primary role of the chorionic villi during placentation?
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What structure closes the penetration defect in the surface epithelium at the implantation site?
What structure closes the penetration defect in the surface epithelium at the implantation site?
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What occurs to the endometrium during the secretory phase of the menstrual cycle at the time of implantation?
What occurs to the endometrium during the secretory phase of the menstrual cycle at the time of implantation?
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Which structure is responsible for the formation of Wharton's jelly?
Which structure is responsible for the formation of Wharton's jelly?
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What are monozygotic twins derived from?
What are monozygotic twins derived from?
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Which of the following regions is noted for its high incidence of twins occurring naturally?
Which of the following regions is noted for its high incidence of twins occurring naturally?
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Which components are primarily found in the umbilical cord?
Which components are primarily found in the umbilical cord?
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What is a characteristic of dizygotic twins?
What is a characteristic of dizygotic twins?
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The umbilical arteries are responsible for what function?
The umbilical arteries are responsible for what function?
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What process is referred to by craniocaudal folding during fetal development?
What process is referred to by craniocaudal folding during fetal development?
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What is the primary function of the decidual reaction?
What is the primary function of the decidual reaction?
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Which part of the decidua covers the implanted embryo?
Which part of the decidua covers the implanted embryo?
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What happens to the decidua capsularis by weeks 22 to 24 of development?
What happens to the decidua capsularis by weeks 22 to 24 of development?
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During which developmental stage do lacunae form in the syncytium?
During which developmental stage do lacunae form in the syncytium?
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What is the term for maternal blood vessels that are congested and dilated after trophoblastic erosion?
What is the term for maternal blood vessels that are congested and dilated after trophoblastic erosion?
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What structure forms as the trophoblast penetrates deeper into the uterine stroma?
What structure forms as the trophoblast penetrates deeper into the uterine stroma?
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What distinguishes secondary chorionic villi from primary villi?
What distinguishes secondary chorionic villi from primary villi?
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What is the primary purpose of the primary villi formed by day 13?
What is the primary purpose of the primary villi formed by day 13?
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Which process occurs to the chorionic villi in the third week of development?
Which process occurs to the chorionic villi in the third week of development?
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What is formed when the capillaries in the chorionic villi fuse?
What is formed when the capillaries in the chorionic villi fuse?
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What is the primary function of uterine contraction after the detachment of the placenta?
What is the primary function of uterine contraction after the detachment of the placenta?
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Which of the following signs indicates separation of the placenta?
Which of the following signs indicates separation of the placenta?
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What is placental abruption associated with?
What is placental abruption associated with?
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Which condition is characterized by high blood pressure, protein in urine, and fluid retention during pregnancy?
Which condition is characterized by high blood pressure, protein in urine, and fluid retention during pregnancy?
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What type of placenta consists of more than two lobes?
What type of placenta consists of more than two lobes?
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What happens in cord prolapse during labor?
What happens in cord prolapse during labor?
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Which condition occurs when there is an unequal distribution of blood from a shared placenta in MZ twins?
Which condition occurs when there is an unequal distribution of blood from a shared placenta in MZ twins?
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Which type of twins occur when the embryo splits incompletely?
Which type of twins occur when the embryo splits incompletely?
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Which layer of the placenta disappears altogether after 20 weeks?
Which layer of the placenta disappears altogether after 20 weeks?
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What does the term 'velamentous placenta' refer to?
What does the term 'velamentous placenta' refer to?
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What is the average weight of the placenta at term?
What is the average weight of the placenta at term?
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What is indicated by a gush of blood during the placental separation process?
What is indicated by a gush of blood during the placental separation process?
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What shape is the mature/term placenta?
What shape is the mature/term placenta?
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What is one of the main functions of the placenta?
What is one of the main functions of the placenta?
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Which of the following substances is NOT transferred from maternal to fetal blood?
Which of the following substances is NOT transferred from maternal to fetal blood?
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How often is the blood volume in the intervillous space replaced?
How often is the blood volume in the intervillous space replaced?
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What is the predominant mechanism of transport for oxygen across the placenta?
What is the predominant mechanism of transport for oxygen across the placenta?
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Which type of artery supplies blood to the intervillous spaces?
Which type of artery supplies blood to the intervillous spaces?
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What happens to the amniotic membranes during labor?
What happens to the amniotic membranes during labor?
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What is the purpose of the amniotic fluid?
What is the purpose of the amniotic fluid?
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What change occurs to the chorionic sac as the pregnancy progresses?
What change occurs to the chorionic sac as the pregnancy progresses?
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Which hormone is NOT produced by the placenta?
Which hormone is NOT produced by the placenta?
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What is the volume of amniotic fluid at term (37 weeks)?
What is the volume of amniotic fluid at term (37 weeks)?
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Flashcards
Umbilical Cord
Umbilical Cord
A structure connecting the fetus to the placenta, containing vessels and protective gel.
Wharton's Jelly
Wharton's Jelly
A gelatinous substance found in the umbilical cord, providing cushioning and protection to vessels.
Umbilical Vein
Umbilical Vein
The blood vessel in the umbilical cord that carries oxygenated blood from the placenta to the fetus.
Umbilical Arteries
Umbilical Arteries
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Monozygotic Twins
Monozygotic Twins
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Dizygotic Twins
Dizygotic Twins
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Multiple Pregnancies
Multiple Pregnancies
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Twinning Risks
Twinning Risks
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Implantation
Implantation
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Trophoblast
Trophoblast
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Cytotrophoblast
Cytotrophoblast
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Syncytiotrophoblast
Syncytiotrophoblast
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Decidua reaction
Decidua reaction
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Human Chorionic Gonadotrophin (HCG)
Human Chorionic Gonadotrophin (HCG)
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Functional endometrium
Functional endometrium
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Blastocyst embedding
Blastocyst embedding
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Decidual cells
Decidual cells
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Decidua
Decidua
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Decidua basalis
Decidua basalis
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Decidua capsularis
Decidua capsularis
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Decidua parietalis
Decidua parietalis
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Lacunar stage
Lacunar stage
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Sinusoids
Sinusoids
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Primary villi
Primary villi
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Secondary villi
Secondary villi
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Tertiary chorionic villi
Tertiary chorionic villi
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Uterotonic agents
Uterotonic agents
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Placental abruption
Placental abruption
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Preeclampsia
Preeclampsia
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Eclampsia
Eclampsia
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Bilobed placenta
Bilobed placenta
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Velamentous placenta
Velamentous placenta
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Cord prolapse
Cord prolapse
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Twin Twin Transfusion Syndrome
Twin Twin Transfusion Syndrome
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Conjoint twins
Conjoint twins
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Retroplacental clot
Retroplacental clot
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Amniotic Fluid Function
Amniotic Fluid Function
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Fetal Swallowing
Fetal Swallowing
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Waste Exchange
Waste Exchange
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Amniotic Fluid Composition
Amniotic Fluid Composition
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Fetal Kidney Role
Fetal Kidney Role
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Amniotic Fluid Temperature Control
Amniotic Fluid Temperature Control
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Cervical Dilation Assist
Cervical Dilation Assist
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Amniochorionic membrane
Amniochorionic membrane
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Functions of the placenta
Functions of the placenta
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Placental transfer
Placental transfer
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Fetal placental circulation
Fetal placental circulation
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Maternal placental circulation
Maternal placental circulation
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Chorionic villi
Chorionic villi
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Amniotic fluid
Amniotic fluid
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Volume of amniotic fluid
Volume of amniotic fluid
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Endocrine secretion by placenta
Endocrine secretion by placenta
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Placenta anatomy shape
Placenta anatomy shape
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Intervillous spaces
Intervillous spaces
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Rupture of membranes
Rupture of membranes
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Study Notes
Placentation and Twinning
- The placenta is a temporary fetomaternal organ
- It forms in the uterus during pregnancy
- It attaches the fetus to the mother's uterine wall via the umbilical cord
- It is highly vascular and endocrine in nature
- The placenta has a circular/discoid shape
- Its purpose is to provide oxygen and nutrients to the fetus, remove waste products of metabolism from the fetus, and secrete hormones necessary for pregnancy maintenance
Placentation: Outline
- Placentation
- Preceding events in 2nd and 3rd week
- Implantation
- Decidua reaction and formation
- Development of the lacunar system in the trophoblast layer
- Development of chorionic villi and formation of the chorion frondosum
- Formation of the placenta proper
- Placental membrane
- Anatomy of the mature placenta
- Functions of the placenta
- Placental circulation
- Fetal membranes and amniotic fluid
- Umbilical cord
- Twinning
- Clinical relevance
Implantation
- About 6 days after fertilization, the blastocyst attaches to the endometrial epithelium, usually adjacent to the embryonic pole
- The trophoblast starts to proliferate rapidly and differentiates into two layers:
- Cytotrophoblast: a layer of mononucleated cells
- Syncytiotrophoblast: a highly invasive layer of multinucleated protoplasmic mass with no visible cell boundaries
- Finger-like processes of the syncytiotrophoblast invade the endometrial epithelium and underlying connective tissue of the endometrium.
- By day 9, the blastocyst is deeply embedded in the endometrium
- The penetration defect in the surface epithelium is closed by a fibrin coagulum
- By the 11th-12th day, the blastocyst is completely embedded.
- The blastocyst now produces a slight protrusion into the lumen of the uterus
- Implantation is complete
Decidua Reaction
- The characteristic transformation of the functional endometrial stromal cells following implantation
- The endometrium is in the secretory phase of the menstrual cycle at the time of implantation
- Soon, the syncytiotrophoblast secretes Human Chorionic Gonadotrophin (HCG)
- HCG intensifes changes in the stromal cells, causing them to enlarge, vacuolate, and load with glycogen and lipids.
- These cells become polyhedral and are called decidual cells.
- The reaction initially is confined to the endometrium near the implantation site but spreads throughout the endometrium of the uterus shortly after.
- The functional endometrium is now called the decidua or gravid endometrium.
- The primary function of the decidual reaction is to provide nutrition for the early embryo and provide an immunologically privileged site for the conceptus
### Decidua divisions
- The decidua is subdivided into three parts:
- Decidua basalis: lies deep to the embryo, anchored to the cytotrophoblastic shell. Consists of a compact layer of large decidual cells.
- Decidua capsularis: covers the implanted embryo at the abembryonic pole, forming a capsule that separates it from the uterine cavity.
- Decidua parietalis: the rest of the endometrium
### Second week of development
- Lacunar stage of trophoblast development
- Following implantation, vacuoles appear in the syncytium forming large lacunae
- Lacunae are separated by trabeculae (partitions of syncytium )
- The syncytiotrophoblast appears spongelike
- By the 11th-12th day, lacunar spaces form intercommunicating networks.
- The lacunae networks are more evident at the embryonic pole.
- The syncytiotrophoblast continues to penetrate deeper into the stroma and erode endothelial lining of the maternal capillaries.
- These capillaries (sinusoids) become congested and dilated.
- The mixture of maternal blood, cellular debris from eroded glands enters the lacunar system.
- Maternal blood begins flowing through the trophoblastic system, establishing the primordial uteroplacental circulation
- The trophoblast absorbs nutrients from the lacunar networks and transfers them to the embryo
- By day 13, primary villi formation occurs.
- Each trabecula is initially entirely made of syncytiotrophoblast.
- The cytotrophoblast cells proliferate locally, penetrating the syncytiotrophoblast (trabecula), forming cellular columns surrounded by syncytium.
- These columns are termed primary villi and are surrounded by maternal blood filling the lacunar spaces (now called intervillous spaces).
### Third week of development
- Primary villi begin to branch shortly after appearing.
- The cytotrophoblast invades the primary villi's center/core, becoming secondary villi.
- These secondary villi cover the entire surface of the chorionic sac.
- Mesoderm (mesenchymal) cells differentiate into capillaries and blood cells, becoming tertiary chorionic villi
Third week of development (continued)
- Capillaries in the chorionic villi fuse, forming arteriocapillary networks
- These networks connect with the embryonic heart via vessels that differentiate in the mesenchyme of the chorion
- By the end of the 3rd week, embryonic blood begins flowing through the capillaries in the chorionic villi
- Oxygen and nutrients in maternal blood diffuse through villi walls, entering the embryo's blood
- Carbon dioxide and waste products diffuse from fetal capillaries into the maternal blood through the villi walls
- Cytotrophoblast cells in the apical region of each villus proliferate, crossing the syncytiotrophoblast and forming a continuous layer on the surface of the decidua.
- This layer is called the cytotrophoblastic shell.
- The shell completely isolates the syncytiotrophoblast from the decidua basalis
- Villi, anchoring the chorion to the decidua, are called anchoring villi (stem chorionic villi
Third week of development (continued II)
- Each anchoring villus consists of a stem (truncus chorii, which branches into ramuli chorii)
- The ramuli chorii are attached to the cytotrophoblastic shell
- The anchoring villi sprout free villi into the intervillous space.
- Almost the entire intervillous space becomes filled with villi. This large surface area is for efficient maternal/fetal exchange
Third week of development (continued III)
- Until week 8, villi on the embryonic pole (decidua basalis) extend extensively, forming the chorion frondosum (bushy chorion).
- As the chorionic sac enlarges, the villi on the abembryonic pole degenerate, forming the chorion laeve (smooth chorion).
Placentation: Introduction
- The placenta is a temporary fetomaternal organ.
- It is formed during pregnancy in the uterus.
- It attaches the fetus to the mother via the umbilical cord.
- It is a highly vascular and endocrine organ.
- The placenta has a circular and discoid shape.
Placentation: Formation
- It has two parts with distinct origins:
- Fetal part: develops from the chorion frondosum
- Maternal part: develops from the decidua basalis.
- Formation is preceded by events including implantation, development of the lacunae system, decidua reaction, development of chorionic villi, and formation of the chorion frondosum.
Placentation : Formation of placenta proper
- Following anchoring villi formation, septa grow inward from the uterine endometrium into the intervillous spaces.
- These decidual septa divide the placenta into 15-20 lobes called cotyledons.
- Cotyledons do not reach the chorionic plate.
- Each cotyledon comprises 2-3 anchoring villi.
### Placentation: Details of each component
- Each decidual septum has a maternal tissue core covered by syncytial cells.
- This structure ensures maternal blood in the intervillous spaces is separated from fetal tissue of the villi.
- Endometrial (spiral) arteries and veins freely traverse the cytotrophoblastic shell and open into the intervillous spaces.
- The placenta grows and expands, covering approximately 15-30% of the uterus’s internal surface.
- Placental thickening stems from villus arborization, not further penetration into maternal tissue.
Placentation: Membranes/barriers
- Membranes/barriers separate maternal and fetal blood within the placenta
- There is no mixing of maternal and fetal blood in the placenta.
- Exchange of gases, nutrients, and waste occur across the placental barrier.
Placentation:: Blood sources
- Maternal blood from the endometrial arteries fills the intervillous spaces.
- Endometrial veins drain the blood from the intervillous spaces.
- Fetal blood circulates within the fetal blood vessels in the chorionic villi.
Placentation: Membranes thickness
- Until the 20th week, the placental membrane has four layers, measuring approximately 0.025 mm.
- The layers include syncytiotrophoblast, cytotrophoblast, mesoderm of the villus, and endothelium of fetal capillaries.
- After the 20th week, the layers progressively thin out, with the cytotrophoblast disappearing.
- The membrane's thickness then decreases to approximately 0.002 mm, facilitating efficient transport.
### Placentation: Anatomy of mature placenta
- Shape: discoid
- Dimensions: ~15-25cm diameter & ~3cm thickness
- Weight: ~1/6th of the fetal weight (~500-600 grams)
- Fetal surface: covered by the chorionic plate, smooth, and shiny, covered by the amniotic membrane
- Umbilical cord attachment: at the center
### Placentation: Maternal Surface
- The maternal surface has a cobble-stone appearance due to 15-20 rounded elevations (cotyledons) separated by grooves made by decidual septa.
- It’s covered by a thin layer of decidua basalis.
### Placentation: Internal Structure
- The chorionic plate contains chorionic vessels, surrounded by mesoderm and syncytiotrophoblast.
- These vessels are continuous with those in the umbilical cord.
Placental Circulation: Maternal
- Blood enters intervillous spaces via spiral arteries, under pressure, reaching the chorionic plate.
- The blood then circulates around the villi for exchange across the thin placental membrane.
- The blood is drained from the space by veins of the decidua basalis.
- In the fully formed placenta, the 150ml of intervillous blood is replaced every 15-20 seconds (at 3-4 times per minute).
### Placental Circulation: Fetal
- Fetal blood arrives at the placenta through the umbilical arteries.
- Inside the placenta, these arteries ramify freely within the chorion and its branches enter the chorionic villi.
- Veins from the chorionic villi drain into the umbilical vein, carrying oxygen-rich blood and nutrients to the fetus.
Fetal Membranes
- Formation of the amniochorionic membrane is preceded by events, including amnion formation, formation of the chorionic sac and chorion, formation of the decidua capsularis and parietalis, and chorionic villi enlargement.
- The chorion laeve (smooth chorion) forms by the degeneration of chorionic villi on the abembryonic pole of the chorionic sac in later pregnancy.
- The enlarging amniotic cavity obliterates the chorionic sac, and the amnion and smooth chorion fuse to form the amniochorionic membrane.
- The amniochorionic membrane fuses temporarily with the decidua capsularis, eventually adhering to the decidua parietalis.
Amniotic Fluid
- Transparent fluid within the amniotic cavity
- Derived from maternal blood by diffusion across the amniochorionic membrane from the decidua parietalis.
- Also from secretions by amniotic cells, the fetus’s respiratory and digestive tracts (lung, intestine, GI tract), and the fetal kidneys through the fetal urinary tract.
- Is also secreted by the fetal skin before keratinization.
Amniotic Fluid: Volume
- 30ml at 10 weeks
- 450ml at 20 weeks
- ~800–1000 ml at term (~37 weeks).
- Amniotic fluid volume is replaced every 3 hours.
Amniotic Fluid: Function and significance
- Maintains a balanced relationship with the fetal circulation, changing with fetal growth and development
- Large amounts of amniotic fluid pass across the amniochorionic membrane into maternal tissue fluid, entering the uterine capillaries.
- Fetus swallows up to 400ml of amniotic fluid per day (nutrients and waste products exchange)
- Excess amniotic fluid from the fetal kidneys is excreted and returned back to the amniotic sac.
- This process helps maintain fetal homeostasis.
- Acts as a hydrostatic bag (bag of waters) in aiding cervical dilatation at the beginning of labor
Umbilical Cord
- A long cord by which the fetus is attached to the uterine wall via the placenta. - At term, it is around 50-55cm long and 1-2cm thick. - Covered by a glistening amniotic membrane. - Twisted (with a potential for false knots).
- One end attaches to the center of the anterior abdominal wall of the fetus (umbilical region).
- The other end attaches to the center of the fetal surface of the placenta.
Umbilical Cord: Formation
- Involves formation of the connecting stalk, the allantoic diverticulum, and the folding of the embryo.
- Incorporation of the yolk sac, vitello-intestinal duct, and allantois into the stalk.
- Development of blood vessels into the umbilical cord also occurs within the stalk.
- Wharton's jelly forms from the mucoid generation of the mesoderm in the umbilical cord stalk
Umbilical Cord: Contents
- Contains two umbilical arteries and one umbilical vein
- Wharton's jelly
- Remains of allantoic diverticulum
- Remains of the vitellointestinal duct and yolk sac
Umbilical Cord: Function
- The umbilical vein carries oxygenated blood from the placenta to the fetus.
- The umbilical arteries carry deoxygenated blood from the fetus to the placenta.
Twinning
- Multiple pregnancies (2 or more fetuses)
- Twins: two fetuses
- Multiple births are becoming more common due to wider access to fertility treatments.
- Some regions (e.g., Igbo-Ora, Oyo State) have a naturally high twinning rate.
- Higher risks associated with multiple gestations due to the increased number of fetuses.
Twinning: Types (monozygotic and dizygotic)
- Monozygotic (identical) twins: result from a single fertilized ovum/zygote splitting. - Dizygotic (fraternal) twins: result from the release and fertilization of two ova/oocytes.
Twinning: Monozygotic types
- Early splitting (two-cell stage): dichorionic diamniotic twins (separate chorionic sacs/placentas, separate amniotic sacs).
- Later splitting (early blastocyst stage): monochorionic diamniotic twins (common chorionic sac/placenta, separate amniotic sacs).
- Very late splitting (bilaminar germ disc stage): monochorionic monoamniotic twins (common chorionic sac/placenta, common amniotic sac).
Twinning: Dizygotic types
- Result from two separate zygotes, with each zygote developing its own embryo, developing its own placenta, amnion, and chorionic sac, and two separate fetuses
- Dizygotic twins are genetically as similar as any two siblings with a shared parentage
Clinical Relevance: Labor/Parturition
- Labour/Parturition: process of fetal and placental expulsion from the uterus.
- Characterized by regular uterine contractions that progressively dilate the cervix.
- Three stages: 1st: Onset of uterine contractions until complete cervical dilation (10 cm). 2nd: Complete cervical dilation to infant delivery. 3rd: Infant delivery to placental delivery.
Clinical Relevance: Placenta delivery
- Placenta expelled 15-30 minutes after infant delivery via the three stages of labor. Placenta separation from the uterine wall due to:
- Reduction in placental site surface area (uterine muscle contraction)
- Haematoma formation as spiral arteries close post-delivery.
Clinical Relevance: Uterotonic Agents
- Uterotonic agents, like oxytocin, are administered post-delivery to promote placental separation.
- Signs of separation include lengthening of the umbilical cord, uterus rising in the abdomen, becoming more globular, and a gush of blood
Clinical Relevance: Placental Abruption
- Placental abruption, also called abruptio placentae, involves premature placental separation from the uterine wall.
- This can lead to bleeding and accumulation of blood behind the placenta. Risk factors include uterine tenderness, vaginal bleeding, decreased fetal movement, and shock.
Clinical Relevance: Preeclampsia/Eclampsia
- Preeclampsia is a condition characterized by elevated blood pressure, proteinuria (protein in urine), and edema (fluid retention) in pregnancy.
- Eclampsia is a more severe condition in pregnancy with preeclampsia-associated convulsions
- Placental abnormalities are a contributing factor to the development of preeclampsia/eclampsia.
Clinical Relevance: Placenta Shape Variations
- Placenta shape variations include bilobed (two lobes), multilobular (more than two lobes), diffuse (not disc-shaped), placenta succenturiata (a small separated part of the placenta still connected to the main part), placenta fenestrata (a hole in the placental disc), and circumvallate (peripheral edge of the placenta covered with a circular fold of the decidua).
Clinical Relevance: Umbilical cord abnormalities
- Cord Prolapse: Umbilical cord protruding through the cervix during labor, potentially compressing the cord between the fetal head and maternal pelvic floor, leading to fetal hypoxia
- Prolonged Cord: Cord encircling the fetal neck during delivery, potentially strangling the fetus.
- Shortened Cord: Pulling the placenta away from the uterus during delivery, causing premature separation.
- Cord knots: True knots in the umbilical cord can reduce blood flow and potentially cause fetal hypoxia and death.
Clinical Relevance: Conjoined Twins
- Conjoined twins (Siamese twins): result from incomplete separation of MZ twins.
- They are connected by a tissue bridge, and separation is only possible if vital parts are not shared. The different types of conjoined twins based on the site and extent of fusion are craniopagus (fusion of heads), thoracopagus (fusion of thorax), and cephalthoracopagus (fusion of head and thorax) and pygophagus (fusion of sacral regions).
Clinical Relevance: Twin-Twin Transfusion Syndrome
- Unequal blood distribution in MZ twins from a shared placenta.
- One twin receives too much blood (becoming larger) and the other twin receives insufficient blood (becoming smaller).
- It could potentially lead to death in one or both twins.
Clinical Relevance: Vanishing Twin
- Refers to the death of one twin (often in the first or second trimester).
- The dead twin is resorbed or remains as a compressed dehydrated mass, resembling parchment paper (fetus papyraceus).
Clinical Relevance: Drug Exposure in Pregnancies
- Drugs and their metabolites cross the placenta, affecting the fetus.
- Substances like alcohol can cause congenital anomalies, and heroin can result in fetal addiction and withdrawal symptoms.
- Certain medications taken during labor or obstetric surgeries can impact the fetus via placental transfer potentially leading to respiratory depression
Clinical Relevance: Prenatal Diagnostic testing
- Amniocentesis: sampling amniotic fluid, often guided by ultrasound, allowing for cell analysis and early diagnosis of chromosomal anomalies (such as trisomy 21 - Down syndrome) and other genetic disorders.
Clinical Relevance: Amniotic Fluid Disorders
- Hydramnios/polyhydramnios: excess amniotic fluid (1500–2000 ml) often related to maternal diabetes or fetal CNS/GIT abnormalities (e.g., anencephaly, esophageal atresia).
- Oligohydramnios: decreased amniotic fluid (<400 ml) potentially related to premature rupture of the amnion, leading to clubfoot or lung hypoplasia. Amniotic bands form when tears in the amnion create fibrous bands that cause ring constrictions and limb amputations.
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Test your knowledge on the role and functions of amniotic fluid and the umbilical cord in fetal development. This quiz covers key aspects such as the materials involved, the functions, and the physical characteristics associated with these vital components. Explore how they contribute to a healthy pregnancy.