02 - Placenta, Female Membrane, Hormones

T

T/F: When fertilization happens, estrogen and progesterone remains high

Zygote

Termed used to describe an egg cell fertilized by sperm

Blastomeres?

What do you call the individual cells produced by the zygote as it undergoes division?

Morula

Term used to describe the 16-cell stage of the zygote

Blastocyst

Term used to describe the morula after fluid accumulation

Blastula

Term used to describe the 58-cell stage of the blastocyst

Inner Cell Mass

These are the 5 embryo-producing cells of the blastula

Trophectoderm

The other 53 cells of the blastula will form what structure prior to implantation?

Trophoblast and Placenta

The other 53 cells of the blastula will form what structure after implantation?

Day 6 or 7

What day does the blastocyst implant into the uterine wall

Decidua

This is a specialized and highly modified endometrium of pregnancy

Hemochorial Plcentation

This is the period where the maternal blood contacts the trophoblast

Decidual NK Cells

The decidua functions to modulate the immune and vascular cell functions mainly via what cells?

Decidua Basalis (Placentalis)

This portion of the decidua lies directly below the developing placenta

Decidua Basalis (Placentalis)

This portion of the decidua contributes to the formation of the placental basal plate

Decidua Capsularis

This is the outer portion of the decidua that covers the embryo

Decidua Capsularis and Parietalis

2 parts of the decidua that later forms the decidua vera

15-16 weeks AOG

When is the decidua vera formed?

Amnion

This is the placental membrane that directly covers the baby

Chorion

This is the placental membrane that lies outside the amnion

Apposition

This phase of blastocyst implantation is characterized by its initial contact to the uterine wall

Adhesion

This phase of blastocyst implantation is characterized by increased physical contact between the blastocyst and decidua

Invasion

This phase of blastocyst implantation is characterized by the penetration of the trophoblast into the decidua and inner 3rd of the myometrium

Day 8

When does the trophoblast differentiate?

Villous Trophoblast

Which differentiated lineage of the trophoblast further differentiates into the cytotrophoblast and the syncytiotrophoblast

Cytotrophoblast

This is the inner mononuclear trophoblast

Syncytiotrophoblast

This is the outer multinucleated trophoblast

Day 10

What day does the blastocyst become encased within the endometrium

Day 12

What day does hemochoral placentation occur?

Body Stalk

Mesenchymal cells from the mesoderm forms what structure?

Interstitial Extravillous trophoblast

This trophoblast will migrate and invade the decidua and myometrium

Endovascular Extravillous Trophoblast

This trophoblast will invade the tunica media of the spiral arteries to make them low-resistance vessels

Pre-eclampsia

Without the invasion of spiral arteries, what complication could possibly arise?

F; Can be seen at 2nd Trimester

T/F: The placenta can already be seen in the US at the early weeks of pregnancy

Uterine a. → Arcuate a. → Radial a. → Spiral a.

Enumerate the Vascular Heirarchy from Uterine Artery → Spiral Artery

Chorion Fundosum

The chorionic villi that is in contact with the placenta will form what leaf-like structure?

Umbilical Cord

The body stalk will eventually form what structure?

Anchoring Villi

This is the villi of the chorion fundosum that extend from the chorionic plate to the decidua basalis

Branching Villi

This is the villi of the chorion fundosum that arborize and extend towards the intervillous space

A

QC: At 1st trimester, size of (1) Placenta (2) Fetus

C

QC: At mid trimester (17 weeks), size of (1) Placenta (2) Fetus

B

QC: At 3rd trimester, size of (1) Placenta (2) Fetus

Fetal Surface

This surface of the placenta is glistening and is covered by amnion

Chorionic Plate

This structure serves as the attachment of the umbilical cord

Maternal Surface

This placental surface lies against the uterine wall

Placental Lobes

These are slightly elevated areas of the maternal surface of the placent

Schultze Mechanism

This type of placental expulsion involves immediately seeing the fetal surface coming out of the vulva

Duncan Mechanism

This type of placental expulsion involves immediately seeing the maternal surface coming out of the vulva

F; Schultze = Central while Duncan = Peripheral

T/F: Schultze expulsion is considered peripheral while Duncan Expulsion is considered Central

Nitabuch Layer

This is a fibrinoid degeneration zone in which the invading trophoblasts meet the decidua basalis

Hofbauer cells

These cells grow in number and function as mediators of protection at the maternal fetal interface

B

VR: (1) Progression of Pregnancy (2) Syncytial Thickness

B

VR: (1) Progression of Pregnancy (2) Langhans Cells

B

VR: (1) Progression of Pregnancy (2) Placental Stroma

A

VR: (1) Progression of Pregnancy (2) Placental Capillaries

A

VR: (1) Progression of Pregnancy (2) Thickness of basement membrane

B

VR: (1) Progression of Pregnancy (2) Blood Vessel Villi

Hydratidiform mole

This abnormality of placental maturation is characterized with villous hydrops, chorionic villi enlargement, and trophoblast hyperplasia

F; 2 arteries and 1 vein

T/F: The umbilical cord is usually checked to make sure it has 2 veins and 1 artery

Cord Coil

This umbilical cord abnormality is characterized as loops of the umbilical cord being wrapped around the baby’s neck

Umbilical Cord Spiraling/Torsion

This umbilical cord abnormality can compromise blood flow to the baby and lead to fetal demise

Beta Subunit

Which subunit of hCG is detected in a pregnancy test?

Syncytiotrophoblast

Structure that produces hCG

Week 9

Peak level of hCG at what week?

~16 weeks

hCG decreases at what week?

A

VR: (1) Choriocarcinoma (2) hCG

A

VR: (1) Hydratidiform mole (2) hCG

A

VR: (1) Fetal Hydrops (2) hCG

Syncytiotrophoblast

Structure that produces HPL

Week 2-3

When can HPL first be detected

A

VR: (1) Insulin (2) HPL Synthesis

B

VR: (1) PGE2 (2) HPL Synthesis

B

VR: (1) PGF2a (2) HPL Synthesis

Week 24
Week 34-36

Peak HPL levels at what week?

A

VR: (1) HPL (2) Risk for GDM

VEGF and PIGF

Proangiogenic factors produced by decidual NK cells to promote vascular growth

IL-8 and Interferon-Inducible-Protein-10

Signaling proteins expressed by decidual NK cells