Repro - 1-7 Placenta And Trophoblastic Disease

Front 1

Zygote gives rise to...

Back 1

fetal membranes - amnion and chorion

embryo

most of the placenta
Villous chorion - fetal portion
Decidualis basalis - maternal portion

Front 2

Villous chorion (chorionic villi)

Back 2

part of the fetal component of theplacenta

Front 3

Decidualis basalis

Back 3

The maternal component of the placenta.

Front 4

Cytotrophoblast

Back 4

Inner layer of the chorionic villi (fetal portion of the placenta)

Front 5

Syncytiotrophoblast

Back 5

Outer layer of chorionic villi; secretes hCG

Front 6

Definiton of ectopic pregnancy

Back 6

implantation of fetus in any site other than normal uterine location

Front 7

Which part of embryo/placenta invades into vessels?

Back 7

Syncitiotrophoblast (outer layer of chorionic villi)

Front 8

Do fetal and maternal vasc system mix?

Back 8

no

Front 9

Placental membranes

Back 9

It is fetal tissue that separates the fetal and maternal circulations.

Front 10

Fetal surf of placenta

Back 10

Has the cord on it

Front 11

Maternal surf of placenta

Back 11

Up against the wall.
If there is a large clot on it, it is usually due to an abruption.

Front 12

What structures sep fetal and mat circulation?

Back 12

It is the placental membranes - is this both amnion and smooth chorion???

i dont know, find this out.

Front 13

Slide 16 is imp

Back 13

kfldj

Front 14

Are spiral arteries in mom or baby?

Back 14

mom
They connect to endometrial arteries.
They are the end arteries where interchange occurs.

Front 15

Function of septum in the placenta

Back 15

Give structure to the caverns of the placenta. This way, if there is a sudden increase in pressure, there is no collapse of the intervillous space.

It gives the placenta some sponginess.

Front 16

Distance of vasculat interaction of the placenta

Back 16

One cell layer thick.

Front 17

Monochorionic placentas imply...

Back 17

monozygotic twins.

Front 18

Slide 19

Back 18

imp for twin placentation

Front 19

Which is on the outside relative to the baby? amnion or chorion?

Back 19

chorion.

Front 20

Where are dichorionic placentas seen?

Back 20

usually dizygotic twins.

sometimes monozygotic twins.

Front 21

Complications of twin pregnancies

Back 21

twin-twin transfusion syndrome

conjointing (monochorionic placentas) - cant sep from sibling.

Front 22

The especially bad thing with monochorionic monoamnionic placentas

Back 22

The babies tumble into each other and cross cords and one dies.

Front 23

Issues with genetically identical twins (monochorionic diamnionic usually)

Back 23

Vessels anastamose to get weird abnormalitise/malformation.

Often there is a donor (frail, weak) and recipient twin (overnourished)

Front 24

Monozygotic twins have __ placentas.

Dizygotic have ___

Back 24

1

2

Front 25

Vague functions of placenta

Back 25

Transfer - gas, nutrients, hormones, wastes, drugs.

metabolism - synth of glycogen, chol and FAs

endocrine secretion - protein hormones (hCG, hPL, thyrotropin) and steroid hormones (estrogens and progesterones)

Front 26

Does the placenta give an immunity barrier for an "alien?"

Back 26

yes

Front 27

Most imp predisposing condition for ectopic pregnancy

Back 27

pelvic inflammatory disease with chronic salpingitis.

Front 28

Disorders of early preg

Back 28

spont abortion

ectopic preg

Front 29

disorders of late preg

Back 29

umbilical cord complic
infections
retroplacental hemorrhage (abruption)
fetal vessel rupture in terminal villi (intervillous hemorrhage)
uteroplacental insuff
toxemia of pregnancy

Front 30

Infections in later pregnancy - these are often screened for

Back 30

Toxoplasmosis
Other (listeriosis, TB, syphilis)
Rubella
CMV
Herpes

Front 31

False knot of umbilical cord

Back 31

Usually a varicose vein

Front 32

True knot

Back 32

you often see a diff btwn the two sides of the knot.

Front 33

Why is cord wrapped around neck a problem?

Back 33

CORD is compressed too bad (the neck isn't an issue)

Front 34

Velamentous cord insertion

Back 34

Cord not inserted in middle of placenta, but in membranes to make it very vulnerable

Front 35

Intrauterine herpes infection affects...

Back 35

brain, liver, adrenals.

Front 36

Uteroplacental insufficiency

Back 36

Abnormal placentation
shape (accessory lobes or bilobed placentas)
End up with an infarcted piece.

Placental previa - implantation at cervical os causing ante-partem bleeding

Placenta accreta - absence of decidua basalis (derived from endometrium) causing post-partem bleeding.

Front 37

With placental infarction, what dies?

Back 37

Fetal villi (the trees in the placenta picture)

Front 38

With intervillous thrombosis, what happens?

Back 38

Issue of the vascular space with congested adjacent villi

Can result in an anemic fetus.

Front 39

Toxemia of pregnancy

Back 39

Pre-eclampsia (last trimester)
HTN, proteinuria, edema
Often with first child and younger women.
Tx - termination of pregnancy and hope the baby can survive.

Eclampsia - convulsions and DIC

Front 40

Proliferative diseases of gestational trophoblast

Back 40

Hydatidiform mole (partial or complete)
invasive mole
placental site trophoblastic tumor
choriocarcinoma (gestational or non-gestational)

Front 41

Hydatidiform Mole

Back 41

From chorionic villi forming grape-like structures

Complete - all villi are edematous. Tons and tons of hCG
can be followed by choriocarcinoma
No maternal DNA (46XX/XY)

Partial mole - Some villi are edematous and trophoblastic prolif is focal.
hCG not as highly elev.
Rarely followed by choriocarcinoma
Mat and pat DNA (69XXY or XXX)

Front 42

Invasive mole

Back 42

One or more invade myometrium or spread to other organs.

Secretes hCG

Can cause uterine hemorrhage, perforation or infection.

Front 43

Placental site trophoblastic tumor

Back 43

Rare tumor (proliferating intermediate-type trophoblast)
Secretes hPL (not hCG)
Locally invasive (no cytotrophoblast)

Front 44

Choriocarcinoma (gestational)

Back 44

Malig tumor arising from gestational trophoblast
Follows spont abortions, hydatidiform moles (complete), or normal preg.

Secretes hCG
Comprises sycytio- and cytotrophoblast

Curable

Front 45

Choriocarcinoma (non-gest)

Back 45

Not associated with pregnancy

Gonadal origin.

May arise in a mixed germ cell tumor or as a pure chorionic tumor.

Can be in gonads or mediastinum.