FETAL MEMBRANES Placenta Nutrition
Transcription
FETAL MEMBRANES Placenta Nutrition
FETAL MEMBRANES Placenta Nutrition 2011 Fetal membranes Chorion Amnion Yolk sac Allantois They develop from zygote, however they are not involved in embryo formation except for small part of yolk sac, that participate on gut formation Amnion Amnionic fluid Amnioblasts, interstitial fluid form endometrium Embryo (before skin keratinization) – transudation from body Umbilical cord Respiratory system, urine 10th week – 30ml 20th week – 350ml 37th week - 7001000ml Function of amniotic fluid It allows symetric growth Protects from infection Facilitates normal development of lung Protects from adhesion Protects from injury Keeps stabile temperature Alows free movement Takes place in homeostasis (electrolytes) Failures of amnionic fluid volume Oligohydramnion – less than 400ml rupture of fetal membranes, renal agenesis – (Potter syndrome) pulmonary hypoplasia, pes equinovarus, face dysmorfy Polyhydramnion – more than 2000 ml – malformed CNS, esofageal atresia, twins, idiopatic Yolk sac Transfer and metabolism of nutrients – as liver Development of blood cells and vessels -vitelline vascular system Participation on formation of primitive gut Primordial gamets in endoderm of yolk sac during 3rd week Allantois Development form hindgut – evagination into embryonic stalk - only transient Vessels – umbilical arteries and veins for placenta supply Intraembryonic part – urachus, urinary bladder ( ligamentum umbilicale medianum) Placenta Fetal organ providing nutrition and many other functions: Function: − Metabolism (synthesis, for example glycogen) − Transport of gases and nutrients − Excretion of waste products − Production of hormones (hCG) Embryo nutrition Nutrients supply in yolk sac (AA, lipids) Histiotrophe – secret from glandular cells in fallopian tube, uterus, digestion of endometrium Haematotrophe – maternal blood Organ that provide nutrition of embryo in mammals - chorion/placenta Placenta - structure Fetal part – chorion – chorionic plate and chorionic villi Maternal part – endometrium – pars functionalis – decidua basalis Decidua Zona functionalis that is changing during pregnancy Decidua basalis Decidua capsularis Decidua parietalis Progesteron – cell in stroma (fibroblasts) are changed in decidual cells (content of glycogen and lipids)+ changes in vascular supply = decidual reaction Implantation Implantation During implantation embryo invades in zona functionalis of endometrium Trophoblast diferentiates into syncytiotrophoblast and cytotrophoblast Extraembryonic mesoderm adds to cytotrophoblast = CHORION Development of chorionic villi Primary: Syncytiotrophoblast and cytotrophoblast Secondary: Syncytiotrophoblast, cytotrophoblast and extraembryonic mesoderm Tertiary: Vessels occur in mesoderm Terctiary villi are all from 3rd week of development Placenta development Chorion laeve Chorion frondosum Decidua capsularis get thiner, later disappears, chorion laeve is on the surface, it unites with decidua parietalis and obliterates uterine cavity ( week 22 -24) Intervillous space It develops from lacunae in sytiotrophoblast It is divided by placental septa Maternal blood – spiral arteries in decidua basalis – uteroplacental vessels It wash up villi – it is drained into placental veins. Fetal and maternal blood do not mix !!! Hemocytoblasts (stem cells) may cross from embryonic to maternal blood and stay there for relatively long time (several years) -chimera Placental circulation Umbilical arteries -deoxygenated blood from embryonic body Chorionic arteries branching in chorionic plate Capillary network in chorionic villi Placental membrana Interface between maternal and fetal blood • Syncytiotrophoblast • Cytotrophoblast • Connective tissue • Endothelium of fetal capillary After week 12 cytotrophoblast gradually disappears, vessels come near to surface and get in contact with syncytiotrophoblast 3rd trimester Nuclei of syncytiotrophoblast form aggregations – syncytial knots that may set free Formation of fibrinoid – it reduces placental transfer Syncytiotrophoblast – microvilli, SER, RER, GC, mito – active synthesis Cytotrophoblast – undifferentiated cells – mitoses Basal membrane Continuous endothelium Feto-maternal junction Different genotype – necessity to supress imunity: Maternal and fetal tissue are separted by the cells that do not have typical superficial antigens. Hormonal changes (progesteron, glucocorticods) – Blood - Syncytiotrophoblast – Connective tissue – Cytotrophoblastic shell Stem - anchoring villi attach chorion to the decidua basalis – inside cytotrophoblastic plug Placenta Placental shape – discoid (olliformis) + haemochorial Placental septa – rests of decidua basalis. They separate placenta from maternal side in lobes - cotyledons Cotyledons – contain 2 and more anchoring villi Diameter – 15 -20 cm, thickness 2-3 cm, weight 500 to 600 g Placental transfer Difusion Facilitated difusion Active transport Pinocytosis Other types of transfer: Damage of placetal barrier – blood cellas Own activity – Treponema pallidum Damage due to infection - toxoplasmosa Transfer Many substances from maternal blood may transfer placental barrier including drugs Nutrients – glucose, AK, fatty acids, water, vitamines, electrolytes Hormones – only steroid unconjugates Maternal antibodies, transferin+ iron Syntesis hCG – human chorionic gonadotropin hCS – human chorionic somatomammotropin/placental lactogen hCT human chorionic thyrotropin hCACTH human chorionic corticotropin Progesteron and estrogens Placental abnormalities Atypical implatation: Placenta previa Placenta accreta Placenta percreta Placenta membranacea Placenta accessoria Atypical attachment of umbilical cord-marginal, velamentous Development of mbilical cord Connective stalk with umbilical arteries and veins and allantois Ductus omphaloentericus connecting gut with yolk sac Extraembryonic coelom Umbilicus Development of umbilical cord • Length 50 cm