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Placenta Quiz

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When does the embryo invade the endometrium? Day 7 What does hCG stand for? Human chorionic gonadotropin Where is is secreted from? Trophectoderm When is hCG first detectable? Day 8

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What are the THREE aims of the implantation? (in terms of placenta..) 1.Anchor the placenta 2.Establishment of basic unit of exchange between fetus and mother 3.Establishment of blood flow within the placenta

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What is the function of hCG? Maintains the corpus lutem Why is this required? Corpus luteum produced progesterone. Progesterone maintains the endometrium until the placenta can take over. What are the three stages/classifications of the villus? Primary syncytio trophoblast penetrated by cords of cytotrophoblast Secondary penetrated by mesenchymal cells Tertiary penetrated by fetal vessels

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How does the villus further develop to adapt to the increasing need of the developing foetus? 1.Thinning of placental barrier 2.Margination of foetal vessels 3.Massive expansion of surface area by arborisation What is the consequence when the placenta is not meeting the needs of the foetus? IUGR intra-uterine growth restriction

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The umbilical cord.. 1. Is made up of 2 umbilical veins and 1 umbilical artery? OR.. 2. Is made up of 2 umbilical arteries and 1 umbilical vein? The second one is correct (think AVA) which carries oxygenated blood? The umbilical vein carries oxygenated blood from mum Whats the name of the other component of the umbilical cord? Whartons jelly

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List THREE factors that affect maternal fetal bloodflow 1.Fetal heart/vessels 2.Umbilical vessels 3.Uteroplacental flow mum MCQ: Maternal-fetal blood flow is which of the following? A.High pressure, high flow B.Low pressure, low flow C.High pressure, low flow D.Low pressure, high flow

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Now for some labeling.. Of a mature placenta WORDS: chorionic villi, placental septa, umbilical cord, amniotic membrane, smooth chorion, umbilical vessels, decidua basalis, endometrial arteries and veins, cytotrophoblastic shell, stump of main villus stem, main villus stem, myometrium, and amniotic fluid. For today just name 1. 2. 4. 7. 8. 11. please.

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What are the THREE placental functions? 1.Endocrine steroid and peptide hormones 2.Transfer of nutrition, waste and gas exchange 3.Immunity What are the TWO peptide hormones? 1.Human chorionic gonadotropin 2.Human placental lactogen Which one of these two peaks at 10-12 weeks? hCG What is the role of human placental lactogen? Glucose metabolism during pregnancy make mum resistant to insulin. Reduced uptake of glucose into maternal cells to favour fetal supply. What are the TWO steroid hormones? 1.Oestrogen 2.Progesterone

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Match the molecule with the transfer mechanism! Water Amino acids Glucose Immunoglobulins Iron Alcohol Active transport Pinocytosis Simple diffusion Active transport Facilitated diffusion Simple diffusion Which immunoglobulin crosses the placenta? IgG think the placenta is gross Which immunoglobulin is found in breast milk? IgA breast milk, areolar

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List FOUR placenta dysfunctions 1.Position/development 2.Growth 3.Blood flow compromised 4.Transport of bad stuff eg. Alcohol What does placenta praevia mean? Low-lying placenta example of a positional dysfunction What are the three types? 1.Marginal 2.Complete 3.Low-lying

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Matching up placenta problems.. What is placenta accreta, increta, percreta? Placenta increta Placenta accreta Placenta percreta Placenta villi invade into part of myometrium Placenta villi invade into whole myometrium Placenta villi invade though the full thickness of the myometrium to the serosa layer and may cause uterine rupture. Uncontrolled invasion or abnormal attachment of the placenta to the myometrium.

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How can placental abruption present in a pregnant lady? Per vaginal bleeding What are the THREE types? 1.Revealed 2.Concealed 3.Concealed and revealed

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List THREE growth dysfunctions of the placenta 1.Uncontrolled growth 2.Gestational trophoblastic disease 3.Molar/choriocarcinoma List THREE blood flow dysfunctions of the placenta 1.Inadequate placentation pre-eclampsia 2.Mechanical IVC compression 3.Volume maternal haemorrhage, can lead to fetal growth restriction

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Pre-eclampsia definition Failure of normal invasion of trophoblast cells which leads to less adapted maternal spiral arteries in the placenta this is an example of abnormal placental development. Triad of clinical features? 1.Hypertension 2.Proteinuria 3.Oedema What is eclampsia? Tonic-clonic seizures in pregnancy

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What are FOUR causes of placental dysfunction? 1.Smoking 2.Drugs eg. Cocaine 3.Alcohol by what transport mechanism does this reach the fetus? What can this cause in the fetus? Simple diffusion moves down the concentration gradient to the fetus causing fetal alcohol syndrome. 4. Infectious agents eg. Rubella, hepatitis B/C, HIV

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Thank-you! Any questions? Good luck with your revision