Guang-xi medical university chen weiping Components of the placenta and fetal membranes : • The chorion, amnion, yolk sac, allantois, and umbilical cord constitute the fetal membranes. • All these membranes develop from the Zygote. The decidua The endometrium that are filled with extravasate and the tissue is edematous, cells of the endometrium become polyhedral and loaded with glycogen and lipids , is named the decidua. (decidua reaction) Three regions of the decidua (1) Decidua Basalis: the part of the decidua deep to the conceptus that forms the maternal component of the placenta. (2) Decidua Capsular: the superficial portion overlying the conceptus. (3) Decidua Parietalis: all the remaining mucosal lining of the uterus. Changes in the trophoblast 1 By the beginning of the second month the trophoblast is characterized by a great number of villi , so it is named the chorion. The surface of the villi is formed by the syncytrophoblast , resting on a layer of cytotrophoblastic cells , with a core of vascular mesoderm. Changes in the trophoblast 2 1.The villi on the embryonic pole continue to grow and expand, giving rise to the chorion frondosum (bushy chorion). 2.The villi on the abembryonic pole degenerete , known as the chorion laeve (smooth chorion). 3.The decidua over the chorion frondosum( bushy chorion) is the decidua basalis Structure of the placenta The chorion frondosum (bushy chorion) and the decidua basalis makes up the placenta. The placenta has two components: a fetal portion formed by chorion frondosum a maternal portion formed by decidua basalis The decidual septa grow from the decidua ,project into the intervillous spaces , separate the villi into cotyledons ( about 15-25 group). Full-term placenta The placenta is a discoid with Diameter 15-25 cm thick 3 cm Weigh 500-600 g Viewed from the maternal side: cotyledons 15-25 slightly bulging areas Viewed from the fetal surface: the chorionic vessels the umbilical cord the amnion Circulation of the placenta The spiral arteries The fetal circulation The intervillo us spaces The endometrial veins The placental membrane The maternal circulation The placental membrane The placental membrane (placental barrier) composed of four layers: the endothelial of fetal vessels the connective tissue the cytotrophoblast the syncytium After fourth month the placenta membrane thins , consist of the endothelial lining of the vessels and the syncytial membrane. syncytiotrophoblast The intervillous spaces cytotrophoblast endothelium of the fetal capillaries connective tissue Transverse section of a villus Fuction of the placenta 1 The placenta has three main activities: (1) transfer (2) endocrine secretion. All these activities are essential for maintaining pregnancy and promoting normal embryonic and fetal development. O2 H2O, Ion Monosaccharides Free fatty acids Amino acids Vitamins Hormones Drugs Viruses CO2 Urea Uric acid Bilirubin H2O, Ion Hormones maternal blood Placental Membrane fetal blood Fuction of the placenta 2 The syncytiotrophoblast synthesizes various hormones. Protein Hormones The protein hormone products of the placenta are (1) human chorionic gonadotropin (hCG), (2) human placental lactogen (hPL). Steroid Hormones The placenta plays a major role in the production of (1) progestins (2) estrogens. The Umbilical Cord The attachment of the umbilical cord is usually near the center of the placenta, but it may be found at any point. The umbilical cord is usually 1 to 2 cm in diameter and 30 to 90 cm in length (average 55 cm). The umbilical cord usually contains two arteries and one vein that are surrounded by mucoid connective tissue,. amnion amniotic sac ectoderm allantois mesoderm endoderm yolk sac Foregut midgut hindgut The Amnion And Amniotic Fluid The amnion forms a fluid-filled membranous amniotic sac that surrounds the embryo and, later the fetus. Because the amnion is attached to the margins of the embryonic disc, its junction with the embryo is located on the ventral surface after folding of the embryo. As the amnion enlarges, it gradually obliterates the chorionic cavity and sheathes the umbilical cord. Origin of the Amniotic Fluid Initially some fluid may be secreted by the amniotic cells, but most amniotic fluid is derived from the maternal blood by transport across the amnion from the decidua parietalis and the intervillous spaces of the placenta. The fetus also makes a contribution to the amniotic fluid by excreting urine into the amniotic cavity. Volume of the Amniotic Fluid The volume of amniotic fluid normally increases slowly, reaching about 30 ml at 10 weeks, 350 ml at 20 weeks, and 1000 ml by 37 weeks. Circulation of the Amniotic Fluid The water content of amniotic fluid changes every three hours. Large amounts of amniotic fluid pass through the amnion into the maternal blood, particularly where the amnion is adherent to the fetal surface of the placenta. Amniotic fluid is also swallowed by the fetus and absorbed by the fetus’s digestive tract. 胎盘 脐带 子宫腔 Exchange of the Amniotic Fluid Large volumes of fluid move in both directions between the fetal and maternal circulations, mainly via the placental membrane. Fetal swallowing of amniotic fluid is a normal occurrence. Most of the fluid passes into the gastrointestinal tract. The fluid is absorbed into the fetal circulation and then passes into the maternal circulation via the placental membrane. Composition of the Amniotic Fluid The fluid in the amniotic cavity is a solution in which undissolved material is suspended. It consists of desquamated fetal epithelial cells. Studies of cells in the amniotic fluid permit diagnosis of the sex of the fetus and the detection of fetuses with chromosomal abnormalities. Significance of the Amniotic Fluid The embryo, suspended by the umbilical cord, floats freely in the amniotic fluid This buoyant medium (1) permits symmetrical external growth of the embryo; (2) prevents adherence of the amnion to the embryo; (3) cushions the embryo against injuries by distributing impacts the mother may receive; (4) helps control the embryo’s body temperature by maintaining a relatively constant temperature; (5) enables the fetus to move freely, thus aiding musculoskeletal development. Oligohydramnios Low volumes of amniotic fluid (e.g., 400 ml in the third trimester) results in most cases from placental insufficiency with diminished placental blood flow. In renal agenesis (failure of the kidneys to form), the absence of the fetal urine is the main cause of oligohydramnios. Polyhydramnios An accumulation of amniotic fluid in excess of 2000 ml may occur when the fetus does not drink the usual amount of amniotic fluid. This condition is often associated with severe malformations of the central nervous system. In other malformations, such as esophageal atresia, amniotic fluid accumulates because it is unable to pass to the stomach and the intestines for absorption. The Yolk Sac By nine weeks, along with the folding of embryo the yolk sac has shrunk to a pear-shaped remnant. It is connected to the midgut by the narrow yolk stalk. By 20 weeks, the yolk sac is very small; thereafter, it is usually not visible. amnion amniotic sac ectoderm allantois mesoderm endoderm Foregut midgut hindgut yolk sac Significance of the Yolk Sac Although the human yolk sac is nonfunctional, it plays an important rule in making hematopoiesis and forming the germ cells during the embryo development. Blood development occurs in the wall of the yolk sac beginning in the third week and continues to form there until hematopoietic activity begins in the liver during the sixth week. The primordial germ cells appear in the wall of the yolk sac in the third week and subsequently migrate to the developing sex glands or gonads. Here, they become the germ cells (spermatogonia or oogonia). Fate of the Yolk Sac At 10 weeks, the small yolk sac lies in the chorionic cavity between the amnion and the chorionic sac. The yolk sac shrinks as pregnancy advances, eventually becoming very small. The yolk stalk usually detaches from the midgut loop by the end of the sixth week. The Allantois Significance of the Allantois Although the allantois does not function in human embryos, it is important for two reasons: (1)blood formation occurs in its wall during the third to fifth weeks; and (2) its blood vessels become the umbilical vein and arteries amnion amniotic sac ectoderm allantois mesoderm endoderm Foregut midgut hindgut yolk sac Fate of the Allantois The intraembryonic portion of the allantois runs from the umbilicus to the urinary bladder, with which it is continuous. As the bladder enlarges, the allantois involutes to form a thick tube called the urachus. After birth, the urachus becomes a fibrous cord, called the median umbilical ligament , that extends from the apex of the urinary bladder to the umbilicus. Twins Twins may originate from two zygotes, in which case they are dizygotic twins or fraternal twins, or from one zygote, i.e., monozygotic twins or identical twins. The fetal membranes and placenta(s) vary according to the origin of the twins. In the case of monozygotic twinning, the type of membranes formed depends on when the twinning occurs. If division of the inner cell mass occurs after the amniotic cavity forms (about eight days), the identical embryos will be within the same amniotic and chorionic sacs. Dizygotic Twins Because they result from the fertilization of two ova by two different sperms, dizygotic twins may be of the same sex or different sexes. Dizygotic twins always have two amnions and two chorions, but the chorions and placentas may be fused. Dizygotic twinning shows a hereditary tendency. Monozygotic Twins Because they result from the fertilization of one ovum, monozygotic twins are of the same sex, genetically identical, and very similar in physical appearance. Physical differences between identical twins are environmentally induced Monozygotic twinning usually begins in the blastocyst stage, around the end of the first week, and results from division of the inner cell mass into two embryonic primordia. Subsequently two embryos, each in its own amniotic sac, develop within one chorionic sac and have a common placenta.