INDS 211 Lecture Notes - Lecture 26: Placental Insufficiency, Antithrombin Iii Deficiency, Factor V Leiden
2 Jan 2019
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Extracellular communication (?integrins endometrial progesterone) receptors; ?pinopods) Synchronized with embryo development: blastocyst hatches from the zp, invades into endometrium, @7-8 days development (n. b. days refers to days since ovulation, vs. weeks since last menstrual period. Placental development: day 9-10 syncytiotrophoblasts in lacunae, formation of maternal blood lakes, day 11-12: cytotrophoblast forms villi surrounded by invading syncytiotrophoblasts through endometrium, day 10-20: primary and secondary villi formation. Mature placenta: 20cm diameter disc, 2-3cm thick, discoid (chorionic plate = decidual plate) fetal surface: smooth, amnion and chorion, fetal vessels. Maternal surface: irregular, lobes/cotyledons, placental septae: weight 1/7th weight of fetus (= 500g at term, villi surface area 11-14m2; large surface area for diffusion, maternal blood flow 300-600 ml/min. Some indication that this is immune mediated: risk factors: primiparous, african american, relative placental ischaemia production of ischaemic/necrotic factors. Continued high resistance/low volume system (causes vasoconstriction everywhere e. g. preeclampsia: outcomes: fetal growth retardation, pre-eclampsia, fetal death.
