EXAM 2

BIOCHEMISTRY: The
Obstetrics 1 DNA Placenta
Replication and
and Fetal Membranes
Repair
1-3
Dra. Teresita C. Brion June 27, 2011

multiple nuclei diverse in size and

shape
Outline
Outline permeated bu a system of
Placental
Placental and
and Fetal
Fetal Membranes
Membranes intercommunicating channels of
Placental
Placental Membrane
Membrane trophoblastic lacunae or small cavities
Development
Development of of Placenta
Placenta o Cytotrophoblast
Placental
Placental Compartments
Compartments
Fetal Innermost layer
Fetal and
and Maternal
Maternal Circulation
Circulation
Fetal Embryonic side
Fetal circulation
circulation
Maternal
Maternal circulation
circulation Cells neares the intervillous space
Fetoplacental
Fetoplacental Endocrinology
Endocrinology - Impetus is provided by the trophoblast
HCG
HCG - Limitation of trophoblast invasion by maternal deciduas
HPL
HPL - 2 poles of Implanted blastocyst:
Other
Other placental
placental hormones
hormones o Outer pole- extends to the uterine cavity and
becomes covered by chorion frondosum and
deciduas capsularis
The
The Placenta
Placenta and
and Fetal
Fetal Membranes
Membranes
o Inner pole- buried in decidua to become placenta
- Trophoblast proliferation and invasion
o Provides attachment of blastocyst to the decidua
PLACENTAL
PLACENTAL MEMBRANE
MEMBRANE o w/ endometrial invasion, maternal blood vessels
(spiral arteries) are tapped to form lacunae w/c
1. Amnion nearer the fetus soon fill with blood
2. Chorion nearer the maternal deciduas - Lacunar period
o Lacunae joins together to form complicated
DEVELOPMENT
DEVELOPMENT OF
OF THE
THE PLACENTA
PLACENTA labrynth patrtitioned by solid trophoblastic
columns that will be known as 1 villi
Day 13-19 Formation of 1 and 2 villi
- Fertilization signals the start of the cascade of events - 1 and 2 villi are formed
- 1 villi are form from solid cellular columns
Day 0-2 Post-fertilization - 2 villi formed when stalks are invaded by mesenchymal
- Cleavage of the zygote into blastomeres cord
Day 3 Post-fertilization - Body stalk (umbilical cord) and amnion are formed
- Morula enters uterine cavity - Placental circulation starts
Day 4-5 Post-fertilization Day 14-15
- Formation of the blastocyst - Maternal blood enters the intervillous space through spiral
- Inner cell mass becomes the embryo arteries in fountain-like bursts
- Outer cell mass becomes the trophoblast Day 19-21 3 villi formation
- Blastocyst- travels the fallopian tube - 3 villi- formed when angiogenesis occurs in situ from
- Free blastocystic stage (wanders, travels) implant to mesenchymal cord
uterus - Fetal capillaries (important for the physiology of placenta)
Day 5-6 Implantation of blastocyst form in situ
- Disappearance of zona pellucid (halo around blastocyst) Day 17
which signals implantation of blastocyst - Feto-placental circulation is established
o Zona pellucida is lost Day 18-21
o Blastocyst is ready to be implanted (late - Without angiogenesis cystic form hydatidiform mole
blastocyst) (abnormal pregnancy)
- Apposition- adherence to the endometrial surface Day 21-40
(commonly at upper posterior wall of the uterus) - Chorion frondosum formation
Day 7-8 Implantation of blastocyst - Intervillous space:
- Trophoblast erodes epithelial cells of the surface o Roof -Chorionic plate
endometrium o Floor -cytotrophoblast from the cell columns with
- Blastocyst invades deeply into the endometrium the tropectoderm and deciduas
Day 9 Implantation of blastocyst
- Blastocyst is completely buried in the maternal
- Placental septa- consists of decidual tissues covering
endometrium trophoblastic elements witht he fetal and maternal
Day 10 Implantation of blastocyst components
- Innermost trophoblast contiguous with, invading the Day 40-50 Cotyledon Formation
endometrium coalesce to become the syncytium - Continued growth of definitive placental chorion frondosum
(bounderies are not well-defined) - Villi in contact with deciduas basalis
Day 12 - Anchoring villi- extend from the chorionic plate to the
- 2 distinguishing layers of trophoblast deciduas
o Syncitiotrophoblast - Placenta has 2 components that become intimately related:
o Chorion frondosum
contiguous w/ maternal deciduas &
o D. basalis
later maternal blood
has secretory function - Stem villi- aboresce and end freely in the intervillous space
and form the placental cotyledon
amorphous cytoplasm
w/o cell borders

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 EXAM 2
- Blood supply and villous nature of the chorion frondosum
BIOCHEMISTRY:
towards the endometrial cavity are lost DNA Replication
Amnion and Repair
- Chorion frondosum becomes an avascular membrane - provides almost all tensile strength of fetal membranes
known as the chorion laeve (smooth chorion) - avascular tissue
Day 225-267 - twin pregnancy
- Cell proliferation ceases o 2 amnions, 1 chorion
- Growth to term o 1 amnion, 1 chorion
- Cellular hypertrophy continues o 1 amnion, 2 chorions

PLACENTAL
PLACENTAL COMPARTMENTS
COMPARTMENTS Umbilical cord
- 2 arteries, 1 vein
- Chorion frondosum leafy chorion; becomes the fetal - Fetal umbilicus to fetal surface of placenta or chorionic
compartment plate
- Deciduas basalis becomes the maternal compartment - Ave length 55cm
- Deciduas capsularis+ deciduas parietalis = decidua vera - Ave diameter 0.6- 2.0cm
- White, moist and covered by amnion
Chorionic Villi in Early and Late Pregnancy - Derived from body stalk
Feature Early Late - Extracellular matrix is comprised of Wharton jelly
Syncitial layer Thick, abundant Thinner, in knots - Blood flow from umbilical vein
Cytotrophoblast Inc. Prominence Less prominent o Ductus venosus emptying directly into ferior
and volume and volume vena cava and other small opening into the fetal
Hofbauer cells Prominent and Less number hepatic circulation
abundant o Inferior vena cava- by hepatic vein
Chorionic stroma Abundant and Minimal and
loose dense
Fetal capillaries/ fibrin Less number Inc. Number and
Fetoplacental
Fetoplacental Endocrinology
Endocrinology
and prominence prominence

Human trophoblast- produces proteins & steroids

Placenta secretes protein hormones, mineralocorticoids and
steroids; endohormone
Fetal
Fetal and
and Maternal
Maternal Circulation
Circulation in
in Placenta
Placenta

- The fetal surface of the placenta is covered by the amnion
where the fetal chorionic vessels course
- The maternal surface is divided into irregular lobes by
furrows produced by septa, w/c consist of fibrous tissue w/
sparse vessels confined mainly to their bases.
FETAL
FETAL CIRCULATION
CIRCULATION
- Deoxygenated fetal blood flows to the placenta throung the
two umbilical arteries
- The umbilical vessels then branch repeatedly beneath the
amnion as well as w/in the dividing villi where the umbilical
cord joins the placenta to form the capillary networks in the
terminal divisions
- Blood with a greater amt of oxygen content returns from
the placenta to form the capillary networks in the terminal
divisions
- Before 10 weeks, there is no end-diastolic flow pattern w/in
the umbilical artery at the end of the fetal cardiac cycle
- At 10 weeks, end-diastolic flow appears and is maintained
throughout normal pregnancies
MATERNAL
MATERNAL CIRCULATION
CIRCULATION
- Maternal blood enters through the basal plate and is driven
high up toward the chorionic plate by maternal arterial
pressure before lateral dispersion occurs
- The maternal blood drains back through venous orifices in
the basal plate and enters the uterine veins after bathing
the external microvillous surface of chorionic villi
- W/ the aid of maternal arterial pressure propulsion,
maternal blood traverses the placenta randomly w/o
preformed channels
- Principal factors regulating BF in the intervillous space:
o Arterial BP
o Intrauterine pressure
o Pattern of uterine contractions
o Factors that act specifically on arterial walls
HUMAN
HUMAN CHORIONIC
CHORIONIC GONADOTROPIN
GONADOTROPIN
- Earliest normal sign of pregnancy
- Detectable in maternal circulation in 8-9 days post-
ovulation
- Doubling time 1.7-2 days (important in monitoring possible
pregnancy loses)
- Rescue corpus luteum to assure continued progesterone
support
- Glycoprotein - subunit- shared with LH, FSH and TSH
- Glycoprotein - subunit unique to HCG
- Secreted by syncitiotrophoblast
- At the time of expected but missed menstruation, about
100 IU/mL
- Maximal level during 10th week : 50,000- 100,000 IU/mL
(may produce vomiting)
- Decreases from 20th week up to term: 10,000-20,000 IU/mL
- Functions:
o Stimulation of fetal testis- acts as LH surrogate
by stimulating leydig cells to synthesize
testosterone and promote sexual differentiation
o Stimulation of maternal thyroid activity via
LH/HCG receptors and TSH receptor
o Uterine vascular vasodilation and myometrial
smooth muscle relexation
o Relaxin secretion by the corpus lutem
o Marker for pregnancy
Low level- poor placental function
abortion/ectopic pregnancy
High level- multiple pregnancy
o Monitoring GTD
HUMAN
HUMAN PLACENTAL
PLACENTAL LACTOGEN
LACTOGEN
- Chorionic growth hormone/ chorionic somatomammotropin
- Glycopeptides similar to prolactin
- Identified in cytotrophoblasts from before 6 weeks
- 2nd 3rd week after fertilization of ovum (5th wk AOG)
- Detected in placenta 5-10 days after conception

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 EXAM 2
- Rises until 34-36 weeks
- BIOCHEMISTRY:
Prolonged maternal starvation DNA
in 1st half of pregnancy leads Replication and Repair
to an increase in the plasma concentration of HPL
- Concentrated in syncitiotrophoblast
- Production rate: 1g/day near term (greatest of any known
hormone in humans)
- Level in late pregnancy: 5-15 ug/L
- Stimulated by insulin and insulin-like growth factor 1
- Inhibited by PGE 2 and PGF 2
- Lower amniotic fluid than in maternal plasma
- Action more on maternal than in fetal tissues
- Secreted primarily in maternal circulation and very little in
fetal
- Metabolic actions:
o Anti-insulin action
Inc. Maternal insulin protein synthesis to
provide mobilizable amino acids/fetal
transport
Maternal lipolysis and an increase in circ
FFA therby providing energy for maternal
metabolism and fetal nutrition
Potent angiogenic hormone, may also play
an important role in the formation of fetal
vasculature
- Not required for pregnancy success
- Function:
o Ensure nutrient supply to fetus esp. During times
of maternal starvation
o Tumor marker in trophoblastic /gonadal tumors,
bronchogenic carcinoma, etc.

OTHER
OTHER PLACENTAL
PLACENTAL HORMONES
HORMONES

1. Relaxin
- Corpus luteum, deciduas, placenta
- Promotes myometrial smooth muscle relaxation
- Rise in early pregnancy is due to secretion by corpus
luteum
2. Parathyroid Hormone-related Protein (PTH-RP)
- Parathyroid of fetus
- Responsive to extracellular Ca++

3. Placental growth Hormone

- Aka Growth hormone variant (hGH-V)
- Biologic activity is similar to HPL

4. Gondadotropin-releasing Hormone (GnRH)

- Found in cytotrophoblast not in syncitiotrophoblast
- Regulated by inhibin and activin
- Stimulates HCG secretion

5. Corticotropin-releasing Hormone (CRH)

- During pregnancy:
Significantly elevated and increased to about
100 pmol/L in early 3rd trimester and to 500
pmol/L during last 5-6 weeks
- After labor:
Increases further by about two-threefold

* Chemical Pregnancy- If HCG doesnt double accordingly, it may

lead to early fetal loss
*GTD gestational trophoblastic disease (h.mole, choriocarcinoma)

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 EXAM 2

TAWA TAYO ! =)) BIOCHEMISTRY: DNA Replication and Repair

Day 171... I've sprouted an odd finger. Counting the one from
yesterday (:::looking down at lap:::), I'm up to 11. As the months of
solitude pass,Ive
become to go insane. It
seems my prison cell is
getting smaller and
smaller. I was quite
sure that soon I
would be dead. But
then, a miracle!
There was a light at
the end of the tunne.I
rush to freedom but
suddenly I was
ambushed by a
mysterious man in
white.. ;P
-The Family Guy :
Escaping the Womb

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 EXAM 2

BIOCHEMISTRY: DNA Replication and Repair

Trans By: Bea*Maira*Mau*Vernz Page 1 of 3