IMPLANTATION AND

PLACENTAL DEVELOPMENT
BEDAH WILLIAM OBSTETRICS 26 TH EDITION
JUMAT, 05 AGUSTUS 2022
SIKLUS OVARIUM
➢Cyclical ovulation continues during the almost 40 years.

➢Without contraception,approximately 400 opportunities

for pregnancy.

➢Essential contributors : GnRH, FSH, LH, Estrogen and Progesterone.

Ovulation
•The ovarian-endometrial cycle is
structured as a 28-day cycle.
•Follicular phase (Days 1 to 14)
•Luteal phase (Days 14 to 21)
DESIDUA
The decidua is classified into three parts
based on anatomical location.

• Decidua basalis

• Decidua capsularis

• Decidua parietalis
IMPLANTASI DAN PEMBETUKAN TROPHOBLAS
▪ Fertilization
▪ Blastocyst
▪ Implantation
▪ Trophoblast Development
▪ Early Invasion
PLACENTA AND CHORION
➢Chorion Development
➢Regulators of Trophoblast Invasion
PLACENTA AND CHORION
AMNION

This epithelium attaches firmly to a distinct basement membrane.

Next, an acellular compact layer composed primarily of interstitial
collagens is followed by the fibroblast-like mesenchymal cell layer.
The outermost layer is the relatively acellular zona spongiosa,
which is contiguous with the chorion laeve.
UMBILICAL CORD
The yolk sac and the umbilical vesicle into which it develops
are prominent early in pregnancy. Initially, the embryo is a
flattened disc interposed between amnion and yolk sac.

Blood exits the fetus via the two umbilical arteries. These are
anterior branches of the internal iliac artery and become
obliterated after birth to form the medial umbilical ligaments.
PLACENTAL HORMONES
The production of steroid and protein
hormones by human trophoblasts is
greater in amount and diversity than
that of any single endocrine tissue in all
of mammalian physiology.
After 6 to 7 weeks’ gestation, little
progesterone is produced in the ovary
UMBILICAL CORD
The yolk sac and the umbilical vesicle into which it develops are prominent early in pregnancy.
Initially, the embryo is a flattened disc interposed between amnion and yolk sac.
FETAL ADRENAL GLAND–PLACENTAL INTERACTIONS

• Placental Estriol Synthesis

• Fetal Adrenal Steroid Precurso

• Fetal Conditions Affecting Estrogen

Production

• Maternal Conditions Affecting Estrogen

Production
 REFERENCES

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decidual NK cells. Mol Hum Reprod 17(9):577, 2011
3. Arnholdt H, Meisel F, Fandrey K, et al: Proliferation of villous trophoblast of the human placenta in
normal and abnormal pregnancies. Virchows Arch B Cell Pathol Incl Mol Pathol 60:365, 1991
4. Bathgate RA, Samuel CS, Burazin TC, et al: Human relaxin gene 3 (H3) and the equivalent mouse relaxin
(M3) gene. Novel members of the relaxin peptide family. J Biol Chem 277:1148, 2002
5. Baulieu EE, Bricaire H, Jayle MF: Lack of secretion of 17-hydroxycorticosteroids in a pregnant woman
with Addison’s disease. J Clin Endocrinol 16:690, 1956
6. Baulieu EE, Dray F: Conversion of 3H-dehydroepiandrosterone (3Beta-hydroxy-delta5-androsten-17-
one) sulfate to 3H-estrogens in normal pregnant women. J Clin Endocrinol 23:1298, 196
TERIMAKASIH