GENERAL EMBRYOLOGY 8

Fetal Membranes
DR. OTHMAN ABU HANTASH
 Placenta
❑It is a vital organ of connection
between the fetus & the mother
allows exchange of material
between fetal & maternal blood.
❑Full term placenta:
• Discoid in shape, 500-600 gram in
weight, 15-20 cm in diameter, 3
cm thickness,
• located mostly in the upper
posterior segment of the uterus,
near the fundus, occupying 15-
30% of internal uterine surface.
 Placenta
❑It has 2 surfaces:
✓ Fetal surface: faces the fetus, it is
smooth & covered with transparent
amnion , the umbilical cord attached
near its center.
✓ Maternal surface: in contact with the
uterine rough, irregular, divided by
grooves into 15-20 slightly elevated
areas called cotyledons, it is covered
by a thin layer of decidua basalis.
❑Component of the placenta:
✓ Maternal part: the decidua basalis
✓ Fetal part: the chorion frondosum.
 Placental Circulation
❑Maternal circulation in the
placenta:
• Maternal blood (oxygenated)
passes from the spiral
arterioles of the decidua
basalis to the intervillous space
between the villi.
• Then the blood leaves via
numerous thin walled decidual
veins.
 Placental Circulation
❑Fetal circulation in the placenta:
• The deoxygenated fetal blood
reaches the placenta via branches
of the 2 umbilical arteries.
• The blood flows through the
arterioles then the capillary loop
inside the villi where exchange of
gases takes place.
• Oxygenated blood return to the
fetus via venules & veins which
join one another & drain into the
umbilical vein.
 Placental Barrier
• It means the layers of the villous wall
which separate fetal blood (in the capillary
loop of the floating villus) from maternal
blood (in the intervillous space).
• In early pregnancy it is formed of 4 layers:
✓ The endothelial lining of the capillary loop
in the villus.
✓ Extraembryonic mesoderm in the core of
the villus.
✓ A layer of cytotrophoblast.
✓ A layer of syncytiotrophoblast.
Function of the Placental Barrier
• In late pregnancy: at the 4th month the placental
barrier is reduced & become formed of:
✓ The endothelial lining of the capillary loop in the villus
✓ A layer of syncytiotrophoblast.
❑Function of the Placental Barrier
✓ It separate between fetal & maternal blood.
✓ It permits gaseous, nutritive & wastes exchange.
✓ Allows passage of maternal antibody to fetal blood.
✓ Prevents passage of bacteria & most of viruses, except
HIV, poliomyelitis, rubella, measles, cytomegalovirus.
✓ Prevents passage of most toxic material & most of
maternal hormones, except some synthetic hormones
 Function of the placenta
❑Respiratory function:
✓ Oxygen diffuse from maternal blood to fetal blood.
✓ The fetus extracts 20-30 ml of O2/minute from the
maternal circulation & even a short term interruption
of the oxygen supply is fatal.
✓ CO2 diffuse from fetal blood to maternal blood.
❑Nutritive function: passage of nutrient substances,
as amino acids, free fatty acids, carbohydrates &
vitamins & minerals is rapid & increases as
pregnancy advances.
❑Excretory function: diffusion of nitrogenous products
e.g urea from fetal to maternal blood.
❑Protective function: function of the placental barrier
 Function of the placenta
❑Secretory (endocrine) function: the placenta secrets
the following hormones:
✓ Progesterone: is secreted starting from the 4th month
it is essential for maintenance of normal pregnancy
✓ Estrogen: reach the maximal secretion at the end of
pregnancy, these high levels stimulate uterine
growth & development of the mammary glands.
✓ HCG produced by syncytiotrophoblast during 1st two
months of pregnancy maintains the corpus luteum.
✓ Somatomammotropin: gives the fetus priority on
maternal blood glucose & makes the mother
somewhat diabetogenic, it also promotes breast
development.
The Amnion & amniotic cavity
• The amnion is the membrane which
bounds the amniotic cavity & is
continuous with the ectoderm at the
amnio-ectodermal junction.
• The amniotic cavity stars to develop
at the 8th day within the epiblast.
• Amnioblast cells start formation of
amniotic fluid.
• In the 3rd week the epiblast layer
becomes ectodermal layer & the
junction between the ectoderm &
amnion is called the amnio-
ectodermal junction.
 Amniotic fluid
• It is clear, watery fluid which is mainly composed
of water, electrolytes, proteins, carbohydrates,
lipids, phospholipids & urea.
• It produced by: starts from amnioblast cells, &
from maternal blood by osmosis through the
amnion, fetal urine is added daily to the amniotic
fluid starting from the 5th month.
• The amount of fluid increases from 30 ml at 10
weeks to 450 ml at 20 weeks to 800-1000 ml at
37 weeks.
• The volume of amniotic fluid is replaced every 3
hours.
 Function of amniotic fluid
❑At early pregnancy:
✓ Acts as shock absorbent, against external trauma.
✓ Acts as heat insulator keeping constant fetal temp.
✓ Prevent adhesion of the embryo.
❑At late pregnancy:
✓ Gives space for fetal movments, muscle development.
✓ Gives space for accumulation of urine, at 5th m. the
fetus start to swallow amniotic fluid (learn suckling).
❑During delivery:
✓ Protects the fetus against uterine contraction.
✓ The amnio-chorionic membrane forms a hydrostatic
wedge that helps to dilate the cervical canal.
 Abnormalities of amniotic fluid
❑ Polyhydramnios is the term used to describe an excess of
amniotic fluid (1,500 to 2,000 mL).
• Causes: Idiopathic causes (35%), Maternal diabetes
(25%), Congenital malformations, including CNS disorders
(e.g., anencephaly) & GIT defects that prevent the infant
from swallowing the fluid
❑ Oligohydramnios refers to a decreased amount (less than
400 mL), it is a rare, may result from renal agenesis.
❑ Amniotic Bands
• Occasionally, tears in the amnion result in amniotic bands
that may encircle part of the fetus, particularly the limbs
and digits. Amputations, ring constrictions, and other
abnormalities, including craniofacial deformations.
 Fetal Membranes in Twins
• Arrangement of fetal membranes in twins
varies considerably, depending on:
❑The type of twins.
✓Dizygotic twins.
✓Monozygotic twins.
❑The time of separation in monozygotic twins.

➢Twin defect: in general twins may suffer from

increased incidence of prematurity, low birth
weight or high birth weight, 0.5-1% increase
incidence of birth defects. 14
 Dizygotic (Fraternal) twins
• They result from simultaneous shedding of two oocytes
& fertilization by different spermatozoa.
• The incidence is 0.7-1.1% of total births & it increases
with maternal age, 2/3 of twins are dizygotic.
• Each zygotes implant individually & each develops its
own placenta, amnion & chorionic sac.
• The 2 zygotes have totally different genetic constitutions
• The twins have no more resemblance than any other
brothers or sisters, (not identical).
• They may or may not be of different sex.
 Dizygotic (Fraternal) twins
Sometimes, the two
placentas are so close
together that they fuse.
The walls of the
chorionic sacs may also
come into close
apposition & fuse.
 Monozygotic twins
• Develops from single fertilized ovum.
• They result from splitting of the zygote at
various stages of development.
• The incidence is 3-4\1000.
• Partners of a monozygotic pair by their strong
resemblance in blood groups, fingerprints,
sex, & external appearance, such as eye & hair
color.
• Arrangement of fetal membranes are variable
according to the stage at which splitting
occures: