1. Placenta Quiz

2. When does the embryo invade the endometrium?
Day 7
What does hCG stand for?
Human chorionic gonadotropin
Where is is secreted from?
Trophectoderm
When is hCG first detectable?
Day 8

3. What are the THREE aims of the implantation? (in terms of placenta..)
Anchor the placenta
Establishment of basic unit of exchange between fetus and mother
Establishment of blood flow within the placenta

4. What is the function of hCG?
Maintains the corpus lutem
Why is this required?
Corpus luteum produced progesterone. Progesterone maintains the endometrium until the placenta can take over.
What are the three stages/classifications of the villus?
Primary  syncytio trophoblast penetrated by cords of cytotrophoblast
Secondary  penetrated by mesenchymal cells
Tertiary  penetrated by fetal vessels

5. How does the villus further develop to adapt to the increasing need of the developing foetus?
Thinning of placental barrier
Margination of foetal vessels
Massive expansion of surface area by arborisation
What is the consequence when the placenta is not meeting the needs of the foetus?
IUGR  intra-uterine growth restriction

6. The umbilical cord ..
1. Is made up of 2 umbilical veins and 1 umbilical artery?
OR ..
2. Is made up of 2 umbilical arteries and 1 umbilical vein?
The second one is correct (think AVA) – which carries oxygenated blood?
The umbilical vein carries oxygenated blood from mum
What’s the name of the other component of the umbilical cord?
Wharton’s jelly

7. List THREE factors that affect maternalfetal bloodflow
Fetal heart/vessels
Umbilical vessels
Uteroplacental flow – mum
MCQ: Maternal-fetal blood flow is which of the following?
High pressure, high flow
Low pressure, low flow
High pressure, low flow
Low pressure, high flow

8. Now for some labeling .. Of a mature placenta
Umbilical cord
Amnion
4. Amniotic membrane
7. Endometrial arteries
8. Endometrial veins
11. Myometrium
12. Decidual basalis
WORDS: chorionic villi, placental septa, umbilical cord, amniotic membrane, smooth chorion, umbilical vessels, decidua basalis, endometrial arteries and veins, cytotrophoblastic shell, stump of main villus stem, main villus stem, myometrium, and amniotic fluid.
For today just name please.

9. What are the THREE placental functions?
Endocrine – steroid and peptide hormones
Transfer – of nutrition, waste and gas exchange
Immunity
What are the TWO peptide hormones?
Human chorionic gonadotropin
Human placental lactogen
Which one of these two peaks at weeks?
hCG
What is the role of human placental lactogen?
Glucose metabolism during pregnancy  make mum resistant to insulin. Reduced uptake of glucose into maternal cells to favour fetal supply.
What are the TWO steroid hormones?
Oestrogen
Progesterone

10. Match the molecule with the transfer mechanism!
Water
Amino acids
Glucose
Immunoglobulins
Iron
Alcohol
Active transport
Pinocytosis
Simple diffusion
Facilitated diffusion
Which immunoglobulin crosses the placenta?
IgG  think the placenta is gross
Which immunoglobulin is found in breast milk?
IgA  breast milk, areolar

11. List FOUR placenta dysfunctions
Position/development
Growth
Blood flow compromised
Transport of “bad stuff” eg. Alcohol
What does “placenta praevia” mean?
Low-lying placenta  example of a positional dysfunction
What are the three types?
Marginal
Complete
Low-lying

12. Matching up placenta problems
Matching up placenta problems .. What is placenta accreta, increta, percreta?
Uncontrolled invasion or abnormal attachment of the placenta to the myometrium.
Placenta increta
Placenta accreta
Placenta percreta
Placenta villi invade into part of myometrium
Placenta villi invade into whole myometrium
Placenta villi invade though the full thickness of the myometrium to the serosa layer and may cause uterine rupture.

13. How can placental abruption present in a pregnant lady?
Per vaginal bleeding
What are the THREE types?
Revealed
Concealed
Concealed and revealed

14. List THREE growth dysfunctions of the placenta
Uncontrolled growth
Gestational trophoblastic disease
Molar/choriocarcinoma
List THREE blood flow dysfunctions of the placenta
Inadequate placentation  pre-eclampsia
Mechanical  IVC compression
Volume  maternal haemorrhage, can lead to fetal growth restriction

15. Pre-eclampsia  definition
Failure of normal invasion of trophoblast cells which leads to less adapted maternal spiral arteries in the placenta  this is an example of abnormal placental development.
Triad of clinical features?
Hypertension
Proteinuria
Oedema
What is eclampsia?
Tonic-clonic seizures in pregnancy

16. What are FOUR causes of placental dysfunction?
Smoking
Drugs eg. Cocaine
Alcohol – by what transport mechanism does this reach the fetus? What can this cause in the fetus?
Simple diffusion – moves down the concentration gradient to the fetus causing fetal alcohol syndrome.
4. Infectious agents eg. Rubella, hepatitis B/C, HIV
Fetal alcohol syndrome causes defects in the heart, neurological in terms of behaviour and development and midline facial abnormalities like the lack of philtrum (cupids bow I think) and flattened nose

17. Thank-you!
Any questions?
Good luck with your revision 