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THE PLACENTA

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With consecutive pregnancies the blastocyst attaches lower in the uterus. Placental Transfer ... No transfer of cholesterol, triglycerides or phospholipids. DRUGS ... – PowerPoint PPT presentation

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Title: THE PLACENTA


1
THE PLACENTA
  • Anna Mae Smith, MPAS, PA-C

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PLACENTA
  • Synthesize
  • cholesterol
  • glycogen
  • fatty acids
  • Especially early in the pregnancy

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Placenta
  • FETAL SIDE
  • MATERNAL SIDE
  • They provide
  • protection
  • nutrition
  • respiration
  • excretion
  • hormone production

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Placenta
  • FETAL SIDE
  • develops from the chorionic sac
  • MATERNAL SIDE
  • DECIDUA - formed from the
  • endometrium

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PLACENTAL ATTACHMENT
  • Posterior wall
  • Anterior wall
  • Fundus
  • With consecutive pregnancies the blastocyst
    attaches lower in the uterus

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Placental Transfer
  • Diffusion
  • water
  • electrolytes
  • minerals
  • gases
  • O2 sat in mom 70
  • O2 sat in umbi. Vein 65

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Placental Transfer
  • Active Transport
  • Sugars
  • Amino Acids
  • Fatty Acids
  • Pinocytosis
  • Gamma globulins - passive
  • immunity
  • Viruses may pass no bacteria!!

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Hormones that cross the placenta
  • Thyroxine, T3
  • Testosterone
  • Synthetic progestins

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Antibodies
  • Passive immunity IgGs
  • Diptheria
  • Smallpox
  • Measles
  • Not chickenpox or pertussis

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Infections
  • CMV
  • Rubella
  • Coxsackie
  • Varicella
  • Polio
  • Syphilis
  • Spirochetes

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Congenital Cataracts in rubella
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Placental Transfer
  • There is normally no blood mixing between fetus
    momhowever, small amounts may enter through very
    small gaps in the fetal membrane!
  • No transfer of cholesterol, triglycerides or
    phospholipids

20
DRUGS
  • Most drugs metabolites cross the placenta by
    diffusion
  • Fetal drug addiction

21
Placental Production
  • Progesterone - hormone of pregnancy!!
  • Formed from maternal
    cholesterol or pregnenolone
  • - Initially produced by the corpus
    luteum
  • Estrogen - estriol

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Amniotic Fluid
  • 1st Trimester - by diffusion
  • Later by fetal kidneys lungs
  • Circulation -
  • 1.swallowed absorbed into the
  • fetal blood stream
  • 2.Diffuses across placental mb back into
    the space
  • 3.Excreted by kidneys lungs

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FETAL CIRCULATION
  • Umb. Vein carries O2 blood from placenta to the
    fetus LIVER
  • DUCTUS VENOSUS - shunts the blood to the inferior
    vena cava
  • Right atrial opening into the Left atrium
  • Ovale foramen

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FETAL CIRCULATION
  • DUCTUS ARTERIOSUS - Opening to the descending
    aorta
  • Responsible for blood return back to the
    placenta through the umbilical arteries

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After Birth
  • STOP blood flow through umbilical vessels
  • therefore immediately decrease pressure in
    right atrium
  • The foramen ovale is sealed off by the septum
    primum

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FIRST BREATH
  • Open up the pulmonary vasculature, allowing more
    blood to flow to the lungs
  • Arterial pressure to the ductus arteriosus
    decreases
  • Descending aorta branches take over output from
    the left ventricle
  • Oxygenated blood leaks into the DA causing
    contraction of these cells which attracks fibrin
    to close this primum septum

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AS Adults...
  • Umbilical Vein - Ligamentum teres( free edge of
    the falciform ligament)
  • Ductus Venosus - Ligamentum Venosum Stretches
    from the left branch of the portal vein to the
    inf. Vena cava vein
  • Ductus Arteriosus - Ligamentum arteriosum stems
    from the left pulmonary art. To the under surface
    of the aortic arch
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