k - 11 physiology of pregnancy (fisiologi)

7/21/2019 K - 11 Physiology of Pregnancy (Fisiologi)

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Physiology of

PregnancyDepartment of PhysiologyDepartment of Physiology

School of MedicineSchool of MedicineUniversity of Sumatera UtaraUniversity of Sumatera Utara


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Endometrium

andDesidua

3 days to move to uterus 3 -5 days in uterus before implanta


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Implantation results from the

action of trophoblast cells that

develop over the surface of

the blastocyst.

These cells secrete proteolytic

enymes that digest and

li!uefy the ad"acent cells ofthe uterine endometrium.

#nce implantation has ta$en

place% the trophoblast cellsand other ad"acent cells &from

the blastocyst and the uterine

endometrium' proliferate

rapidly% forming the placenta

and the various membranes of


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(a$ing the connection to (om


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Blastocyst:

A uid lled sphere of cells formed fromthe morula which implants in the

endometrium

!ropho"last:) #ne of the cells ma$ing up the

outer wall of the "lastocyst

which will form the chorion

%nner &ell Mass:

) A group of cells inside of the"lastocyst from which the threeprimary germ layers will

develop


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Implantation


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*ollo+ing implantation the endometrium is $no+nas the decidua and consists of three regions, thedecidua "asalis' decidua capuslaris' and

decidua parietalis

The decidua basalislies bet+een the chorion andthe stratum basalis of the uterus. It becomes the

maternalpart of the placenta.

The deciduacapsulariscovers the embryo and islocated bet+een the embryo and the uterine cavity.

The decidua parietalislines the noninvolved areasof the entire pregnant uterus.


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Decidua


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Parts of Endometrial ining


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hen the conceptus implants

in the endometrium% the

continued secretion of

progesterone causes the

endometrial cells to s+ell

further and to store even more

nutrients.

These cells are no+ called

decidual cells, and the total

mass of cells is called the

decidua. /s the trophoblast

cells invade the decidua%

digesting and imbibing it% the

stored nutrients in the decidua

are used by the embryo for

gro+th and development.

Figure 824 sho+s this


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Implantation 0iability of the corpus luteum is maintained

by human chorionic gonadotropin &h12'secreted by the trophoblasts

h12 prompts the corpus luteum to continueto secrete progesterone and estrogen

1horion ) developed from trophoblasts afterimplantation% continues this hormonalstimulus

et+een the second and third month% the

placenta, /ssumes the role of progesterone and estrogen

production

Is providing nutrients and removing +astes


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4ormonal 1hanges DuringPregnancy

Figure 28.6


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*etal (embrane

and

Placenta


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*etal (embranes

1alled the ag of aters 1onsists of t+o layers

' Amnion- inner membrane% ne6t to

fetus7' &horion- outer membrane% ne6t tomother

*unction, to house the fetus for the

duration of pregnancy% protectsfrom outside +orld% preventsvertical transmission of infection.


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&horion:

) #utermost em"ryonic mem"rane

which forms the placenta (produces human chorionicgonadotropin


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Amnion:

) Mem"rane which surrounds em"ryo

to form the amniotic cavity (produces amniotic uid


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Amnionic )luid:

) Protects fetus from trauma ( permits

free movement without adhesion


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*ol$ Sac$:

) Provides initial nutrients' supplies

earliest +B&s and seeds the gonadswith primordial germ cells


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Properties of Amniotic )luid Amniotic uid is the uid medium that

the fetus is surrounded within theamniotic cavity

!he volume ranges from ,--./'0-- ml'depending on the wee$ of pregnancy

Mainly composed of water

Also composed of ions including sodium'chlorine' and calcium

Amniotic uid contains urea' whichcomes

from the fetus


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1ariations #f Su"stances %nAmniotic )luid

0

200

400

600

800

1000

1200

2 3 4 5 6 7 8 9Months of Pregnancy

Amoun

tofsubstance(%

or

mg/100ml)

Hemoglobin

(%)

Iron (mg/100ml)

Choleserol

(mg/100ml)

!i"i#s(mg/100ml)


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Amniotic )luid 1olume 1ersus2estation Period %n 3ee$s

/ Amniotic uidrapidly from anaverage vol of4-ml "y /0 wee$sof pregnancy to,--ml at mid.

pregnancy

0 !he 0,th wee$ of

pregnancy' the vol

of amniotic uid

continues to

5 Ma6imum of a"out/ liter of uid at57 to 58 wee$s


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!he placenta consists of thousands!he placenta consists of thousands

of tiny "ranched ngers of tissueof tiny "ranched ngers of tissue

called &9#+%#%& 1%;;% thesecalled &9#+%#%& 1%;;% thesepro


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/llo+s female mammals to carry the/llo+s female mammals to carry the

young inside their bodies during earlyyoung inside their bodies during early

development.development.

During pregnancy% the developing foetusDuring pregnancy% the developing foetus

receives all its nutrients via the placenta.receives all its nutrients via the placenta.

/ll the +aste products in the foetus8s/ll the +aste products in the foetus8sblood are removed via the placenta.blood are removed via the placenta.

The placenta also produces hormones.The placenta also produces hormones.

!he Placenta


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Implantation of thelastocyst


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Implantation of thelastocyst


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&horionic 1illi:

)inger.li$e growths of the tropho"lastsinto the endometrium to form the placenta


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Placentation

Figure 28.7a-c

Pl t d * th


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Placenta and *urtherEmbryonic Development


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1ontents

7 arteries that carry blood to the placenta

umbilical vein that carries o6ygenated blood tothe fetus

primitive connective tissue

9tub drops o: in 7 +ee$s leaving scar &umbilicus'

;mbilical1ord


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Placenta - function Delivery and e6cretion

Delivers #7


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Placental )unction

O2

Glucose VitaminsMinerals


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!he Placenta!a"le showing e6change of materials

across the placenta

Mother to)oetus

)oetus to Mother

#6ygen

2lucose

Amino acids

;ipids' fatty acids (

glycerol

1itamins

%ons : a' &l' &a' )e

Alcohol' nicotine = other

drugs

1iruses Anti"odies

&ar"on dio6ide

Urea

#ther waste products


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Fetal Side of placenta Maternal side of placenta

!he Placenta


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Placenta8s4ormons

1horionic gonadotropin &for humans


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1horionic gonadotropin &for humans h12'

Produced by cells of the chorion or trophoblast

1horion develops from the trophoblast 1ytotrophoblast produces h12 very early in

embryonic life

(ost early pregnancy tests con>rm pregnancy

by binding to h12 +ith a speci>c antibody andthen to a color producing molecule &chromagen'

h12 prolongs the life of the corpus luteum andmaintains the production of P

h12 stimulates placental production of E and P


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h12 during pregnancy

P t


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Progesterone (aternal blood supplies cholesterol

Placenta converts cholesterol to progesterone Produces enough to support pregnancy by 5-?

+$s in humans

@ecessary for endometrial support and secretion

necessary for support of pregnancy

E6erts negative feedbac$ on 4 and *94

#varian follicles do not gro+

@o stimulation for ovarian steroid production

Increases fat deposition

9timulating appetite Diverting energy stores from sugar to fat

*eto-Placental ;nit -


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*eto-Placental ;nit -Estrogens

Progesterone from placenta to fetal

adrenal glandThrough umbilical and fetal vasculature

#uter layers &corte6'

fetal adrenal one converts P to D4E/ D4E/ circulates to fetal liver

converted to ?-#4-D4E/ sulfate

1onverted to estriol in the placenta

E3is the primary estrogen during pregnancy

*etus and placenta cooperate toproduce maternal estrogens


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1horionic 9omatomammotropin&h19' = Placental actogen &P'

h19 = hP% both li$e P


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Endocrinology of pregnancy

Placenta also secretes

1horionic 2n


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1hange in hormone levels

during pregnancy

k - 11 physiology of pregnancy (fisiologi)

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