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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