placenta - columbia university · placenta formation and role joan w. witkin [email protected]...
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A. Estrogen from growing follicle stimulates regrowth of endometrium.
B. Progesterone from corpus luteum stimulates secretion of endometrial glands.
C. Corpus luteum depends on LH -Negative feedback by E and P inhibits LH and CL degenerates.
Menstrual cycle
A B C
Preparation of the Uterus
Hypothalamus/pituitary
Ovary
Uterus
Estrogen Progesterone
CL
GnRH*
*
*
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Human chorionic gonadotropin (hCG) from embryo maintains corpus luteum. P and E from CL sustain the endometrium.
Pregnancy
ReceptivehCG
P E
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Progress of embryo in hours or days post ovulation
Window of receptivityEndometrium - edematous, secretory
Decidual reactionGlycogen, cytokine (LIF), integrin (αvβ3), pinopodes
Endometrium
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Normal implantation site Implantation
Ectopic sites of implantation
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Blastocoel
Inner cell massTrophoblast
ImplantationAdhesion & Penetration
Glycocalyx Microvilli altered
Tight junctions
Basal lamina
Uterine epithelium
Cytotrophoblast
Syncytiotrophoblast
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Peri-implantation dialogueEmbryo: hCG and other factors and receptorsUterus: LIF and other cytokines, growth factors, integrins, receptors
Adhesion & PenetrationChanges: microvilli (terminal web), MUC-1, junctions, basement membrane
Basement membrane
Decidua
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Embryo - Endometrium - Allograft - Why no immune rejection? Maternal - Decidual reaction altered immune systemEmbryonic - HLA-G
8 days
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Embryo 8 weeks Fetus 12 weeks
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Lacunae in syncytiotrophoblast
9 days
Uterine gland
Uterine cavity
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12 days
Maternal blood in lacunae of syncytiotrophoblastLacunar circulation
Uterine cavity
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Chorionic villi
Primary villi - 11-13 daysCytotrophoblast covered by syncytiotrophoblast
Secondary villi - 16 daysCore of extraembryonic mesenchyme
Tertiary villi - 21 days Embryonic blood vessels
Chorionic cavity
Anchoring villus
Stem villus
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(2 arteries)
1. Vitelline circulation - yolk sac2. Chorionic circulation - placenta
1
2
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Amnion
Definitive Yolk sac
4 weeks
Uterine cavity
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EMBRYO
UTERUS
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Macaque 22 days Macaque 60 days
Syncytiotrophoblast
Embryonic vessel
4 months
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Peri-implantation: 0-2 weeks Uterine glands Endometrial stroma - glycogen
Embryonic: 3-8 weeksMaternal plasma in lacunae
anaerobic metabolism
Fetal: 9 weeks - birth Maternal whole blood 12 wks
aerobic metabolism
Metabolic needs
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FORMATION AND ROLE OF THE PLACENTA
1. Preparation of the uterusWindow of receptivity
2. Implantation (nidation)Apposition, AdhesionPenetration of endometrial epitheliumInvasion of decidua
3. Establishment of a hemochorial placentaLacunarDevelopment of chorionic villiIntervillous
Maternal plasma onlyWhole blood