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Placentation Muhammad P Wijaya

 Week 1

❖ Zygot to morula
❖ morula: inner, outer
 day 8

❖ outer cell to: cyto, syncitio

❖ inner: epiblast, hypo
 Day 9

❖ syncitio to lacunae
 day 12

❖ destruction of vessel
 until 12, 12-16 W

❖ villus and extravillous tropoblast

Endovascular trophoblast enters the lumen of the spiral
arteries and initially forms cellular plugs. It then destroys
vascular endothelium via an apoptosis mechanism and
invades and modifies vascular media. Thus, fibrinoid
material replaces smooth muscle and connective tissue
of the vessel media. Spiral arteries later regenerate
endothelium.
❖ Trophoblasts produce urokinase-type plasminogen activator, which converts plasminogen into the
broadly acting serine protease plasmin. This in turn both degrades matrix proteins and activates matrix
metalloproteinases (MMPs), which are a family of structurally similar enzymes. One member of the
family, matrix metalloproteinase-9 (MMP-9), appears to be critical for human trophoblast invasion. MMP-
9 production is increased by trophoblast factors such as IL-1 and hCG as well as paracrine uterine
factors such as leukemia inhibiting factor and colony-stimulating factor-1

❖ early pregnancy ILFG II

❖ There are also integrin-mediated adhesive interactions of trophoblast cells with each other. In
particular, the interaction of L-selectin with its carbohydrate ligands in the cytotrophoblast is important in
formation and maintenance of cell columns (Prakobphol and colleagues, 2006). Trophoblasts are further
secured by fetal fibronectin (Feinberg and colleagues, 1991). Fetal-specific fibronectin (fFN) is a unique
glycopeptide of the fibronectin molecule. It is also called trophoblast glue to describe a critical role in the
migration and attachment of trophoblasts to maternal decidua. And related, presence of fFN in cervical
or vaginal fluid is used as a prognostic indicator for preterm labor
 day 13

❖ primary villi
❖ scundarry
❖ tersiery
❖ As growth of embryonic and extraembryonic tissues
continues, the blood supply of the chorion facing the
endometrial cavity is restricted
❖ end 3rd month, As the fetus grows, the decidua
capsularis merges with the parietalis. The capsularis then
is largely lost by pressure and the attendant loss of blood
supply. The area of decidua where decidua capsularis
and decidua parietalis merge is referred to as the decidua
vera.
 DNK
❖ This is important because it prevents them from recognizing
and destroying fetal cells as "foreign." Hanna and associates
(2006) have elucidated the ability of dNK cells to attract and
promote invasion of trophoblast into the decidua and promote
vascular growth. Decidual NK cells express both interleukin-8
and interferon-inducible protein-10, which bind to receptors on
invasive trophoblast cells to promote their invasion into the
decidua toward the spiral arteries. Decidual NK cells also
produce proangiogenic factors, including VEGF and placental
growth factor (PlGF), which promote vascular growth in the
decidua.
❖ Placenta barrier
❖ and vessel move to lateral
 Growth and maturation

❖ more rapid and at the end 1/6

❖ Hofbauer cells
❖ lesser connective, syncitium, cito, more vessel