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Cytotrophoblast
"Cytotrophoblast" is the name given to both the inner layer of the trophoblast (also called layer of Langhans) or the cells that live there. It is interior to the syncytiotrophoblast and external to the wall of the blastocyst in a developing embryo. The cytotrophoblast is considered to be the trophoblastic stem cell because the layer surrounding the blastocyst remains while daughter cells differentiate and proliferate to function in multiple roles. There are two lineages that cytotrophoblastic cells may differentiate through: fusion and invasive. The fusion lineage yields syncytiotrophoblast and the invasive lineage yields interstitial cytotrophoblast cells. Cytotrophoblastic cells play an important role in the implantation of an embryo in the uterus. Fusion lineage The formation of all syncytiotrophoblast is from the fusion of two or more cytotrophoblasts via this fusion pathway. This pathway is important because the syncytiotrophoblast plays an important role in fetal-maternal ...
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Trophoblast
The trophoblast (from Greek : to feed; and : germinator) is the outer layer of cells of the blastocyst. Trophoblasts are present four days after fertilization in humans. They provide nutrients to the embryo and develop into a large part of the placenta. They form during the first stage of pregnancy and are the first cells to differentiate from the fertilized egg to become extraembryonic structures that do not directly contribute to the embryo. After gastrulation, the trophoblast is contiguous with the ectoderm of the embryo and is referred to as the trophectoderm. After the first differentiation, the cells in the human embryo lose their totipotency and are no longer totipotent stem cells because they cannot form a trophoblast. They are now pluripotent stem cells. Structure The trophoblast proliferates and differentiates into two cell layers at approximately six days after fertilization for humans. Function Trophoblasts are specialized cells of the placenta that play an i ...
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Choriocarcinoma
Choriocarcinoma is a malignant, trophoblastic cancer, usually of the placenta. It is characterized by early hematogenous spread to the lungs. It belongs to the malignant end of the spectrum in gestational trophoblastic disease (GTD). It is also classified as a germ cell tumor and may arise in the testis or ovary. Signs and symptoms * increased quantitative chorionic gonadotropin (the "pregnancy hormone") levels * vaginal bleeding * shortness of breath * hemoptysis (coughing up blood) * chest pain * chest X-ray shows multiple infiltrates of various shapes in both lungs * presents in males as a testicular cancer, sometimes with skin hyperpigmentation (from excess chorionic gonadotropin cross reacting with the alpha MSH receptor), gynecomastia, and weight loss (from excess chorionic gonadotropin cross reacting with the LH, FSH, and TSH receptor) in males * can present with decreased thyroid-stimulating hormone (TSH) due to hyperthyroidism. Cause Choriocarcinoma of the placenta dur ...
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Placenta
The placenta is a temporary embryonic and later fetal organ that begins developing from the blastocyst shortly after implantation. It plays critical roles in facilitating nutrient, gas and waste exchange between the physically separate maternal and fetal circulations, and is an important endocrine organ, producing hormones that regulate both maternal and fetal physiology during pregnancy. The placenta connects to the fetus via the umbilical cord, and on the opposite aspect to the maternal uterus in a species-dependent manner. In humans, a thin layer of maternal decidual (endometrial) tissue comes away with the placenta when it is expelled from the uterus following birth (sometimes incorrectly referred to as the 'maternal part' of the placenta). Placentas are a defining characteristic of placental mammals, but are also found in marsupials and some non-mammals with varying levels of development. Mammalian placentas probably first evolved about 150 million to 200 million years ...
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Extravillous Trophoblast
Extravillous trophoblasts (EVTs), are one form of differentiated trophoblast cells of the placenta. They are invasive mesenchymal cells which function to establish critical tissue connection in the developing placental-uterine interface. EVTs derive from progenitor cytotrophoblasts (CYTs), as does the other main trophoblast subtype, syncytiotrophoblast (SYN). They are sometimes called intermediate trophoblast. EVTs that derive from CYT cells on the surface of placental chorionic villi that come into contact with the uterine wall - at the placental bed - begin to express the HLA-G antigen. These interstitial subtype of EVTs then have the ability to invade and implant into the maternal decidua, where they anchor the developing placenta. The endovascular EVTs remodel maternal spiral arteries to control blood perfusion and oxygenation in the developing placenta. EVT are a low-incidence (<5% of trophoblasts), but critical and multifunctional, subtype of trophoblast in the placenta. < ...
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Pre-eclampsia
Pre-eclampsia is a disorder of pregnancy characterized by the onset of high blood pressure and often a significant amount of protein in the urine. When it arises, the condition begins after 20 weeks of pregnancy. In severe cases of the disease there may be red blood cell breakdown, a low blood platelet count, impaired liver function, kidney dysfunction, swelling, shortness of breath due to fluid in the lungs, or visual disturbances. Pre-eclampsia increases the risk of undesirable outcomes for both the mother and the fetus. If left untreated, it may result in seizures at which point it is known as eclampsia. Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus. It is also more frequent in a woman's first pregnancy and if she is carrying twins. The underlying mechanism involves abnormal formation of blood vessels in the placenta amongst other factors. Most cases are diagnosed before delivery. Commonly, pre-eclampsia continues i ...
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Syncytiotrophoblast
Syncytiotrophoblast (from the Greek 'syn'- "together"; 'cytio'- "of cells"; 'tropho'- "nutrition"; 'blast'- "bud") is the epithelial covering of the highly vascular embryonic placental villi, which invades the wall of the uterus to establish nutrient circulation between the embryo and the mother. It is a multi-nucleate, terminally differentiated syncytium, extending to 13cm. Function It is the outer layer of the trophoblasts and actively invades the uterine wall, during implantation, rupturing maternal capillaries and thus establishing an interface between maternal blood and embryonic extracellular fluid, facilitating passive exchange of material between the mother and the embryo. The syncytial property is important since the mother's immune system includes white blood cells that are able to migrate into tissues by "squeezing" in between cells. If they were to reach the fetal side of the placenta many foreign proteins would be recognised, triggering an immune reaction. Howeve ...
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Blastocyst
The blastocyst is a structure formed in the early embryonic development of mammals. It possesses an inner cell mass (ICM) also known as the ''embryoblast'' which subsequently forms the embryo, and an outer layer of trophoblast cells called the trophectoderm. This layer surrounds the inner cell mass and a fluid-filled cavity known as the blastocoel. In the late blastocyst the trophectoderm is known as the trophoblast. The trophoblast gives rise to the chorion and amnion, the two fetal membranes that surround the embryo. The placenta derives from the embryonic chorion (the portion of the chorion that develops villi) and the underlying uterine tissue of the mother. The name "blastocyst" arises from the Greek ' ("a sprout") and ' ("bladder, capsule"). In other animals this is a structure consisting of an undifferentiated ball of cells and is called a blastula. In humans, blastocyst formation begins about five days after fertilization when a fluid-filled cavity opens up in the mor ...
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Implantation (human Embryo)
Implantation (nidation) is the stage in the embryonic development of Placental mammal, mammals in which the blastocyst hatches as the embryo, adheres, and invades into the wall of the female's uterus. Implantation is the first stage of gestation, and when successful the female is considered to be pregnancy, pregnant. In a woman, an implanted embryo is detected by the presence of increased levels of human chorionic gonadotropin (hCG) in a pregnancy test. The implanted embryo will receive oxygen and nutrients in order to grow. There is an extensive variation in the type of Trophoblast, trophoblast cells, and structures of the placenta across the different species of mammals. Of the five recognised stages of implantation including two pre-implantation stages that precede placentation, the first four are similar across the species. The five stages are migration and hatching, pre-contact, attachment, adhesion, and invasion. The two pre-implantation stages are associated with the Pre-em ...
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Chorionic Villi
Chorionic villi are villi that sprout from the chorion to provide maximal contact area with maternal blood. They are an essential element in pregnancy from a histomorphologic perspective, and are, by definition, a product of conception. Branches of the umbilical arteries carry embryonic blood to the villi. After circulating through the capillaries of the villi, blood returns to the embryo through the umbilical vein. Thus, villi are part of the border between maternal and fetal blood during pregnancy. Structure Villi can also be classified by their relations: * Floating villi float freely in the intervillous space. They exhibit a bi-layered epithelium consisting of cytotrophoblasts with overlaying syncytium ( syncytiotrophoblast). * Anchoring (stem) villi stabilize mechanical integrity of the placental-maternal interface. Development The chorion undergoes rapid proliferation and forms numerous processes, the chorionic villi, which invade and destroy the uterine decidua and a ...
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Decorin
Decorin is a protein that in humans is encoded by the ''DCN'' gene. Decorin is a proteoglycan that is on average 90 - 140 kilodaltons (kDa) in molecular weight. It belongs to the small leucine-rich proteoglycan (SLRP) family and consists of a protein core containing leucine repeats with a glycosaminoglycan (GAG) chain consisting of either chondroitin sulfate (CS) or dermatan sulfate (DS). Decorin is a small cellular or pericellular matrix proteoglycan and is closely related in structure to biglycan protein. Decorin and biglycan are thought to be the result of a gene duplication. This protein is a component of connective tissue, binds to type I collagen fibrils, and plays a role in matrix assembly. Naming Decorin's name is a derivative of both the fact that it "decorates" collagen type I, and that it interacts with the "d" and "e" bands of fibrils of this collagen. Function Decorin appears to influence fibrillogenesis, and also interacts with fibronectin, thrombospondin, ...
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Hydatidiform Mole
A molar pregnancy also known as a hydatidiform mole, is an abnormal form of pregnancy in which a non-viable fertilized egg implants in the uterus. A molar pregnancy is a type of gestational trophoblastic disease that used to be known as a ''hydatidiform mole''. A molar pregnancy grows into a mass in the uterus that has swollen chorionic villi that grow in clusters resembling grapes. A molar pregnancy can develop when a fertilized egg does not contain an original maternal nucleus. The products of conception may or may not contain fetal tissue. Molar pregnancies are categorized as partial moles or complete moles, with the word 'mole' being used to denote simply a clump of growing tissue, or a 'growth'. A complete mole is caused by a single sperm (90% of the time) or two (10% of the time) sperm combining with an egg which has lost its DNA. In the first case, the sperm then reduplicates, forming a "complete" 46 chromosome set. The genotype is typically 46,XX (diploid) due to the sub ...
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Edema
Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area may feel heavy, and joint stiffness. Other symptoms depend on the underlying cause. Causes may include Chronic venous insufficiency, venous insufficiency, heart failure, kidney problems, hypoalbuminemia, low protein levels, liver problems, deep vein thrombosis, infections, angioedema, certain medications, and lymphedema. It may also occur after prolonged sitting or standing and during menstruation or pregnancy. The condition is more concerning if it starts suddenly, or pain or shortness of breath is present. Treatment depends on the underlying cause. If the underlying mechanism involves Hypernatremia, sodium retention, decreased salt intake and a diuretic may be used. Elevating the legs and support stockings may be useful ...
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