胚外膜与胎盘 Extra-embryonic membrane and placentation教学教程.pptVIP

Extra-embryonic membrane and placentation;胚外膜(extraembryonic membrane): 1.絨毛膜(chorion) 2.羊膜(amnion) 3.卵黃囊(yolk sac) 4.尿囊(allantois);Placenta胎盤;;;;Villi: primary chorionic villi secondary chorionic villi tertiary chorionic villi or stem villi; 絨毛膜板;胎盤膜(placental membrane) ;;Functions of Placenta;Placental abnormalities Placenta percreta植入性胎盤 Placenta accreta胎盤黏連 Placenta previa前置胎盤;Uterine growth during pregnancy;Fetal membrane: amnion, yolk sac;Amniotic fluid : 10週—30ml; 20週—350ml; 37週—800-1000ml Sources ： amniotic cells, secretion of respiratory tract, maternal fluid, urine Circulation： 未皮質化之皮膚 消化道吞食或呼吸道吸入，吸收後進入血流，再經胎盤交換 Function： -平衡或對稱生長 -提供自由運動 -傳染疾病的壁障(barrier) -防止黏連 -吸收震動 -維持恆溫;Allantosis and yolk sac;Yolk sac卵黃囊: Nutrition (2nd~3rd week) Vasculogenesis and angiogenesis Foregut, midgut and hindgut Primordial germ cell Allantois尿囊 Derived from yolk sac Vasculogenesis ? umbilical a. and v. Uninary bladder Urachus ? median umbilical lig.;Umbilical cord: Connecting stalk, amnion 30~90cm 1 umbilical v. and 2 umbilical a. False knots and true knots ;;;;False knot;Parturition (labor)分娩: Dilation stage擴張期 Expulsion stage排出期 Placental stage胎盤期 Recovery stage恢復期;Parturition: 1. Dilation stage: 7-12 hrs;子宮開始收縮 (真陣痛 ) 子宮頸口變薄 擴張子宮頸口→ 10公分 ;Parturition: 2. Expulsion stage: 20’-50’;;Parturition: 3. Placental stage: 15’;胎頭過大、臀產式、胎兒窘迫 胎盤早期剝離、前置胎盤、臍帶脫出;胞衣、胎衣（紫河車）;Dizygotic twins: separate;Dizygotic twins: fused;Monozygotic twins;; Dizygotic (DZ) twins Monozygotic (MZ) twins (65%) Zygote 2 1(2 embryoblasts) Fetal 2 amnions 2 amnions membrane 2 chorions or fused 1 chorion 2 placentas or fused 1 placenta Sex various same sex Genotype different same Incidence racial difference the same in population Rate increase with mother’s age independent with mother’s age ;Fetal membrane of bird;;;Classification Based on Placental Shape and Contact Points Diffuse placenta擴