1. Extra-embryonic membrane and placentation
陳建榮

2. 胚外膜(extraembryonic membrane):
1.絨毛膜(chorion)
2.羊膜(amnion)
3.卵黃囊(yolk sac)
4.尿囊(allantois)

3. Placenta胎盤 Fetomaternal organ
Fetal portion: villus chorion of chorionic sac
Maternal portion:
the functional layer of endometrium
Endomatrial stromal cell  Decidual cell蛻膜細胞
(decidual reaction)
 decidua basalis
Decidua: decidua basalis基蛻膜
decidua capsularis囊蛻膜
decidua parietalis壁蛻膜

10. primary chorionic villi secondary chorionic villi
tertiary chorionic villi or stem villi
Cytotrophoblastic shell 細胞滋養層殼

11. 絨毛膜板
Cytotrophoblastic shell
細胞滋養層殼

12. 胎盤膜(placental membrane)
10 weeks
full term
胎盤膜(placental membrane)
合體滋養層
細胞滋養層
絨毛的結締組織
胎兒微血管內皮
Erythroblastosis fetalis胎性母紅血球增多症

14. Functions of Placenta 代謝(metabolism)
synthesis glycogen, cholesterol, fatty acids…
運送氣體和營養素
營養(nutrition)
呼吸(respiratory)
排泄(excrection)
激素製造(hormone production)

15. Placental abnormalities
Placenta percreta植入性胎盤
Placenta accreta胎盤黏連
Placenta previa前置胎盤

16. Uterine growth during pregnancy

17. Amniotic fluid Fetal membrane: amnion, yolk sac Amnion 羊膜 10 wks
3 week
Amniotic fluid
20 wks
4 week

18. 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
Amniotic cavity

19. Allantosis and yolk sac
3 wks
9 wks
3 month
Adult

20. Yolk sac卵黃囊: Allantois尿囊 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.

21. Umbilical cord: Connecting stalk, amnion 30~90cm
1 umbilical v. and 2 umbilical a.
False knots and true knots

25. False knot

26. Parturition (labor)分娩:
Dilation stage擴張期
Expulsion stage排出期
Placental stage胎盤期
Recovery stage恢復期

27. Parturition:
1. Dilation stage: 7-12 hrs
Oxytocin 陣痛

28. 子宮開始收縮 (真陣痛 )
子宮頸口變薄
擴張子宮頸口→ 10公分

29. Parturition:
2. Expulsion stage: 20’-50’

31. Parturition:
3. Placental stage: 15’
4. Recovery stage > 2hrs

32. 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

33. 胞衣、胎衣（紫河車）

34. Dizygotic twins: separate

35. Dizygotic twins: fused

36. Monozygotic twins

38. Multiple pregnancies Zygote 2 1(2 embryoblasts)
Dizygotic (DZ) twins Monozygotic (MZ) twins (65%)
Zygote (2 embryoblasts)
Fetal 2 amnions amnions
membrane 2 chorions or fused chorion
2 placentas or fused 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

39. Fetal membrane of bird
Chorion
Yolk sac
Allantois
Amnion

42. Classification Based on Placental Shape and Contact Points
Diffuse placenta擴散型胎盤: Seen in horses and pigs.
Cotyledonary placenta子葉型胎盤: This type of placentation is observed in ruminants.
Zonary placenta帶狀胎盤: Seen in carnivores like dogs and cats, seals, bears, and elephants.
Discoid placenta盤狀胎盤: Seen in primates and rodents.

43. Placentation in Horses
Diffuse placenta擴散胎盤

44. Placentation in Horses
Diffuse placenta擴散胎盤

45. Placentation in Ruminants
Cotyledonary placenta子葉型胎盤

46. Placentation in Ruminants

47. Placentation in Dogs and Cats
Zonary placenta帶狀型胎盤

48. Placentation in Dogs and Cats

49. Discoid placenta盤狀胎盤
Rodent
Human

50. 胎盤膜(placental membrane)

51. Maternal Layers Retained Endometrial Epithelium
Type of Placenta
Maternal Layers Retained
Examples
Endometrial Epithelium
Connective Tissue
Uterine Endothelium
Epitheliochorial
上皮絨毛膜型 +
Horses, swine, ruminants
Endotheliochorial
內皮絨毛膜型 -
Dogs, cats
Hemochorial
血液絨毛膜
Humans, rodents

52. Epitheliochorial上皮絨毛膜型

53. Summary of Species Differences in Placental Architecture
Type of Placenta
Common Examples
Diffuse, epitheliochorial
擴散型胎盤,上皮絨毛膜型
Horses and pigs
Cotyledonary, epitheliochorial
子葉型胎盤,上皮絨毛膜型
Ruminants (cattle, sheep, goats, deer)
Zonary, endotheliochorial
帶狀胎盤,內皮絨毛膜型
Carnivores (dog, cat, ferret)
Discoid, hemochorial
盤狀胎盤,血液絨毛膜
Humans, apes, monkeys and rodents