Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her BabyVan Blarcom, Carolyn Conant
Science
Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her Baby
Van Blarcom, Carolyn Conant
Infants -- Care; Maternity nursing; Pregnancy
=The Chorion and Placenta.= Very early in pregnancy, probably while the
fertilized ovum is journeying down the tube, tiny, thread-like
projections, called _villi_, appear over the surface of the primitive
chorion, giving it the shaggy appearance of a chestnut burr. Shortly
after this shaggy ovum reaches the uterus and is embedded in the lining,
the chorion, or the outer fetal membrane, is formed, being partly
derived from the ectodermal layer of cells growing within the
blastodermal vesicle. The chorion grows rapidly in size and thickness,
and the villi upon its surface increase in size, number and complexity
by frequent branching. In so doing the villi push their way into the
maternal tissues surrounding them, and destroy the capillary walls with
which they come in contact. Maternal blood escapes through the destroyed
walls, forming tiny hemorrhagic areas, or “lakes of blood.” The
chorionic villi float freely in these pools of maternal blood, which is
constantly being refreshed by an inflow of arterial and an outflow of
venous blood through the mother’s vessels.
Blood vessels soon appear in these chorionic villi, and fetal blood then
circulates through them. It becomes apparent, therefore, that the
maternal and fetal blood streams are in such close relation that they
are separated by only the thin membrane which forms the walls of the
vessels in the villi. (Fig. 20.)
[Illustration:
FIG. 20.—Diagram of fetus, cord, membranes and placenta in utero at an
early stage of their development.
]
This arrangement makes it possible for the steadily proliferating villi
to discharge one of their functions, which is to receive from the
maternal blood nourishment for the embryo, and give up to the parent
waste products from the growing body. This exchange of nourishment and
waste matter takes place by means of osmosis. But freely as the exchange
of materials occurs, there is never any contact, or mixing of maternal
and fetal blood, nor does maternal blood at any time flow through fetal
vessels. It was believed at one time that the fetus was nourished by
milk which was in some way secreted by the gravid uterus, but this is
disproved by present knowledge of the placental function.
The second function of the villi, particularly after they have developed
to the placental stage, is to assist in securely attaching the embryo to
the uterine wall.
The villi are equally distributed over the surface of the chorion at
first, but as the sac increases in size and pushes out into the uterine
cavity, they gradually atrophy and disappear, excepting over the small
area beneath the vesicle where the chorion is in contact with the
decidua basalis. At this site the villi become much more abundant, and
it is here that the placenta eventually develops. This part of the
chorion is termed the _chorion frondosum_, while the remainder, which is
in contact with the decidua capsularis, is the _chorion læve_.
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