Objectives - Describe the three regions of the decidua according to

their relation to the implantation site - - Talk briefly about the function of the decidua

DECIDUA
- specialized, highly modified endometrium of pregnancy and is a function of hemochorial placentation.

transformation of secretory endometrium to deciduais dependenton estrogen and progesterone and factors secreted by the implanting blastocyst.

 Transformation of the secretory endometrium to deciduas is dependent on the action of estrogen, progesterone and other factors secreted by the implanting blastocyst during trophoblast invasion

The decidua directly beneath the site of blastocyst implantation is modified by trophoblast invasion and becomes the decidua basalis The deciduas basalis contributes to the formation of the basal plate of the placenta The deciduas capsularis is the portion of deciduas that overlies the enlarging blastocyst The remainder of the uterus is lined by deciduas pareitalis (aka deciduas vera)

Zona compacta surface or compact zone Zona spongiosa middle or spongy zone Zona basalis the basal zone

 Blood supply to the deciduas parietalis is supplied by the spiral arteries and the blood supply to the capsularis layer is lost as the embryo grows The deciduas basalis continues to develop and contributes to the formation of the basal plate of the placenta

 Natural killer lymphocytes referred to as endometrial large granular lymphocytes are abundant in the decidua The deciduas is the source of the prolactin which is present in enormous amounts in amnionic fluid during pregnancy

The cellular and vascular changes occurring in the endometrium as the blastocyst implants constitute the decidual reaction. Thickness & vascularity of the mucous membrane greatly increased its glands are elongated & tortuous Interglandular tissue is also increased and is crowded with decidual cells . These cells swell with accumulation of lipid & glycogen . These changes decidua reaction at 1st are confined to the area immediately surrounding the implantation site but soon occur throughout the endometrium

Nitabuchs layer is a zone of fibrinoid degeneration where the invading trophoblasts meet the decidua. It is absent when the decidua is defective, as in placenta accrete

Prolactin in the deciduas is as high as 10,000 ng/mL of amniotic fluid on the 20th to 24th week of gestation

Regulates amniotic fluid volume and electrolyte concentrations May be involved in the regulation of the surfactant synthesis in the fetus May inhibit uterine muscle contractility Suppresses the immune response Can also function as an autocrine and paracrine growth factor in the uterus