Implantation
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The process during which the blastocyst attaches to
the endometrium and subsequently embeds in it.
Time
of implantation
It occurs at 6 days after fertilization and
by the 11 th to 12th days of development the blastocyst is
completely embedded in the endometrial stroma.
Implantation
bleeding
Bleeding may occur at the implantation site as a
result of increase blood flow into the lacanarspaces.
Implantation bleeding occur near the 28th
day of menstrual cycle, it may confused with normal menstrual bleeding.
Mechanism
of implantation:
it has three stages:
(a) the blastocyst contacts the implantation
site of the endometrium (apposition);
(b) trophoblast cells of the blastocyst attach
to the receptive endometrial epithelium (adhesion); and
(c) invasive trophoblast cells cross the
endometrial epithelial basement membrane and invade the endometrial stroma
(invasion)
Normal
sites of implantation: The blastocyst implants in the endometrium along the anterior or
posterior wall of uterus near the fundus.
(Trophoblast cells of blastocyst
invade the epithelium and underlying endometrial stroma with the help of
proteolytic enzymes)
Abnormal implantation:
1.
Implantation in abdominal cavity
2.
Implantation in the pouch of Douglas
3.
Implantation in the ampullary region of f. tube
(most common)
4.
Implantation in the internal os
5.
Ovarian implantation
6.
Interstitial implantation
7.
Tubal implantation
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