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Sharon Placenta
Sharon Placenta
FUNCTION
OF PLACENTA INCLUDING
PLACENTAL
INSUFFICIENCY
DEFINITION:
• Placenta is a fleshy structure that develops
mostly from fetal chorionic tissue and
maternal decidua during pregnancy. It lies
implanted on the uterine wall. It is
connected with fetus through umbilical
cord in the amniotic cavity .It maintains
pregnancy and carries vital fetal functions.
• The human placenta is discoid because of
its shape; hemochorial, because of direct
contact of chorion with the maternal blood
DEVELOPMENT OF THE
HUMAN PLACENTA
Decidua : It is the name given to
endometrium during pregnancy.
• Decidua basalis
• Decidua capsularis
• Decidua parietalis
Early Trophoblast
2 Umbilical vein
3 Fetal capillaries
The maternal circulation system
• Via the spiral arteries (80 -100 mm Hg) that
come from the uterine arteries (Aa. uterinae),
maternal blood gets into the intervillous spaces.
• Subsequently the blood leaves the intervillous
spaces via the uterine veins that are arranged in
the periphery of the intervillous space.
• The flow of the placental blood amounts to 600
cm3/min and the pressure in the spiral arteries to
70 mm Hg. In the intervillous spaces the pressure
falls to only 10 mm Hg .The blood in the intervillous
space is exchanged 2-3 times per minute.
1 Spiral arteries
2 Uterine veins
3 Intervillous spaces
A Basal plate
The placental
membrane(barrier)
• In the first trimester it consists of the syncytiotrophoblast, the
cytotrophoblast (Langhans' cells), the villus mesenchyma (in which
numerous ovoid Hofbauer cells that exhibit macrophage properties are
found) and the fetal capillary walls.
•
1 Intervillous space
2 syncitiotrophoblast
3 cytotrophoblast
4 villus mesenchyma
5 fetal capillaries
6 Hofbauer macrophage
• During the 4th month the
cytotrophoblast disappears from the
villus wall and the thickness of the
barrier decreases while the surface
area increases (roughly 12 m2
towards the end of the pregnancy).
In the 5th month the fetal vessels
have multiplied their branches and
gotten closer to the villus surface.
•
1 Intervillous space
2 Syncytiotrophoblast
3 Cytotrophoblast
4 Villus mesenchyma
5 Fetal capillaries
6 Hofbauer macrophages
• During the 6th month the nuclei of
the syncytiotrophoblast group
together in the so-called proliferation
knots. The other zones of the
syncytiotrophoblast lack nuclei and
are adjacent to the capillaries
(exchange zones).
1 Intervillous space (with maternal blood)
2 Placental barrier of a terminal villus
3 Fetal capillaries
4 Merged basal membranes of the fetal capillary and of the
syncythiothrophoblast
5 Endothelial cells
6 Rare cytotrophoblast cells
7 Basal membrane of the capillaries
8 Basal membrane of the trophoblast portion
9 Syncytiotrophoblast with proliferation knots (nuclei rich region)
PLACENTAL FUNCTIONS
• Functions:
• Proteolysis and lipolysis in mother and
promotes transfer of glucose and amino
acids to the fetus.
• It antagonizes insulin action, high level of
maternal insulin promotes protein synthesis.
• Stimulates breast development to prepare
for lactation.
•
Pregnancy specific -1 glycoprotein (PS β-1G
• Function: It is a potent immuno-suppressor of
lymphocyte proliferation and prevents rejection of
the conceptus.
• Placenta accreta/percreta/increta
• Placental abruption
• Placenta praevia
CORD ABNORMALITIES
• BATTLEDORE PLACENTA
VELAMENTOUS PLACENTA
• Abnormal length of cord
long cord (>100 cm)
short cord (<40 cm)
• Cord Knots
• Cord Vessels
• Thromboses
PLACENTAL INSUFFICIENCY
• Definition: Placental insufficiency is
a complication of pregnancy in which
the placenta cannot bring enough
oxygen and nutrients to a baby
growing in the womb.
• Etiology
• Effects
Risks to the fetus
• 8-fold higher risk of death during delivery
• 5-fold higher risk of poor oxygenation at birth that may
lead to cerebral palsy and other complications
• Hypothermia, or low body temperature
• Hypoglycemia, or low blood sugar
• 30 to 40% chance of learning disabilities
• Premature delivery
• Poor tolerance of labor
• Increased chance of cesarean birth
• Increased chance of having birth defects
• Increased chance of meconium aspiration, in which the
baby inhales some of the amniotic fluid during labor
• Polycythemia, which is an excess of red blood cells
• Hypocalcemia, which is too little calcium in the blood
• Treatment
• Side effects of the treatment
• Monitoring the condition
• Preventing the condition
INTRA UTERINE GROWTH
RETARDATION