Placenta
BY: GROUP 4A
Under Prepared By:
supervision
Dr Hanan Ibrahim Nourhan Salah
Dr Eman Ehsan Abdalateef Ibrahim
Dr rasha farag Jaheen
Dr Amira Elhawet
OUTLINES :
• Introduction
• Anatomy of the
placenta
• Function of the
placenta
• Abnormalities of the
placenta
• Umbilical cord
INTRODUCTION
The placenta is a remarkable, temporary organ that
develops within your uterus during pregnancy. It plays
a vital role in supporting the growth and development
of your baby. Think of it as a lifeline connecting you and
your baby, facilitating the exchange of essential
nutrients, oxygen, and waste products. The placenta is
formed gradually during the first three months of
pregnancy ,while , after the four months , it grows
parallel to the development of the uterus.
Anatomy of
placenta
The placenta looks like a disc of bumpy tissue
rich in blood vessels
, making it appear dark red at term. Most of the
mature placental
tissue is made up of blood vessels.
They connect with the baby through the
umbilical cord
and branch throughout the placenta disc like
the limbs of a tree.
Anatomy of placenta
Its anatomy can be divided into several key components:
• Maternal Side
Decidua: The endometrial tissue that lines the uterus
during pregnancy. It is divided into three regions:
1.Decidua basalis: The part of the decidua that lies
beneath the placenta and is involved in placental
attachment.
2.Decidua capsularis: The portion that covers the
developing embryo.
3.Decidua parietalis: The remaining decidual tissue
Anatomy of
• Fetal Side placenta
Chorion: The outermost membrane surrounding
the fetus
, which contributes to the formation of
the placenta. It has finger-like projections
called chorionic villi that extend into the
maternal tissue.
Amnion: The innermost membrane that
surrounds
the fetus, forming the amniotic sac.
Anatomy of
placenta
• Chorionic Villi
These are small, finger-like projections that extend from the
chorion into the decidua basalis. They are essential for
nutrient and gas exchange between the mother and fetus.
There are two types of chorionic villi:
Primary villi: Formed early in pregnancy, consisting of a core
of cytotrophoblast surrounded by syncytiotrophoblast.
Secondary and tertiary villi: Develop later and contain fetal
blood vessels.
Anatomy of
placenta
• Placental Structure
Placental Membrane: Composed of layers that facilitate
exchange between maternal blood and fetal blood,
including:
1.Syncytiotrophoblast (outer layer)
2.Cytotrophoblast (inner layer)
3.Connective tissue (stroma)
4.Fetal endothelium (inner layer of fetal blood
Anatomy of
placenta
Blood Supply
Maternal Blood Supply: Maternal blood enters the
intervillous space through spiral arteries, where it
bathes the chorionic villi.
Fetal Blood Supply: Fetal blood circulates through
umbilical arteries to the placenta and returns via the
umbilical vein.
Anatomy of
• Umbilical Cord placenta
Connects the fetus to the placenta,
containing two umbilical
arteries and one umbilical vein,
surrounded by
Wharton’s jelly
for protection
Function of Placenta
• Act as a lung for the fetus ,
Respiratory the fetus absorbs O2 from
system maternal hemoglobin and
release CO2 into maternal
circulation
• It provides the nutritional
Nutrition needs of the developing
fetus.It also turns complex
foods into simpler compounds.
Excretion • Acts as a fetal kidney that
excreted waste products from
the fetus into maternal
circulation
Function of Placenta
Storage • Glucose is stored in the form of
glycogen and converted back
into glucose in the required
form until the fetus liver is
sufficiently mature
Haemopoietic • It forms hemoglobin the fetus
Immunological • Antibodies that reject the fetus
are not considered a foreign
body to the mother
Function of Placenta
Prevention • The placenta will protect the
fetus from some harmful
diseases that affect the mother
.
• Organisms cannot pass
through the placenta barrier
but some types of bacteria and
viruses may cause birth defects
Some drugs morphine, heparin can pass and affect the
respiratory center
Antibodies and immunoglobulins are transferred to the fetus
from the mother and give immunity to the infant during the
first three months
Abnormalities of
placenta
These placental disorders are called placenta previa,
placenta accreta, placenta increta or placenta
percreta.
Placental disorders are usually diagnosed by
ultrasound in the second trimester (about 18 to 20
weeks into a pregnant
1.Abnormal Shape
2.Abnormal weight
3.Abnormal position
Abnormalities of
placenta
1.Abnormal shape
A Circumvallate placenta :
the placenta shows a small central chorionic plate
surrounded by a thick whitish ring consisting of a double
fold of chorion and amnion. It causes the membranes of the
placenta to fold back around its edges. It can increase the
chance of complications such as preterm delivery and
placental abruption, as well as increasing the risk of
neonatal death , an emergency cesarean and antepartum
hemorrhage
Abnormalities of
placenta
B.Succenturiate(accessory) Placenta:
is a second or third placental lobe that is much smaller than
the largest lobe. Unlike bipartite lobes, the smaller
succenturiate lobe often has areas of infarction or atrophy. The
risk factors associated are advanced maternal age,
primigravida, proteinuria in the first trimester of pregnancy,
and major malformations in the fetus. The membranes between
the lobes in such placenta can be torn during delivery, and the
extra lobe can be retained after rest of the placenta has been
delivered, with consequent postpartum bleeding Exploration of
Abnormalities of
C.Bipartite placenta. placenta
is a variation in placental morphology and refers to a placenta
separated into two near equal-sized lobes. If more than three
lobes are present, it is termed a trilobed(Tripartite placenta)
Retention of one lobe after child birth may cause postpartum
hemorrhage or puerperal infection.
D.placenta Fenestrate
is a rare condition in which the central portion of the discoid
placenta is missing. Rarely, there may be an actual hole in the
placenta, but more frequently, the defect involves the villous
tissue, and the chorionic plate remains intact. At delivery, this
Abnormalities of
placenta
E.Battledore placenta.
(marginal cord insertion) is where the umbilical cord is
inserted at or near the placental margin rather than in the
center. The cord can be inserted as close to 2 cm from the edge
of the placenta (velamentous cord insertion). The incidence is
7% to 9% of singleton pregnancies and 24% to 33% of twin
pregnancies. Complications associated with battledore
placenta are preterm labor, fetal distress, and intrauterine
growth restrictions.
Abnormalities of
placenta
F.Ring-shaped placenta
The ring-shaped placenta is annularly-shaped, a variant of
placenta membranacea. It can sometimes be a complete ring
of placental tissue, but more often, tissue atrophy in a
portion of the ring results in a horseshoe shape. The
incidence is less than 1 in 6000. The ring-shaped placenta
can cause antepartum, postpartum bleeding, and fetal
growth restriction.
Abnormalities of
placenta
2.Abnormal Weight.
The placenta increases in size and weight as in congenital
syphilis, hydrops foetalis and diabetes mellitus.
3.Abnormal position.
Normally, the placenta attaches at the top or side of the
uterus. In some cases, the placenta develops in the wrong
location or attaches itself too deeply into the uterine wall.
These placental disorders are called placenta previa, placenta
accreta, placenta increta or placenta percreta.
4.Abnormal Adhesion.
A.placenta increta
Placenta increta is a condition where the placenta attaches
more firmly to the uterus and becomes embedded in the
organ's muscle wall.
B.placenta percreta.
Placenta percreta is a condition where placenta attaches itself
and grows through the uterus and potentially to the nearby
organs (such as the bladder).
C.placenta Accerate. is a serious pregnancy condition that
occurs when the placenta grows too deeply into the uterine
wall. Typically, the placenta detaches from the uterine wall
after childbirth. With placenta accreta, part or all of the
placenta remains attached. This can cause severe blood loss
Umbilical cord
• The umbilical cord is a tube that connects the mother to
her baby during pregnancy.
• The umbilical cord form during fifth week of gestation
(seventh week of pregnancy).
•The average length is between 50:60cm and It has three
blood vessels: one vein that carries food and oxygen from
the placenta to baby and two arteries that carry waste from
baby back to the placenta.
• After birth, the cord is clamped and cut. Eventually
Abnormalities of the
Umbilical cord
(A) Abnormal cord insertion:
•Battledore Insertion of the Cord (marginal insertion of the
cord):
The umbilical cord is attached to the edge of the
placentagiving it squash?racket appearance.
•Velamentous insertion of the cord: The cord is inserted into
the membranes some distance away from the edge of the
placenta. The umbilical vessels run through membranes from
the cord to placenta (vasa praevia). Such vessels may lie
across the cervix where they may be compressed leading to
Abnormalities of the
Umbilical cord
(B) Abnormal cord length:
• Short cord which may lead to:
_Intrapartum haemorrhage due to premature separation of
the placenta.
_Delayed descent of the foetus druing labour.
_Inversion of the uterus.
•Long cord which may lead to:
_Cord presentation and cord prolapse.
_Coiling of the cord around the neck.
_true knots of the Cord.
Abnormalities of the
Umbilical cord
(C) Knots of the cord:
1. True knot:
when the foetus passes through a loop of the cord. If pulled
tight, foetal asphyxia may result.
2. False knot:
localised collection of Wharton's jelly containing a loop of
umbilical vessels
References :
WebMD
https://www.webmd.com/baby/anemia-in-pregnancy
Mayo clinic
https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034
https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/symptoms-causes/syc-20355876
American society of hematology
https://www.hematology.org/education/patients/anemia/iron-deficiency
https://www.hematology.org/education/patients/anemia/sickle-cell-disease
Cleveland Clinic
https://my.clevelandclinic.org/health/diseases/14508-thalassemias
NIH
https://www.ncbi.nlm.nih.gov/books/NBK545151/
CDC
https://www.cdc.gov/thalassemia/about/index.html
NHS
https://www.nhs.uk/conditions/sickle-cell-disease/
MCD
https://www.msdmanuals.com/professional/gynecology-and-obstetrics/approach-to-the-pregnant-woman-and-prenatal-care/anemia-in-pregnancy
Thank
You
