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EMBRYOLOGY EDIT The Placenta: Its Development and Function  TABLE OF CONTENTS:

Formation of placenta 3

Full term placenta 4

Structure of a Cotyledon 5

Fetal Placental circulation / Maternal 6 Placental Circulation Placental membrane 7

Function of the Placenta 8

Anomalies of Placenta 9

2 When it is formed? Formed by the beginning of the 4th month. What is it? What is the function of it? It is a Fetomaternal structure It is the primary site for (Part from the and exchange of gases and part from the mother) nutrients between the mother and the fetus.

Placenta

#Formation of placenta

 Fetal part: Villous . (Gravid ) : It is the functional layer of the It is the bushy area at the embryonic pole. endometrium during which Its villi are more in number, enlarged and branch profusely. is shed after parturition.

 Maternal Part: 3 Decidua Basalis (part of the decidua deep to the conceptus). #Full term placenta

 Discoid in shape. Fetal surface Maternal surface  Weighs: (500 – 600)g. Has two surfaces: • Smooth because it is covered • Rough. 1. Fetal with the . • Formed of (15 –20) irregular 2. Maternal • The is attached to convex areas (Cotyledons): its center. -which are separated by grooves • The chorionic vessels are (placental septa). radiating from the umbilical cord. -Each cotyledon is covered by a thin layer of decidua basalis.

4 #Structure of a Cotyledon

 It consists of two or more Stem Villi with their many branch villi.

 It receives (80-100) maternal spiral that enter the #intervillous spaces at regular intervals.

#Intervillous spaces

 Large filled spaces which are freely communicating  They receive spiral arteries from the lacunae in the .  The spaces are drained through endometrial .

5 #Fetal Placental circulation / Maternal Placental Circulation

Fetal Placental Maternal Placental Circulation Circulation

- 80–100 spiral endometrial arteries discharge into the intervillous spaces. -The blood is propelled in jet like fountains by the Two Umbilical Arteries: maternal blood pressure. Carry poorly oxygenated blood from the fetus to the -The pressure of this entering blood is higher than placenta. that in the . -It forms a roof of the space. -As the pressure dissipates, the blood flows slowly around the branch villi. within the branch , they form: Arterio-capillary venous network: -It brings the fetal blood extremely close to the maternal - Exchange of metabolites and gases with the fetal blood. blood. -The well oxygenated fetal blood in the capillaries passes - As the pressure decreases, the blood flows back into veins accompanying the chorionic arteries. from the chorionic plate and enter the endometrial -At the umbilical cord, they form the One Umbilical . veins to the maternal circulation.

6 #Placental membrane

 It is a composite thin membrane of extra fetal tissues which separates the fetal and maternal bloods.

Up to (20) weeks, it is composed of (4) layers:

Cytotrophoblast Endothelium of Connective tissue Syncytiotrophoblast (Disappear later) fetal capillaries. of the villus. At some sites, the syncytio comes in direct contact with the endothelium of the At full term It becomes thinner and composed of (3) layers only: capillaries and forms Vasculosyncytial placental membrane. Endothelium of Connective tissue Syncytiotrophoblast fetal capillaries. of the villus.

7  Fetal drug addiction can be due to some drugs as Heroin.  All sedatives and analgesics can affect the fetus to some degree. #Function of the Placenta  Drugs used for management of labor can cause respiratory distress to the newborn.

8 Table from team 433 #Anomalies of Placenta

1. Placenta Accreta: Abnormal absence of chorionic villi with partial or complete absence of the decidua basalis.

2. Placenta Percreta: • Chorionic villi penetrate the to the perimetrium. • The most common presenting sign of these two anomalies is trimester bleeding.

3. Placenta Previa: #Fate of the placenta • The is implanted close to or overlying the The strong uterine contractions that continue internal uterine os. after compress uterine blood vessels to • It is associated with late pregnancy bleeding. limit bleeding & cause the placenta to detach • Delivery is through Cesarean section. from the uterine wall (within 15 minutes after birth of the infant). 9

d. c. b. a. 3 d. c. b. a. 2 d. c. b. a. within____after 1 . . The placenta isformed at: . .The Criteria of Criteria of Maternal Surface 5 4 4 1 th th th sh A & C. Decidua The umbilical Rough. 1 24 15 15

placenta placenta detach will from the uterine wall

month. month Week Week week. min. hours. hours.

basalis

birth of birth of the infant cord. .

are: :

d. c. b. a. full term placenta: 6 d. c. b. a. No associated bleeding (Placenta 5 . Which . Which of the following layers disappear at . Which of the following istrue regarding Syncytiotrophoblast A & B. Deliveryis through Cesarean Abnormal Cytotrophoblast Connective Endothelium previa

absence absence of chorionic ): tissue of tissue of the villus.

of of fetal capillaries.

section

villi

5. 4. 3. 2. 1. D C C D A

11 MCQs Done by:

Embryology team 434

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