Placenta

Reproductive block-Embryology-Lecture 4
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 Color guide :
Only in boys slides in Green

Objectives Only in girls slides in Purple

important in Red
Notes in Grey

At the end of the lecture, students should be able to:

● Identify nothing because there is no objectives in the Dr’s lectures
● There is also nothing here but we want to fill the space
● It is worth noting that, this lecture was done while coronavirus
pandemic
● I would like to thank the batch and academic leaders for their hard
working in these two years
● Free space for adding any things
Placenta
Introduction
● It is a fetomaternal structure.
● Formed by the beginning of the 4th month. and by the end of the 4th month a complete vascular
network in placenta is established (after degenerate of corpus luteum)
● It is the primary site for exchange of gases and nutrients between mother and fetus
● Full term placenta shows: Discoid in shape, Weighs (500 – 600)g, Diameter 15-25 cm, Thickness
2-3 cm.
● Umbilical cord is attached to the center.
● It has two surfaces: Fetal & Maternal.
Fate of placenta : Within 15 minutes after birth of the infant, the strong uterine contractions that
continue after birth compress uterine blood vessels to limit bleeding & cause the placenta to detach
from the uterine wall.

Formation

Maternal Part
Fetal Part
● Decidua Basali (part of the decidua deep to the
● Villous Chorion.
conceptus.)
● It is the bushy area at the embryonic
● By the end of 4th month, the decidua basalis is
pole.
replaced by the fetal component of the placenta.
● Its villi are more in number, enlarged
● Decidua (Gravid Endometrium): It is the functional
and branch profusely.
layer of the endometrium during pregnancy which is
shed after parturition.
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Placenta cont.
Placental externally

Surfaces
Fetal Surface Maternal Surface

● Smooth because it is covered with the ● Rough.

amnion. ● Derived from endometrium.
● Developed from chorionic sac. ● Formed of (15 –20) irregular convex areas
● The umbilical cord is attached to its center. (Cotyledons) which are separated by grooves
● The chorionic vessels are radiating from (placental septa).
the umbilical cord. ● Each cotyledon is covered by a thin layer of
decidua basalis.

Placental internally

● It consists of two or more stem villi with their many branch villi.
Structure of a
● It receives (80-100) maternal spiral arteries that enter the intervillous spaces at
Cotyledon regular intervals.

● Large blood filled spaces which are freely communicating.

Intervillous ● They receive spiral arteries from the lacunae in the syncytiotrophoblast. Cotyledon

Space ● The spaces are drained through endometrial veins.

● Both arteries and veins pass through pores in the cytotrophoblastic shell.
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Placental circulation
Fetal placental circulation
1. 80 –100 spiral endometrial arteries
discharge into the intervillous space.
Two Umbilical Arteries: 2. The blood is propelled in jet like
● Carry poorly oxygenated blood fountains by the maternal blood
from the fetus to the placenta. pressure.
● Within the branch chorionic ● Now the pressure of this
villi, they form: entering blood is higher than
that in the intervillous space.
● It forms a roof of the space.
Arterio-capillary venous network: ❸ 3. As the pressure dissipates, the blood
● It brings the fetal blood flows slowly around the branch villi.
extremely close to the maternal ● Exchange of metabolites and
blood. gases with the fetal blood.
● The well oxygenated fetal blood
❷
4. As the pressure decreases, the blood
in the capillaries passes into flows back from the chorionic plate
veins accompanying the
and enter the endometrial veins to
chorionic arteries.
❹ ❶ the maternal circulation.

At the umbilical cord, they form the

One Umbilical Vein. Maternal placental circulation

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

Upto(20) weeks At full term

it is composed of four layers: it becomes thinner and composed of three layers only:

1 Syncytiotrophoblast 1 Syncytiotrophoblast
2 Cytotrophoblast. 2 Connective tissue of the villus

3 Connective tissue of the villus 3 Endothelium of fetal capillaries

4 Endothelium of fetal capillaries At some sites, the syncytio comes in direct contact
with the endothelium of the capillaries and forms
Vasculo syncytial placental membrane.

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Functions of placenta
Has there main function

1. Metabolic 2. Transportation of: 3. Endocrine

Synthesis:
(1) Progesterone:Maintains
Synthesis of: A) Gases: B) Drugs and Drug metabolites: pregnancy if the corpus luteum
● Glycogen ● Exchange of O2, CO2 and CO is ● They cross placenta by simple diffusion. is not functioning well
● Cholesterol through simple diffusion. ● They can affect the fetus directly or
● Fatty Acids ● The fetus extracts (20 –30) ml of (2) Estrogen: Stimulates uterine
indirectly by interfering with
which supply O2/minute from the maternal blood growth and development of the
placental metabolism.
the fetus with mammary glands.
nutrients and
energy. D) Hormones: Protein hormones do not (3) Human chorionic
C) Maternal Antibodies: Maternal
reach the embryo in sufficient amounts. somatomammotropin (HCS) or
immunoglobulin G gives the fetus
some of these hormones (Thyroxine & Hpl: A growth hormone that
passive immunity to some infectious
Testosterone which may cause gives the fetus the priority on
diseases (measles, small box) and not to
masculinization of a female fetus) can maternal blood glucose. It
others (chicken box).
cross the placental membrane. promotes breast development
for milk production
F) Nutrients and Electrolytes: Water,
E) Waste products: Urea and uric acid (4)Human chorionic
Amino acids, Carbohydrates, Vitamins
pass through the placental membrane gonadotropin (HCG) : Maintains
and Free Fatty Acids are rapidly
by simple diffusion. the corpus luteum and used as
transferred to the fetus.
indicator of pregnancy.
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Anomalies Of Placenta
Placenta ● Abnormal absence of chorionic villi with partial or complete absence of
Accreta the decidua basalis.

● Chorionic villi penetrate the myometrium to the perimetrium.

Placenta
● The most common presenting sign of these two anomalies is trimester
Percreta
bleeding.

● The blastocyst is implanted close to or overlying the internal uterine os.

Placenta
● It is associated with late pregnancy bleeding.
Previa
● Delivery is through Cesarean section.

Effect Of Maternal Drugs On Fetus

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

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 Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8

QUIZ C C B A B D B B

Q1: Which of the following layers mostly disappears in full term placenta Q5: which of these hormone Maintains the corpus luteum
A. syncytiotrophoblast A. hCS
B. Endothelium of fetal capillaries B. hCG
C. Cytotrophoblasts C.Progesterone
D. Connective tissue of the villi D. Estrogen
Q2: Which of the following Anomalies is associated with late pregnancy bleeding Q6: The most common presenting sign of Placenta Percreta
A. Placenta Accreta A. anal bleeding
B. Placenta Percreta B. pain in the abdomen
C. Placenta Previa C. blood in urine
D. Placenta increta D. trimester bleeding
Q3: fetal surface of placenta Derived from….. Q7: the Umbilical Arteries carry
A. endometrium A. deoxygenated blood
B. chorionic sac B. poorly oxygenated blood
C. Yolk sac C. highly oxygenated blood
D. Connective tissue of the villus D. mixed blood
Q4: placenta can synthesis …….. Q8: Each Cotyledon contains
A. Glycogen A. one or more stem vill
B. Collagen B. two or more stem vill
C. amino acid C. only two stem vill
D. protein D. at least three stem vill
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