PLACENTA AND UMBILICAL CORD 3/20/2011

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

INTRODUCTION TROPHOBLAST
• Chorionic plate and decidua forms PLACENTA. • Increase no. of secondary and tertiary villi which
• With the growth of the embryo to meet the are continuous with extra
extra-embryonic
embryonic vascular
system.
increasing demand of nutrients there is increase
in the surface area and change in disposition • Recall the layers of villi.
of membrane. • 4th month –
– extension into IV space.
– cytotrophoblast disappears
– syncytium thins out, break off in IVS
– syncytial knot enters maternal blood
3/20/2011 drksbasnet.blogspot.com 2 3/20/2011 drksbasnet.blogspot.com 3

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

3/20/2011 drksbasnet.blogspot.com 4 3/20/2011 drksbasnet.blogspot.com 5

drksbasnet.blogspot.com 1
PLACENTA AND UMBILICAL CORD 3/20/2011

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

CHORION FRUNDOSUM
• Villi over the embryonic pole grow and form
CHORION FRUNDOSUM.
FRUNDOSUM
• Villi over the abembryonic pole degenerate. This
side of chorion is called CHORION LAEVE.

3/20/2011 drksbasnet.blogspot.com 6 3/20/2011 drksbasnet.blogspot.com 7

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

DECIDUA
THE FUNCTIONAL LAYER OF ENDOMETRIUM

• Basalis
– over chorion frundosum
– compact cells ↑ lipid/glycogen
– DB + CF form placcenta
• Capsularis
– over abembryonic pole
– stretched and degenerate.
• Chorion laeve contacts with decidua paritalis
obliterating uterine lumen.

3/20/2011 drksbasnet.blogspot.com 8 3/20/2011 drksbasnet.blogspot.com 9

drksbasnet.blogspot.com 2
PLACENTA AND UMBILICAL CORD 3/20/2011

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

• The chorionic cavity obliterates by the fusion of

AMNION with CHORION.

• AMNIOCHORIONIC MEMBRANE forms.

3/20/2011 drksbasnet.blogspot.com 10 3/20/2011 drksbasnet.blogspot.com 11

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

STRUCTURE OF PLACENTA

• Two components.
• Fetal chorion frundosum. Chorionic plate
• Maternal decidua basalis. Decidual plate
• Junctional region
– trophoblast and decidua intermingled
– decidual and syncytial giant cells
– amorphous extracellular materials.
IV space lined with syncytial layer, filled with maternal blood and villi
are grow into it.

3/20/2011 drksbasnet.blogspot.com 12 3/20/2011 drksbasnet.blogspot.com 13

drksbasnet.blogspot.com 3
PLACENTA AND UMBILICAL CORD 3/20/2011

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

FULL TERM PLACENTA

• Incomplete decidual septa separate placenta • MATERNAL SIDE cotyledons covered with decidua basalis.
i t cotyledons
into t l d on 4thand
d 5th month.
th • FETAL SIDE chorionic plate covered with amnion
vessels converging to umbilical cord
• Placenta covers 15 to 30% of uterus. cord can be ECCENTERIC, MARGINAL or
• Thickness increases because of arborization of VELAMENTOUS.
villi. DESCOID, Ø 15 – 25cm , wt 500 -600 gm, thickness 3 cm.

3/20/2011 drksbasnet.blogspot.com 14 3/20/2011 drksbasnet.blogspot.com 15

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

PLACENTAL CIRCULATION
• 80 -100 narrow spiral arteries enter IVspace.
• IV space 150 mll bl
blood,
d 3 – 4 cycle/min
l / i
• Surface area of chorionic villi 4-14 sq m.

3/20/2011 drksbasnet.blogspot.com 16 3/20/2011 drksbasnet.blogspot.com 17

drksbasnet.blogspot.com 4
PLACENTA AND UMBILICAL CORD 3/20/2011

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

FUNCTIONS OF PLACENTA PLACENTAL BARRIER

• Gas exchange 20-30ml oxygen/min • DRUGS ?
• N t i t / electrolyte
Nutrient l t l t • VIRUSES RUBELLA, CYTOMEGALOVIRUS, COXSACKIE, VARIOLA,
• Immunological function VARICELLA, MEASLES AND POLIO VIRUS

Im competence begin by 4th month • HORMONES

Ig is maternal, its transport starts by 14th wk THYROXIN at slow rate
SYNTHETIC PROGESTERONE effect ?
• Endocrine function
progesterone, estriol and hCG and somatomammotropin. OESTEROGEN effect?

3/20/2011 drksbasnet.blogspot.com 18 3/20/2011 drksbasnet.blogspot.com 19

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

UMBILICAL CORD
• Primitive umbilical ring is formed by
aminoectodermal
i t d l jjunction.
ti
• At 5th week this ring contains
• CONNECTING STALK allantois and umbilical vessels
• YOLK SAC DUCT its vessels
• CANAL COMMUNICATING INTRA / EXTRA embryonic cavities

• Enlargement
E l t off amniotic
i ti cavity.
it Amnion
A i
envelopes the stalks. Thus primitive umbilical
cord develops.
3/20/2011 drksbasnet.blogspot.com 20 3/20/2011 drksbasnet.blogspot.com 21

drksbasnet.blogspot.com 5
PLACENTA AND UMBILICAL CORD 3/20/2011

SHREE GANESHAYA NAMAH SHREE GANESHAYA NAMAH

UMBILICAL CORD AMNIOTIC FLUID

At birth the cord is • A clear fluid formed by amniotic cells and maternal
• Ø 2 cm blood.
blood
• 50 – 60 cm long • It absorbs shock, prevent adherence and allow free
• Tortuous having false knots movement of fetus.
• 2 arteries and a vein. – 10/52 30ml
– 20/52 450ml
– 37/52 800 – 1000ml
• Replaced every 3 hr
hr.
• Fetus swallows 400ml/ day from 5th month.

3/20/2011 drksbasnet.blogspot.com 22 3/20/2011 drksbasnet.blogspot.com 23

SHREE GANESHAYA NAMAH

AMNIOTIC FLUID
• <400ml OLIGOHYDRAMNIOS ? Renal agenesis
– club
l b ffoott / lung
l hypoplasia
h l i

• >1500 – 2000ml POLYHYDRAMNIOS

– Idiopathic / maternal DM / anencephaly / oesophagial atresia.

3/20/2011 drksbasnet.blogspot.com 24

drksbasnet.blogspot.com 6