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Note: Zone A
corresponds to
theinteractive
diagramof this
module
1 Umbilical cord
2 Amnion
3 Chorionic plate
4 Intervillous space (maternal blood)
5 Basal plate
6 Cotyledon
7 Villus
maternal portion
fetal portion
Quiz 11
Fig. 14 - maternal side Fig. 15 - fetal side Legend
Fig. 14
Placenta: View
from the maternal
side
Fig. 15
Placenta: view
from the fetal side
This system decays after the ninth day in the lacunar stage 5b .
Through the lytic activity of the syncytiotrophoblast (Fig. 18 and 19) the maternal
capillaries are eroded and anastomose with the trophoblast lacunae, forming the
sinusoids. At the end of the pregnancy the lacunae communicate with each other and
form a single, connected system that is delimited by the syncytiotrophoblast and is
termed the intervillous space.
Fig. 18: 9th .10th day - Lacunar stage Fig. 19: 9th -10th day – Primary villus Legend
Lacunar stage (Fig. 18)
and primary villus (Fig.
19)
Spaces form in the
trophoblast (Fig. 18).
Subsequently, due to the
erosion of the maternal
capillaries, blood gets into
the vacuoles, engendering
the maternal sinusoids.
(Fig. 19)
Between the 11th and 13th day cytotrophoblast cells penetrate into the cords of the
syncytiotrophoblast creating the primary trophoblast villi 5b .
Fig. 20: 11th -13th day 11th -13th day Legend
Primary villus with the
cytotrophoblast, which
penetrates into the
processes of the
syncytiotrophoblast,
forming the primary
trophoblast villi.
1 Cytotrophoblast
2 Syncytiotrophoblast
After the 16th day the extra-embryonic mesoblast also grows into this primary
trophoblast villus, which is now called a secondary villus 5c and expands into the
lacunae that are filled with maternal blood. As was already mentioned, the ST forms the
outermost layer of every villus.
1 Extra-embryonic mesoblast
2 Cytotrophoblast
3 Syncytiotrophoblast
At the end of the 3rd week the villus mesoblast differentiates into connective tissue
and blood vessels. They connect up with the embryonic blood vessels. Villi that contain
differentiated blood vessels are called tertiary villi 6 .
Fig. 22: 21rst day 21rst day Legend
Tertiary villi with extra-
embryonic mesoblast
(EEM) in the center and
additional embryonic
blood vessels. The EEM
remains in this stage, still
surrounded by
cytotrophoblast. The outer
envelope of the villus is
still formed by the ST.
1 Extra-embryonic mesoblast
2 Cytotrophoblast
3 Syncytiotrophoblast
4 Fetal capillaries
From this time on gases, nutrients, and waste products that diffuse through the
maternal and fetal blood must pass through a total of four layers:
After the 4th month the cytotrophoblast in the tertiary villi disappear slowly, the villi Reminder
divide further and become very thin, whereby the distance between the intervillous Histological comparison
space with maternal blood and the fetal vessels gets smaller. The villi that arise in this between a young
way are called free villi. placenta and one at the
end of pregnancy
Fig. 23 - After the end of the 4th month Placenta at term Legend
Free villi with extra-
embryonic mesoblast
(EEM) and fetal blood
vessels in the center.
1 Extra-embryonic mesoblast
2 Remains of cytotrophoblast
3 Syncytiotrophoblast
4 Fetal capillaries
HTA of the
pregnancy
(French)
More info
During a normal pregancy the maternal spiral arteries that
nourish the placenta are continuosly pulled into the lacunar
system.
These structural adaptations are accompanied by an
edema, the dissolution of the endothelium and destruction
of the tunica media and the membrana elastica interna,
which are replaced by fibrous tissue. Through these
alterations the arteries are removed from neuro-vascular
control and the influence of the tone-producing vessel
mediators (prostaglandin, nitrous oxide, endothelin). Thus,
a larger blood flow is allowed in the placenta.
The migration of the trophoblast cells stands under a strict
temporal-spatial control, an alteration of which can provoke
a disorder in placental function. This ranges from a
preeclampsia (characterized by insufficient penetration by
the trophoblast) to a chorion carcinoma (characterized by
an excessive trophoblast invasion).
Maternal and fetal tissues form two units that are closely Quiz
bound together at the placental level. Quiz 12
The fetal part of the placenta is made up of the chorionic
plate with its placental villi, the cytotrophoblast layer and
the intervillous spaces. The chorionic plate (great part of
the placenta on the fetal side) consists of the amnion, the
extra-embryonic mesenchyma, the cytotrophoblast and
the syncytiotrophoblast.
The basal plate, the peripheral region of the placenta on
the maternal side that is in contact with the uterine wall, is
made up of two tissues: embryonic tissue
(cytotrophoblast, syncytiotrophoblast), on the one side,
and of maternal tissue (decidua basalis) on the other.
The chorionic
plate (Fig. 27)
(namely the
fetal part of the
placenta) and
the basal plate
(Fig. 28),
(maternal part
of the placenta)
form two units
closely
connected at
the placental
level.
1 Decidual tissue
2 Syncytiotrophoblast
3 Cytotrophoblast islands
4 Septum
These septa delimit the cotyledons but never merge with the
chorionic plate. Maternal blood can accordingly circulate
freely from one cotyledon to the other (interactive diagram).
The villus stems of the placenta lengthen considerably
towards the end of the pregnancy and the fibrinoid deposits
(extra-cellular substance made up of fibrin, placental
secretions and dead trophoblast cells), accumulate in the
placenta. This happens especially under the chorionic plate,
where they form the subchorialLanghans' layer, as well as
at the level of the basal plate beneath the stem villi and the
cytotrophoblast layer, where the fibrin deposits form Rohr's
layer. Still deeper in the decidua basalis these deposits
form Nitabuch's layer. This is where the placenta detaches
itself from the uterus at birth (interactive diagram).
More info
The fibrinoid deposits are structurally and chemically
closely related to fibrin that is formed by the activation of
fibrinogen in the blood vessels. Recent research results
emphasize the existence of two types of fibrinoid (16).
The fibrinoid deposits are present in all normal placentas,
increase in thickness during the pregnancy, and can take
up a maximum of 30% of the placental volume without
affecting its function. Normally, at the end of the pregnancy,
they do not occupy more than 10 to 20% of the placenta
volume.
It seems their generation is connected with micro-lesions of
the syncytiotrophoblast. Through these injuries, the
mesenchyma comes into contact with maternal blood. This
provokes the activation of local coagulation mechanisms.
The mechanism resembles those which are brought about
through endothelial lesions in the blood vessels of adults.
Fibrinoid deposits also envelop all necrotic material that
ensues from placental degeneration. When these deposits
are massive and block one or more vessels to the villi, they
form white infarcts, which can be seen macroscopically on
the placenta.
The functional importance of the fibrinoid seems to be
quite complex. Besides their sealing effects, they also play
a role in the immunologic "barrier" between feto-maternal
tissue as well in the anchoring of the placenta.
The decidua
More info
After the end of the 4th week all of the placental villi
are tertiary villi. Histologically and morphologically
they develop themselves further in the direction of a
new type of villus that is better adapted to the
growing embryonic needs. The tertiary villi, with a
diameter between 60 -200 mm, are homogenous and
rich in mesenchyma with few capillaries. They grow
first in length and later, through proliferation of the
trophoblast and extra-embryonic mesoblast (EEM) as
well as of endothelial cells, they also increase in
density and width. The trophoblast covering forms
numerous trophoblast buds, which at the beginning
are formed by the syncytiotrophoblast (similar to the
primary villi), but nevertheless cytotrophoblast and
the EEM grow very rapidly into these villi.