Development of Normal

Placenta
 Introduction
 To sustain Pregnancy auxillary structure
develops
1. Placenta
2. Umbilical cord
3. Fetal Membranes
 The Decidua
 Decidua is the name of the Endometrium
during Pregnancy
• Conception

Increased secretion of estrogen

Growth of Endometrium (4 times thickness of its

Non-Pregnant state)
contd…
  Corpusluteum

Large amount of Progesterone

Stimulate secretary activity of Endometrial

glands & increase the size of blood vessels

Soft, Vascular, Spongy bed to receive Fertilized

Ovum
contd…
 Three layers are found in Decidua
1.Basal layer – Lies immediately above Myometrium
- Remain unchanged itself
- Regenerates new Endometrium in Puerperium

2.Functional layer – Consist tortuous glands which are

rich in secretions
-Stroma cells enlarged – “decidual reaction”
-Prevents excessive invasion
-Secure anchorage & allows access to good nutrients&O2
Contd…
3. Compact layer – Forms surface of Decidua
-Composed of closely packed Stroma cells &neck

of the glands
*The decidua underneath the Blastocyst named as
-Decidua Basalis
-Decidua Capsularis
-Decidua Parietalis

contd…
Decidua Basalis: Underlies the developing Embryo &
forms the maternal side of the Placenta
Decidua Capsularis : Which over lies the Embryo &
bulges into the uterine cavity as the Embryo & fetus
grow
Decidua Parietalis : Which lines the rest of the
uterine
cavity. At 22nd wks of gestation, decidua Capsularis
fuses with Parietalis & filling the uterine cavity
 The Trophoblast
Blastocyst surface
Small Projections
Most proliferate at the area of contact (Trophoblastic
layer) differentiate in to 3 layers
1. Outer syncytiotrophoblast (Syncytium)
2. Inner Cytotrophoblast
3. Layer of mesoderm or primitive mesenchyme
 Syncytio Trophoblast

-Composed of nucleated protoplasm

-Capable of breaking down tissue in the process of

embedding
-Erodes walls of blood vessels of decidua and get

access for maternal nutrition

 Cytotrophoblast
- Well defined single layer of cells produces HCG
- HCG informs Corpusluteum pregnancy begun
- Corpusluteum Estrogen and Progesterone

Suppresses Maintains
integrity
of decidua

FSH Prevent Shedding

 Mesoderm

- Consists of loose connective tissue

 Development of Placenta

Introduction:
 Placenta is a thick, disk-shaped organ
Major functions are metabolic, transfer

substances and endocrine

Fetal side is smooth, with branching vessels

covered by membrane
contd…
 Maternal side is rough where is attaches to the
uterus
 Umbilical cord inserted in the fetal side at
center
 During early pregnancy, it is larger than
embryo or fetus
 Placenta is about one-sixth the weight of the
fetus at term.
  Fertilized ovum

Covered with fine downy hair with consist of the projections

from the Trophoblastic layer

These proliferate and branch about 3 weeks after fertilization

Forms Chorionic Villi

Become most profuse in blood supply richest area-in basal

decidua
 This Part of Trophoblast-”Chorion frondosum”

contd…
 Villi

Under capsular decidua

Less nourished
Gradually degenerate
Chorion laeve(Bald clarion)
That is the origin of Chorionic membrane
contd…
 The Villi

Erode walls of maternal blood vessels

Degenerate decidua

Forms a lake of maternal blood

Villi floats into it

• The Opened blood vessels are known as “Sinuses”
• Areas surrounding the Villi as blood spaces

contd…
 Maternal blood circulates slowly

Enables Villi to absorb food, O2 and excrete waste-

known as Nutritive Villi

-Few Villi deeply attached to decidua is called

anchoring Villi
contd…
  One stem

Branching structure
Each Chorionic Villus

Centre it consist of mesoderm and fetal blood vessels,

and branches of the Umbilical artery and vein
Covered by
A Single layer of Cytotrophoblast cells and external
layer of the villus is syncytiotrophoblast

contd…
 So 4 layer of tissue separate the maternal blood from
fetal blood
 Placenta completely formed and functioning from
10 weeks after fertilization
 It is Loose structure in earlier stage but becomes
more compact as it matures
 Between 12 and 20 weeks of gestation the placenta
weighs > the fetus
contd…
  Later pregnancy

Fetal liver starts functioning

So
Cytotrophoblast and Syncytiotrophoblast gradually
degenerate

Easier exchange of O2 and Co2

Circulation Through The Placenta
 Fetal heart

Pumps
Fetal blood which is low in O2

Umbilical Arteries

Capillaries of Chorionic Villi

contd…
 Placenta

Exchange of O2 and Co2

Umbilical vein

Blood return to fetus

contd…
 Maternal blood delivered into placental bed in
decidua by spiral arteries (80 – 100)

 Direction of flow is similar to fountain

 Blood passes upwards and bath Villus

 It circulates around it and drains back into a branch

of the uterine vein
 The Mature Placenta
Main functions are
1. Transfer of Nutrient and waste products
a. Respiratory
b. Excretory
c. Nutritive
2. Produce or metabolizes the hormones and
enzymes necessary to maintain
3. Barrier function
4. Immunological function
contd…
 1. Transfer Function
 Factors involved
-Physical properties of the substance to be
transferred
- Extent and Functional integrity of placental
membrane
- Rate of blood flow, (Fetal and maternal or either
side of the membrane)

contd…
 Mechanisms Involved

- Simple and facilitated diffussion

- Active Transfer

- Pinocytosis

- Leakage (Breaking the membrane)

contd…
 a. Respiratory Function
- Although fetal lung movements take place in utero
No Gas Exchange in lungs

- Intake of o2 And Output of Co2

Across fetal membrane
By simple diffusion

- O2 supply at rate of 5ml/kg/min

 b. Excretory Function

Urea, uric acid and creatinine

Excreted to maternal blood

Simple diffusion
 c. Nutritive Function
 Maternal adequate Nutrients Consumption is
important to meet the needs of fetus
i) Glucose
ii) Lipids
iii) Amino acids
iv) H2O and electrolytes
v) Hormones
contd…
i) Glucose

- Principle Source of energy

- Transferred by facilitated diffusion

- Evidenced by rapid transfer

- Fetal glucose lower than mother indicates rapid

utilization
contd…
ii) Lipids

- Needed for growth and Development

- In early Pregnancy Triglycerides and Fatty acids
Transferred from mother
- In late Pregnancy Triglycerides and Fatty acids
Synthesized in the fetus
- Cholesterol is capable of direct transfer

contd…
iii) Amino Acids

- Transferred by active transport through enzymatic

mechanism

- Amino Acids concentration more in fetal blood than

maternal blood

contd…
 iv) Water and Electrolytes
Na +, K+, C l – Ca+, Phosphorus and Iron

Cross Placenta Cross Placenta

Simple Diffusion Active Transport

Levels are higher in fetus than mother

- H2O Soluble Vitamins active transport
- Fat Soluble Vitamins transferred slowly
v) Hormones

-Insulin, Steroids, Thyroid, HCG cross in very slow

rate

-Lower concentration in fetal blood than maternal

blood

-Parathormone & Calcitonin never cross the

placenta
 Enzymatic & Hormone production /
Metabolism
 Enzyme Metabolism
-Diamine oxidase which inactivate circulatory
pressure
-Oxytocinase which neutralize oxytocin
-Phospholipase A2 which synthesizes arachidonic
acid

contd…
 Hormone Production

- HCG - Cytotrophoblastic layer

- Estrogen - Secretion by Corpusluteum

Placental Takes over Production

- Progesterone – Syncitial layer of placenta

- (human placental lectogen)HPL

 3. Barrier Function

- Noxious agent circulating in maternal blood

- Maternal infection Virus and bacteria (rubella,

chickenpox, measles and mumps)

- Drugs
 4. Immunological Function
 Fibrinoid and siolomucin

Coated in Trophoblast

Suppress Trophoblastic antigen

 Development of specific mucoprotein – Muco
polysaccharide complex by decidual cells
 Placenta hormone, steroids and Chorionic
Gonadotrophin have weak immunosuppressive
effect.
 Term Placenta

 Round, Flat mass about 20 cm in diameter and

2.5 cm thick at center

 Weighs one sixth of baby’s body weight at term

The Maternal Surface

 Dark red in colour, 20 lobes seperated by sulci

 Lobe Made up of lobules

Contain Villus with its branches

 Deposition of lime salts make the surface gritty
The Fetal Surface
 Amnion covers the fetal surface of the placenta
 It gives white shiny appearance
 Cord inserted in centre
 Blood vessels spread out from it
The Fetal Sac

 Outer – Chorion  Inner – Amnion

• Closely adherent with • Contains amniotic fluid
uterine wall • Smooth, tough
• Thick, opaque, friable translucent membrane
membrane derived from • Derived from inner cell
Trophoblast mass
• Forms base of placenta • Has a role in formation of
amniotic fluid
 Amniotic Fluid
 Functions
o Allows growth and Free movement of fetus
o Equalizes pressure
o Protect fetus from injury
o Fluids maintain constant temperature
o Provides small amount of nutrients
o Protect the umbilical cord and placenta from uterine
contraction
o Aids in effacement of the cervix and dilatation of os
 Origin

Fetal Vessels in placenta

Source
Maternal Vessels in decidua

-Secreted by Amnion

-Fetal urine from 10th weeks of gestation

 Volume
- Increases through out Pregnancy until 38 weeks
about 1 liter

- At term slightly diminishes to 800ml

- If total amount exceeds 1500ml Polyhydramnios

- If total amount < 300ml - Oligohydramnios

- Congenital anomalies leads to abnormal volume

 Constituents
- Termed liquor amni
- Clear, pale straw colored fluid
- 99% H2O, 1% dissolved matter

Food substances
Waste products
Skin cells
Vernix
Lanugo
 Abnormal Constituent

Meconium
 The Umbilical Cord
- Cord or funis extends from fetus to placenta
- Transmits umbilical blood vessels 2arteries &
1 vein

Enclosed by Wharton's jelly

- Whole cord covered with amnion
- Length 50 cm
if < 40 cm Short Cord
if > 50 cm Long Cord
- if knot distinguish as True or False
Anatomical Variations of Placenta

- Succenturiate lobe of placenta

- Circumvallate placenta

- Battledore insertion of the cord

- Valemenotous insertion of the cord

- Bipartite placenta

- Tripartite placenta