Lecture - Placenta Development

From Embryology
Embryology - 19 Mar 2024    Facebook link Pinterest link Twitter link  Expand to Translate  
Google Translate - select your language from the list shown below (this will open a new external page)

العربية | català | 中文 | 中國傳統的 | français | Deutsche | עִברִית | हिंदी | bahasa Indonesia | italiano | 日本語 | 한국어 | မြန်မာ | Pilipino | Polskie | português | ਪੰਜਾਬੀ ਦੇ | Română | русский | Español | Swahili | Svensk | ไทย | Türkçe | اردو | ייִדיש | Tiếng Việt    These external translations are automated and may not be accurate. (More? About Translations)

Introduction

Spiegel and Casseri: De formato foetu liber singularis (Dedication dated 1626).

This lecture is an introduction to the development and functions of the placenta.


The placenta (Greek, plakuos = flat cake) named on the basis of this organs appearance. The placenta a mateno-fetal organ which begins developing at implantation of the blastocyst and is delivered with the fetus at birth. Only recently have we begun to understand the many different functions this organ carries out in addition to its role in embryonic nutrition.


If you have time after working through this online lecture page, have a look at the Medicine practical class, 7 pages the students work through in 2 hours.


The placenta and placental blood at birth has recently been seen as a new source for stem cells in bone marrow replacement therapy in many diseases. The topic of stem cells will be covered later in this current course.


2018 Lecture - Print PDF


Lecture Objectives

  • Understanding of placental villi development
  • Understanding of placental structure
  • Understanding of placental functions
  • Brief understanding of placental abnormalities

Lecture Resources

References  
UNSW Embryology logo
Hill, M.A. (2020). UNSW Embryology (20th ed.) Retrieved March 19, 2024, from https://embryology.med.unsw.edu.au
Placenta Links: placenta | Lecture - Placenta | Lecture Movie | Practical - Placenta | implantation | placental villi | trophoblast | maternal decidua | uterus | endocrine placenta | placental cord | placental membranes | placenta abnormalities | ectopic pregnancy | Stage 13 | Stage 22 | placenta histology | placenta vascular | blood vessel | cord stem cells | 2013 Meeting Presentation | Placenta Terms | Category:Placenta
Historic Embryology - Placenta 
1883 Embryonic Membranes | 1907 Development Atlas | 1909 | 1910 Textbook | 1917 Textbook | 1921 Textbook | 1921 Foetal Membranes |1921 human | 1921 Pig implantation | 1922 Single placental artery | 1923 Placenta Review | 1939 umbilical cord | 1943 human and monkey | 1944 chorionic villus and decidua parietalis | 1946 placenta ageing | 1960 first trimester placenta | 1960 monkey | 1972 Placental circulation | Historic Disclaimer
Textbook cover Larsen's human embryology 5th edn.
Moore, K.L., Persaud, T.V.N. & Torchia, M.G. (2015). The developing human: clinically oriented embryology (10th ed.). Philadelphia: Saunders.
The following chapter links only work with a UNSW connection.
Textbook cover Larsen's human embryology 5th edn.
Schoenwolf, G.C., Bleyl, S.B., Brauer, P.R., Francis-West, P.H. & Philippa H. (2015). Larsen's human embryology (5th ed.). New York; Edinburgh: Churchill Livingstone.
The following chapter links only work with a UNSW UNSW Library subscription
Movies  
2016LecturePlacenta-icon.jpg
 ‎‎Placenta
Page | Play
Week2 001 icon.jpg
 ‎‎Week 2 - Implant
Page | Play
Chorion 001 icon.jpg
 ‎‎Week 2 - Bilaminar
Page | Play
Fetal circulation 01 icon.jpg
 ‎‎Fetal Circulation
Page | Play
Fetal circulation 01 icon.jpg
 ‎‎Neonatal Circulation
Page | Play
Stage 13 MRI S01.jpg
 ‎‎Heart Sag MRI
Page | Play
2016 Lecture Video Recording  
This 2016 lecture video recording may differ from the the current 2018 online lecture.
<html5media height="600" width="820">File:2016Lecture-Placenta.mp4</html5media>
Click Here to play on mobile device
Moviebar-icons.jpg

Nutrition

  • Histiotrophic - describes the intital transfer of nutrition from maternal to embryo.
    • occurs before implantation and during early implantation mainly from uterine glands.
  • Haemotrophic - describes the later blood-borne nutrition.
    • occurs in the embryonic and fetal period after placenta development.

Fetal Membranes

Villi Stages

Implanting human conceptus 01.jpg Gray0032.jpg

Gray0036.jpg

Primary villi

Week 2 - first stage of chorionic villi development, trophoblastic shell cells (syncitiotrophoblasts and cytotrophoblasts) form finger-like extensions into maternal decidua.

Gray0037.jpg

Secondary villi

Week 3 - second stage of chorionic villi development, extraembryonic mesoderm grows into villi, covers entire surface of chorionic sac.

Gray0031.jpg

Tertiary villi

Week 4 - third stage of chorionic villi development, mesenchyme differentiates into blood vessels and cells, forms arteriocapillary network, fuse with placental vessels, developing in connecting stalk. Basal region will form chorionic plate.

Chorionoic Villi Location

Historic - Semi-diagramatic sagittal section of human uterus containing an embryo. Note the villi locations and the names for different maternal decidual regions.

Gray0034.jpg Bailey494.jpg

Originally cover entire chorionic surface and become restricted to decidua basalis region forming 2 regions:

Week 4 - Carnegie stage 11
Embryo-membranes stage 11.jpg
  • Frondosum - "leafy" where villi are mainly located
  • Capsularis - smooth chorion, where villi are absent or not abundant
Week 5 - Carnegie stage 14
Stage 14 - Lateral View

Stage14 bf18.jpg

 ‎‎Mobile | Desktop | Original

Stage 14 | Embryo Slides
Stage 14 - Ventral View

Stage14 bf21.jpg

 ‎‎Mobile | Desktop | Original

Stage 14 | Embryo Slides
Week 7 - Carnegie stage 18)
Stage18 bf10.jpg

Villi Terms

Early placental structure
  • primary villi - week 2, first stage of chorionic villi development, trophoblastic shell cells (syncitiotrophoblasts and cytotrophoblasts) form finger-like extensions into maternal decidua.
  • secondary villi - week 3, second stage of chorionic villi development, extraembryonic mesoderm grows into villi, covers entire surface of chorionic sac.
  • tertiary villi third stage of chorionic villi development, mesenchyme differentiates into blood vessels and cells, forms arteriocapillary network, fuse with placental vessels, developing in connecting stalk
  • stem villi - or anchoring villi, cytotrophoblast cells attached to maternal tissue.
  • branched villi - or terminal villi, grow from sides of stem villi, region of main exchange, surrounded by maternal blood in intervillous spaces.
  • terminal villi - not active outgrowths caused by proliferation of the trophoblast. Passive protrusions induced by capillary coiling due to growth of the fetal capillaries within the mature intermediate villi (third trimester).
  • chorionic plate - region of membrane at the base of the villi through which placental arteries and vein passes.

Placenta at Birth

Fetus in utero, between fifth and sixth months
  • Placenta (Greek, plakuos = flat cake)
  • embryonic/maternal organ
  • villous chorion/decidua basalis
  • continuous with amniotic and chorionic sacks

Dimensions

  • at birth - discoid up to 20cm diameter and 3 cm thick (term) and weighs 500-600 gm
  • Shapes - accessory placenta, bidiscoid, diffuse, horseshoe
  • maternal and embryonic surface, both delivered at parturition
    • retention may cause uterine hemorrhage
Placenta term anatomy 01.jpg
Fetal Surface Maternal Surface
  • umbilical cord attachment - cord 1-2 cm diameter, 30-90cm long
  • covered with amniotic membrane and attached to chorionic plate
  • umbilical vessels branch into chorionic vessels which anastomose
  • Cotyledons - form cobblestone appearance, originally placental septa formed grooves.
  • covered with maternal decidua basalis

Human placenta vascular CT 01.jpg

CT term placental blood vessels showing branching pattern of placental artery.

Placental Classification

Dog placenta (E35-38)

Classification of placenta is on the basis of histological (microscopic) structural organization and layers between fetal and maternal circulation, giving 3 main groups:

  • Haemochorial - placenta where the chorion comes in direct contact with maternal blood (human)
  • Endotheliochorial - maternal endometrial blood vessels are bare to their endothelium and these comes in contact with the chorion. (dogs, cats)
  • Epitheliochorial - maternal epithelium of the uterus comes in contact with the chorion.considered as primitive (pigs, cows)

The presence of these three differing types of placenta have also been used to describe the pattern mammalian evolution. See also Placental Layers

Haemomonochorial human placenta EM01.jpg

Haemochorial human placenta

Placental Types

Mouse placenta
  • Discoid in humans, mouse, insectivores, rabbit, rat, and monkeys.
  • Zonary in dog, cat, bears and seals.
  • Cotyledenary in cow, deer, goat, and giraffe.
  • Diffuse in horse, pig, camels, lemurs, opossums, kangaroo, and whales


Links: Comparative Placentation

Chorionoic Villi Trimester Development

  • Trimester 1 and 2 - immature intermediate villi, developmental steps towards the stem villi.
  • Trimester 3 - mature intermediate villi develop during the last trimester, produce numerous terminal villi.
    • Terminal villi are not active outgrowths caused by trophoblast proliferation, passive protrusions induced by capillary coiling due to excessive longitudinal growth of the fetal capillaries within the mature intermediate villi.
    • Capillary bed arrangement in the terminal villi can vary from simple U-like loops to branched network, due to capillary elongation and sprouting. (Data from[1])


Spiral artery trophoblast plug cartoon1.jpg

First trimester spiral artery trophoblast plug.[2]

Scheme of placental circulation

Placental Cord Blood Vessels

Kyoto16834 stage17-umbilicus.jpg Stage 22 image 225.jpg
Week 6 Umbilicus containing initial placental cord. Week 8 Embryo showing the placental blood vessels within the ventral body wall.


Placental cord vessels 01.jpgPlacental cord cross-section.jpg

  • initially in the connecting stalk (then umbilical cord) anastomose in chorion
    • extend maternally - toward chorionic villi
    • extend embryonically - to the sinus venosus and dorsal aorta
  • Arteries - paired, carry deoxygenated blood (from dorsal aorta) and waste products to the placental villi
  • Veins - paired initially then only left at end of embryonic period, carry oxygenated blood to the embryo (sinus venosus)

Placental Function

Fetal blood flow liver and brain
  • 4 layers separate maternal and fetal blood: syncitiotrophoblast, cytotrophoblast, villi connective tissue and fetal capillary endothelium
  • 3 main functions: metabolism, transport and endocrine

Placental Metabolism

Synthesizes: glycogen, cholesterol, fatty acids

  • provides nutrient and energy

Placental Transport

Placenta oxygen exchange levels.jpg

gases and nutrition

  • oxygen, carbon dioxide, carbon monoxide
  • water, glucose, vitamins
  • hormones, mainly steroid not protein
  • electrolytes
  • maternal antibodies
  • waste products - urea, uric acid, bilirubin
  • drugs and their metabolites (fetal drug addiction)
  • infectious agents (cytomegalovirus, rubella, measles, microorganisms)

Placental Endocrine

Trophoblast cell hCG
  • Human chorionic gonadotrophin (hCG) - like leutenizing hormone, supports corpus luteum
  • Human chorionic somatommotropin (hCS) (or placental lactogen) - hormone level increases in maternal blood through pregnancy, decreases maternal insulin sensitivity (raising maternal blood glucose levels and decreasing maternal glucose utilization) aiding fetal nutrition ("anti-insulin" function)
  • Human chorionic thyrotropin (hCT) - Peptide placental hormone, similar to anterior pituitary released thyroid stimulating hormone (TSH), which along with human chorionic gonadotrophin (hCG) is thought to act on maternal thyroid. There is little recent research published on this hormone, its level and activities.
  • Human chorionic corticotropin (hCACTH) - placental hormone thought to have corticotropin (ACTH)-like activity, increasing maternal cortisol levels.
  • Steroid Hormones
    • progestins - progesterone, support of the endometrium and suppress uterine smooth muscle contractility.
    • estrogens - estriol, stimulate growth of the myometrium and mammary gland development.
    • both hormones support maternal endometrium
  • Relaxin - Humans high levels early in pregnancy than at birth promotes angiogenesis probably plays a role in development of the uterus/ placenta than in the birth process

Fetal Placenta

Villi cross-section

Trophoblast cells are the major source of placental hormones.

Placental growth hormone (PGH) is mainly expressed in the syncytiotrophoblast cells (PGH differs from pituitary derived growth hormone by 13 amino acids). extravillous cytotrophoblast - arise from anchoring villi invade the uterine spiral arteries, generating fibrinoid material and endovascular trophoblastic cells. syncytiotrophoblast

Fetal Blood Vessels At least 2 phases of development during pregnancy driven by vascular endothelial growth factor (VEGF):

  1. Initially cytotrophoblasts are the cellular stimulus to vasculogenesis and angiogenesis.
  2. Later Hofbauer (lacental villi macrophages of mesenchymal origin) and stromal cells take over the stimulation of blood vessel development.

Placenta Human chorionic gonadotrophin (hCG) After implantation cells within the developing placenta (syncitiotrophoblasts) synthesize and secrete Human chorionic gonadotrophin (hCG) into the maternal bloodstream. The main function of serum hCG is to maintain the corpus luteum in the maternal ovary and therefore maintain the early pregnancy, that is block the menstrual cycle. Later the placenta itself supports the pregnancy.

Maternal Placenta

Uterine and placental vasculature.jpg Placenta spiral artery conversion.jpg
Uterine and placental vasculature Placenta spiral artery conversion

Fibrinoid - said to exist as 2 forms of extracellular matrix:

  1. Fibrin-type fibrinoid is a maternal blood-clot product which replaces degenerative syncytiotrophoblast
  2. Matrix-type fibrinoid is secreted by invasive extravillous trophoblast cells.

Fibrinoid layer (Nitabuch's layer) is thought to act to prevent excessively deep implantation.

Decidualization

Process of endometrial stromal cells (fibroblast-like) change in morphology (polygonal cells) and protein expression and secretion (specific decidual proteins: prolactin, insulin-like growth factor binding protein-1, tissue factor, interleukin-15, and VEGF).

  1. Estrogen and progesterone - receptive phase, luminal and glandular epithelial cells change in preparation for blastocyst adplantation.
  2. Human Chorionic gonadotropin - luminal epithelium endoreplication leading to epithelial plaque formation.
  3. Human Chorionic gonadotropin - trophoblast invasion and decidualization of human stromal fibroblasts.
Placenta anchoring villi.jpg

Artery Dilatation - due to extravillous trophoblast cells invading uterine wall and maternal spiral arteries replacing both smooth muscle with fibrinoid material and part of vessel endothelium. There is also a proliferation of maternal blood vessels.

Other changes

  • Endoreplication - rounds of nuclear DNA replication without intervening cell or nuclear division (mitosis).
  • Cytokines - of maternal origin also act on placental development.
  • Natural Killer (NK) cells - 30% of all the decidual cells towards the end of the first trimester of pregnancy. These lymphocytes are present in the maternal decidua in large numbers (70%, normal circulating blood lymphocytes 15%) close to the extravillous trophoblast cells. Have a cytolytic potential against virus-infected and tumor-transformed cells.


  1. Castellucci M, Scheper M, Scheffen I, Celona A & Kaufmann P. (1990). The development of the human placental villous tree. Anat. Embryol. , 181, 117-28. PMID: 2327595
  2. Weiss G, Sundl M, Glasner A, Huppertz B & Moser G. (2016). The trophoblast plug during early pregnancy: a deeper insight. Histochem. Cell Biol. , 146, 749-756. PMID: 27510415 DOI.

Placental Abnormalities

Placental abnormalities
Historic model of placenta previa
Hydatidiform mole pathology
  • Placenta Accreta - abnormal adherence, with absence of decidua basalis. The incidence of placenta accreta also significantly increases in women with previous cesarean section compared to those without a prior surgical delivery.
  • Placenta Increta - occurs when the placenta attaches deep into the uterine wall and penetrates into the uterine muscle, but does not penetrate the uterine serosa. Placenta increta accounts for approximately 15-17% of all cases.
  • Placenta Percreta - placental villi penetrate myometrium and through to uterine serosa.
  • Placenta Previa - In this placenatal abnormality, the placenta overlies internal os of uterus, essentially covering the birth canal. This condition occurs in approximately 1 in 200 to 250 pregnancies. In the third trimester and at term, abnormal bleeding can require cesarian delivery and can also lead to Abruptio Placenta. Ultrasound screening programs during 1st and early 2nd trimester pregnancies now include placental localization. Diagnosis can also be made by transvaginal ultrasound.
  • Vasa Previa - (vasa praevia) placental abnormality where the fetal vessels lie within the membranes close too or crossing the inner cervical os (opening). This occurs normally in 1:2500-5000 pregnancies and leads to complications similar too those for Placenta Previa.Type II is defined as the condition where the fetal vessels are found crossing over the internal os connecting either a bilobed placenta or a succenturiate lobe with the main placental mass. Some recent evidence of successful in utero laser ablation of type II vasa previa at 22.5 weeks of gestation.
  • Abruptio Placenta - a retroplacental blood clot formation, abnormal hemorrhage prior to delivery.
  • Chronic Intervillositis - (massive chronicintervillositis, chronic histiocytic intervillositis) Rare placental abnormality and pathology defined by inflammatory placental lesions, mainly in the intervillous space (IVS), with a maternal infiltrate of mononuclear cells (monocytes, lymphocytes, histiocytes) and intervillous fibrinoid deposition.
  • Hydatidiform mole - placental tumor with no embryo development. Several forms of hydatidiform mole: partial mole, complete mole and persistent gestational trophoblastic tumor. Many of these tumours arise from a haploid sperm fertilizing an egg without a female pronucleus (the alternative form, an embryo without sperm contribution, is called parthenogenesis). The tumour has a "grape-like" placental appearance without enclosed embryo formation. Following a first molar pregnancy, there is approximately a 1% risk of a second molar pregnancy.


Links: Placenta - Abnormalities

Placental Cord Abnormalities

There are few abnormalities associated with umbilical cord development, other that abnormally short or long cords, which in most cases do not cause difficulties. In some cases though, long cords can wrap around limbs or the fetus neck, which can then restrict blood flow or lead to tissue or nerve damage, and therefore effect develoment.

Placental cord cross-section.jpg Placental cord knot.png

  • Cord knotting - can also occur (1%) in most cases these knots have no effect, in some cases of severe knotting this can prevents the passage of placental blood.
  • Cord torsion - Rare event where even without knot formation can also affect placental blood flow, even leading to fetal demise.


Placental Infections

Malaria plasmodium falciparum.jpg Listeria maternal-fetal barrier.jpg
Malaria (plasmodium falciparum) Listeria maternal-fetal barrier
  • Several infective agents may cross into the placenta from the maternal circulation, as well as enter the embry/fetal circulation. The variety of bacterial infections that can occur during pregnancy is as variable as the potential developmental effects, from virtually insignificant to a major developmental, abortive or fatal in outcome.
  • Pregnant women have an increased susceptibility to malaria infection. Malarial infection of the placenta by sequestration of the infected red blood cells leading to low birth weight and other effects. There are four types of malaria caused by the protozoan parasite Plasmodium falciparum (main), Plasmodium vivax, Plasmodium ovale, Plasmodium malariae). This condition is common in regions where malaria is endemic with women carrying their first pregnancy (primigravida).

Placental Pathology

MH - content in this section is not examinable.

  • Chronic Villitis - can occur following placental infection leading to maternal inflammation of the villous stroma, often with associated intervillositis. The inflammation can lead to disruption of blood flow and necrotic cell death.
  • Massive Chronic Intervillositis (MCI) - maternal blood-filled space is filled with CD68-positive histiocytes and an increase in fibrin, occuring more commonly in the first trimester.
  • Meconium Myonecrosis - prolonged meconium exposure leads to toxic death of myocytes of placental vessels (umbilical cord or chorionic plate).
  • Neuroblastoma - a fetal malignancy that leads to an enlarged placenta, with tumor cells in the fetal circulation and rarely in the chorionic villi.
  • Thrombophilias - (protein C or S deficiency, factor V Leiden, sickle cell disease, antiphospholipid antibody) can generate an increased fibrin/fibrinoid deposition in the maternal or intervillous space, this can trap and kill villi.

Additional Images

Virtual Slides
Placental Villi

HillH52slide2x40 13-icon.jpg

 ‎‎Mobile | Desktop | Original

Placenta | Embryo Slides
Human Circumvallate Placenta

Circumvallate placenta 01.jpg

 ‎‎Mobile | Desktop | Original

Placenta Abnormal | Embryo Slides
Tertiary Villi cross-section Abnormal placenta


Historic - Fetal Membranes Images

External Links

External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation.


Placenta Terms

Placenta Terms (expand to view) 
  • after-birth - term used to describe the delivery of placenta and placental membranes following birth of the child.
  • allantois - An extraembryonic membrane, endoderm in origin extension from the early hindgut, then cloaca into the connecting stalk of placental animals, connected to the superior end of developing bladder. In reptiles and birds, acts as a reservoir for wastes and mediates gas exchange. In mammals is associated/incorporated with connecting stalk/placental cord fetal-maternal interface.
  • amniocentesis - Clinical term for a prenatal diagnostic test where an ultrasound guided needle is used to extract a sample of the amniotic fluid. Amniocentesis
  • anastomosis - Term used to describe the connection between two tubes. Applied to describe the connection between peripheral blood vessels without an intervening capillary bed.
  • anchoring villi - (stem villi) describes the placental villi (embryonic) that attach to the decidua (maternal) tissue. The tip of the villi consists of a column of trophoblast cells attached to an epithelial plaque.
  • angioblasts form clusters or blood islands on surface of yolk sac.
  • angiogenesis - Term describing the development of new vessels from already existing vessels, this process is secondary to vasculogenesis which is the initial formation of first blood vessels by differentiation of pluripotent mesenchymal cells (extraembryonic mesoderm).
  • capsularis - portion of maternal decidua that covers the conceptus facing towards the uterine cavity.
  • cerebroplacental ratio - (CPR) a doppler ultrasound measurement calculated as the simple ratio between the middle cerebral artery pulsatility index (MCA‐PI) and the umbilical artery pulsatility index (UA‐PI). Fetuses with an abnormal ratio are thought to be a predictor of adverse pregnancy outcome.
  • chorioamnionitis - (CA) An intraamniotic puerperal infection described as having 3 forms: histologic, clinical (clinical chorioamnionitis, IAI), and subclinical. Intraamniotic infection is a common (2-4%) event in labor and the systemic inflammatory response can also lead to preterm birth and neonatal complications.
  • chorion - The extraembryonic membrane generated from trophoblast and extraembryonic mesoderm that forms placenta. chorion and amnion are made by the somatopleure. The chorion becomes incorporated into placental development. The avian and reptilian chorion lies beside the egg shell and allows gas exchange.
  • chorionic cavity - The fluid-filled extraembryonic coelom (cavity) formed initially from trophoblast and extraembryonic mesoderm that forms placenta. chorion and amnion are made by the somatopleure. The chorion becomes incorporated into placental development. The avian and reptilian chorion lies beside the egg shell and allows gas exchange. In humans, this cavity is lost during week 8 when the amniotic cavity expands and fuses with the chorion.
  • chorion frondosum - (frondosum = leafy) The chorion found on conceptus oriented towards maternal blood supply where the majority of villi form and proliferate, will contribute the fetal component of the future placenta.
  • chorion laeve - (laeve = smooth) The smooth chorion found on conceptus away from maternal blood supply (towards uterine epithelium and cavity) with very few villi present.
  • chorionic somatomammotropin - (CSH, human lactogen) A hormone synthesized within the placenta by syncytiotrophoblast cells. This protein hormone (190 amino acid) has a structure is similar to pituitary growth hormone.
  • chorionic villus sampling - (CVS) The taking a biopsy of the placenta, usually at the end of the second month of pregnancy, to test the fetus for genetic abnormalities.
  • coelocentesis - A sampling of extracoelomic fluid usually for an early prenatal diagnostic technique.
  • connecting stalk - the original extra-embryonic mesoderm structure attaching the embryonic disc to the chorion. The placental blood vessels form within this structure.
  • cord blood - (human umbilical cord blood, HUCB) A term used to describe blood collected from the placenta usually after birth. Has been identified as a source of stem cells with potential therapeutic uses and is stored in Cord Blood Banks throughout the world.
  • cord knotting Term describing umbilical or placental cord knotting. This occurs in about 1% prevents the passage of placental blood, pseudoknots also occur usually with no effect.
  • cord presentation - A term used to describe at birth the presence of the umbilical cord between the fetal presenting part and the cervix, with or without membrane rupture.
  • cord prolapse - A term used to describe at birth the descent of the umbilical cord through the cervix alongside (occult) or past (overt) the presenting part in the presence of ruptured membranes (incidence of 0.1% to 0.6%).
  • cotyledon - (Greek, kotyle = a deep cup) In the embryos of seed plants, the "seed leaves," in which nutrients are stored for use after germination. In placental animals, the term is also to describe the leaf-like structure of the placenta surface.
  • cytotrophoblast - The "cellular" trophoblast layer surrounding (forming a "shell") the early implanting conceptus. Beginning at uterine adplantation, proliferation and fusion of these cells is thought to form a second outer trophoblast layer, the syncytiotrophoblast. The cytotrophoblast layer contributes to formation of the placental villi, the functional component of the fetal placenta.
  • decidua basalis - The term given to the uterine endometrium at the site of implantation where signaling transforms the uterine stromal cells (fibroblast-like) into decidual cells. This forms the maternal component of the placenta, the decidualization process gradually spreads through the remainder of the uterus, forming the decidua parietalis.
  • decidua basalis reaction - Term describing the maternal endometrial changes that occur initially at the site of, and following, blastocyst implantation. Seen as a deposition of glycogen, fibrin and proliferation of blood vessels. See also decidualization.
  • decidua capsularis - The term given to the uterine endometrium which has been converted to decidua surrounding the conceptus on the smooth chorion side.
  • decidua parietalis - The term given to the remainder of the uterine endometrium, away from the site of implantation, that gradually becomes comverted to decidua.
  • decidual cell - The uterine stromal cells (fibroblast-like) that differentiate in response to both steroid hormones (progesterone) and embryonic signals. These cells then alter uterine environment to support further embryonic development as well as producing cytokines related to prolactin (PRL) and have an innate immune function.
  • decidual reaction - maternal endometrial reaction invoked in order to block the rapid extension of the implanting syncytium.
  • decidualization - (decidualisation, decidual reaction) The process by which uterine stromal cells differentiate in response to both steroid hormones and embryonic signals into large epitheliod decidual cells. This process is essential for the progress of implantation and establishing fetal-maternal communication.
  • DHEA - (dehydroepiandrosterone, androstenolone) precursor of sex steroid hormones and is converted to testosterone and estradiol. Postnatally, an abundant circulating steroid produced in the adrenal gland. The fetal adrenal cortex produces dehydroepiandrosterone sulfate (DHEA-S) used by the placenta to produce estrogens. DHEA, androstenedione, and testosterone can be metabolized to epiandrosterone, and etiocholanolone. PMID 15635500
  • fetal drug addiction - occurs when drugs used maternally cross the placental barrier and can establish neural/physiological addiction in the unborn fetus. drugs
  • fetal erythroblastosis - (Haemolytic Disease of the Newborn) A clinical term describing an immune response between fetal and maternal blood groups; from fetus Rh+ / maternal Rh-. The leakage of blood from fetus, particularly at birth, causes maternal anti-Rh antibodies, which is then dangerous for a 2nd or future pregnancies.
  • fetal intra-abdominal umbilical vein varix - (FIUV, umbilical vein varix) focal dilatation of the umbilical venous diameter at the level of cord insertion, the dilatation diameter increases linearly with gestational age. Represent about 4% of umbilical cord abnormalities

with an incidence of about 2.8 per 1,000 pregnancies, there is also a rarer form of extra-abdominal varices.PMID 24883288

  • fibrinoid layer - (Nitabuch's layer) A layer formed at maternal/fetal interface during placentation and is thought to act to prevent excessively deep conceptus implantation. Fibrin-type fibrinoid (maternal blood-clot product) and matrix-type fibrinoid (secreted by invasive extravillous trophoblast cells).
  • floating chorionic villi - Term used to describe the placental microanatomy structure of chorionic villi that are not attached to the maternal decidua and float in the maternal blood-filled space (lacunae). Structurally the same as anchoring chorionic villi conceptus side that are attached to the maternal decidua.These villi go through the same stages of development: primary villi - secondary villi - tertiary villi
  • hemotrophic nutrition - Term used to describe in late placenta development the transfer of blood-borne nutrition from maternal to embryo/fetuscompared to early histiotrophic nutrition.
  • heterotopic pregnancy - (Greek, heteros = other) Clinical term for a very rare pregnancy of two or more embryos, consisting of both a uterine cavity embryo implantation and an ectopic implantation.
  • histiotrophic nutrition - Term used to describe in early placenta development the intital transfer of nutrition from maternal to embryo (histiotrophic nutrition) compared to later blood-borne nutrition (hemotrophic nutrition). Histotroph is the nutritional material accumulated in spaces between the maternal and fetal tissues, derived from the maternal endometrium and the uterine glands. This nutritional material is absorbed by phagocytosis initially by blastocyst trophectoderm and then by trophoblast of the placenta. in later placental development nutrition is by the exchange of blood-borne materials between the maternal and fetal circulations, hemotrophic nutrition.
  • Hofbauer cells - Cells found within placental villi connective tissue. Have a role as macrophages of mesenchymal origin with potentially additional functions (remodeling, vasculogenesis, regulation of stromal water content).
  • Human chorionic corticotropin - (hCACTH) placental derived hormone equivilant to corticotropin (ACTH) from the pituitary.
  • Human chorionic gonadotrophin - (hCG) like leutenizing hormone, supports corpus luteum, originally secreted by trophoblast cells.
  • Human chorionic somatommotropin - (hCS, placental lactogen) hormone level increases in maternal blood through pregnancy, decreases maternal insulin sensitivity (raising maternal blood glucose levels and decreasing maternal glucose utilization) aiding fetal nutrition.
  • Template:Hydatiform mole - A uterine tumour with "grape-like" placenta appearance without enclosed embryo formation, arises mainly from a haploid sperm fertilizing an egg without a female pronucleus. It is one form of gestational trophoblastic disease(GTD), a number of abnormalities including hydatiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumor (PSTT).
  • hysterectomy – clinical term for the surgical removal of the uterus.
  • Langhans layer - cytotrophoblast cell layer.
  • maternal antibodies - antibodies from the mother's immune system that are capable of crossing placental barrier. They can provide immune protection to the embryo, but may also participate in immune disease (fetal erythroblastosis).
  • maternal sinusoids - placental spaces around chorionic villi that are filled with maternal blood. This is the closest maternal/fetal exchange site.
  • Nitabuch's layer - (fibrinoid layer) The layer formed at maternal/fetal interface during placentation and is thought to act to prevent excessively deep conceptus implantation. Fibrin-type fibrinoid (maternal blood-clot product) and matrix-type fibrinoid (secreted by invasive extravillous trophoblast cells).
  • Morbidly adherent placenta (MAP) A general clinical term used to describe the different forms of abnormal placental implantation (Accreta, Increta and Percreta).
  • oligohydramnios - Clinical term for the accumulation a deficiency of amniotic fluid during pregnancy. See also polyhydramnios, an excess of amniotic fluid.
  • persistent right umbilical vein - (PRUV) A placental cord abnormality associated with fetal abnormalities and poor neonatal prognosis. The estimated incidence of persistent right umbilical vein in a low-risk population is 1 : 526. PMID 12047534
  • polyhydramnios - Clinical term for the accumulation of excess amniotic fluid during pregnancy. See also oligohydramnios, a deficiency of amniotic fluid.
  • placenta - (Greek, plakuos = flat cake) The developmental organ formed from maternal and fetal contributions in animals with placental development. In human, the placenta at term is a discoid shape "flat cake" shape; 20 cm diameter, 3 cm thick and weighs 500-600 gm. Placenta are classified by the number of layers between maternal and fetal blood (Haemochorial, Endotheliochorial and Epitheliochorial) and shape (Discoid, Zonary, Cotyledenary and Diffuse). The placenta has many different functions including metabolism, transport and endocrine.
  • placenta accreta - The abnormal placental adherence, either in whole or in part of the placenta with absence of decidua basalis, leading to retention as an after-birth to the underlying uterine wall. The incidence of placenta accreta also significantly increases in women with previous cesarean section compared to those without a prior surgical delivery.
  • placental arteries - (umbilical arteries) In placental animals, the blood vessels which develop within the placental cord carrying relatively deoxygenated blood from the embryo/fetus to the placenta. In humans, there are two placental arteries continuous with the paired internal iliac arteries (hypogastric arteries) arising off the dorsal aortas. At birth this vessel regresses and form the remnant medial umbilical ligament.
  • placental cord - (umbilical cord) The placental cord is the structure connecting the embryo/fetus to the placenta. It is initially extra-embryonic mesoderm forming the connecting stalk within which the placental blood vessels (arteries and veins) form. In human placental cords the placental blood vessels are initially paired, later in development only a single placental vein remains with a pair of placental arteries. This structure also contains the allantois, an extension from the hindgut cloaca then urogenital sinus. Blood collected from the placental cord following delivery is a source of cord blood stem cells.)
  • placental diameter - is measured in the transverse section by calculating the maximum dimensions of the chorionic surface.
  • placental growth factor - (PlGF) A growth factor of the vascular endothelial growth factor (VEGF) family, released from the placental trophoblast cells and other sources that stimulates blood vessel growth.
  • placental malaria - The malarial infection of the placenta by sequestration of the infected red blood cells. This condition can be common in regions where malaria is endemic with women carrying their first pregnancy (primigravida).
  • placenta membranacea - rare placental abnormality characterized by the presence of chorionic villi directly attached to and covering the fetal membranes. Placenta Membranacea
  • placenta previa - placenta overlies internal os of uterus, abnormal bleeding, may require cesarian delivery.
  • placental thickness - is measured at its mid-portion from the chorionic plate to the basilar plate, on a longitudinal plane (less than 4 cm at term). Excludes any abnormalities (fibroids, myometrial contractions, or venous lakes). The placental thickness approximates in millimeters to the weeks of gestation.
  • placental vein - (umbilical vein) In placental animals, the blood vessels which develop within the placental cord carrying relatively oxygenated blood from the placenta to the embryo/fetus. In humans, there are initially two placental veins which fuse to form a single vein. The resence of paired veins in the placental cord can be indicative of developmental abnormalities.
  • placentophagia - Term used to descrbe the maternal ingestion of afterbirth materials (placental membranes and amniotic fluid) that can occur following mammalian parturition (birth).
  • primary villi - (primary chorionic villi) Term describing the earliest stage of embryonic placenta development. In humans, the conceptus during week 2 this first stage of chorionic villi development consists of only the trophoblastic shell cells (syncitiotrophoblasts and cytotrophoblasts) forming finger-like extensions into maternal decidua. Initially these finger-like projections cover the entire surface of chorionic sac and later become restricted to the placental surface. The villi stages are ongoing as the placenta continues to grow through both the embryonic and fetal development.
  • pre-eclampsia - During pregnancy a combination of high blood pressure, protein in urine and fluid retention resulting in maternal sudden excessive swelling of the face, hands and feet. Eclampsia is the subsequent development of convulsions, kidney failure, liver failure, clotting problems or mortality.
  • Rh alloimmunization - feto-maternal haemorrhage generally in late pregnancy results in an Rh-negative woman becoming sensitised to Rh-positive fetal cells that enter her circulation. Clinically treated with anti-D immune globulin prophylaxis, alloimmunization occurs in 9–10% of at-risk pregnancies. immune
  • secondary villi - (secondary chorionic villi) Term describing the second stage of embryonic placenta development. In humans, the conceptus during week 3 onward this stage of chorionic villi development consists of the trophoblastic shell cells (syncytiotrophoblast and cytotrophoblasts) filled with extraembryonic mesoderm forming finger-like extensions into maternal decidua. Initially these finger-like projections cover the entire surface of chorionic sac and later become restricted to the placental surface. The villi stages are ongoing as the placenta continues to grow through both the embryonic and fetal development. Placental villi stages: primary villi - secondary villi - tertiary villi
  • syncytiotrophoblast - A multinucleated cell currently thought to form by the fusion of another trophoblast cell the cytotrophoblasts, within the trophoblast layer (shell) of the implanting conceptus. In early development, these cells mediate implantation of the conceptus into the uterine wall and secrete the hormone (Template:Human Chorionic Gonadotrophin, hCG) responsible for feedback maintainance of the corpus luteum (in maternal ovary) and therefore maintaining early pregnancy.
  • trophoblast - (trophectoderm, Greek, trophe = "nutrition" and blast = a primordial cell) cells that firstly support adplantation, implantation and endocrine support of pregnancy. Contribute to the extraembryonic tissues, fetal placenta and membranes. Initially form 2 populations individual cytotrophoblast cells and their fused multinucleate syncytiotrophoblast cells.
  • Twin-twin transfusion syndrome - (TTTS) in monozygotic twins with monochorionic and diamniotic placenta, with intrauterine blood transfusion from one twin (donor) to another twin (recipient) where there is an imbalance of blood flow from the donor twin to the recipient twin. Clinically diagnosed by the alternate presence of polyhydramnios in one fetus and oligohydramnios in the co-twin, occurs in about 10% of monochorionic twins.
  • umbilical cord (placental cord) fetal attachment cord 1-2 cm diameter, 30-90cm long, covered with amniotic attached to chorionic plate, umbilical vessels (artery, vein) branch into chorionic vessels. Vessels anastomose within the placenta.
  • umbilical vein varix - (fetal intra-abdominal umbilical vein varix, FIUV) focal dilatation of the umbilical venous diameter at the level of cord insertion, the dilatation diameter increases linearly with gestational age. Represent about 4% of umbilical cord abnormalities

with an incidence of about 2.8 per 1,000 pregnancies, there is also a rarer form of extra-abdominal varices. PMID 24883288

  • vasculogenesis - formation of first blood vessels by differentiation of pluripotent mesenchymal cells (extraembryonic mesoderm) followed by angiogenesis which is the development of new vessels from already existing vessels.
  • vasculosyncytial membranes - localised areas of the placental villous membrane where the barrier thickness separating maternal and fetal circulations is reduced to as little as 1-2 microns. PMID 1287078
  • villi - Plural of villus, which is a thin projection from a surface. The term in development is used to describe the individual functional units together of the fetal placenta.
  • virus - small infectious agents that may cross the placental barrier. Can infect embryo and/or placenta and cause developmental abnormalities. (e.g. cytomegalovirus, rubella, measles).
  • Wharton's jelly - placental cord (umbilical cord) gelatinous connective tissue composed of myofibroblast-like stromal cells, collagen fibers, and proteoglycans. Increases in volume (myxomatous, connective tissue embedded in mucus) at parturition (birth) to assist closure of placental blood vessels. Matrix cells from Wharton's jelly have recently been identified as a potential source of mesenchymal stem cells (MSC), also called mesenchymal stromal cell. This placental cord substance is named after Thomas Wharton (1614-1673) an English physician and anatomist who first described this placental tissue.
Other Terms Lists  
Terms Lists: ART | Birth | Bone | Cardiovascular | Cell Division | Endocrine | Gastrointestinal | Genital | Genetic | Head | Hearing | Heart | Immune | Integumentary | Neonatal | Neural | Oocyte | Palate | Placenta | Radiation | Renal | Respiratory | Spermatozoa | Statistics | Tooth | Ultrasound | Vision | Historic | Drugs | Glossary


 2018 ANAT2341 - Timetable | Course Outline | Moodle | Tutorial 1 | Tutorial 2 | Tutorial 3

Labs: 1 Preimplantation and Implantation | 2 Reproductive Technology Revolution | 3 Group Projects | 4 GM manipulation mouse embryos | 5 Early chicken eggs | 6 Female reproductive tract | 7 Skin regeneration | 8 Vertebral development | 9 Organogenesis Lab | 10 Cardiac development | 11 Group projects | 12 Stem Cell Journal Club

Lectures: 1 Introduction | 2 Fertilization | 3 Week 1/2 | 4 Week 3 | 5 Ectoderm | 6 Placenta | 7 Mesoderm | 8 Endoderm | 9 Research Technology | 10 Cardiovascular | 11 Respiratory | 12 Neural crest | 13 Head | 14 Musculoskeletal | 15 Limb | 16 Renal | 17 Genital | 18 Endocrine | 19 Sensory | 20 Fetal | 21 Integumentary | 22 Birth | 23 Stem cells | 24 Revision

 Student Projects: Group Projects Information Project 1 | Project 3 | Project 4 | Project 5 | 2018 Test Student | Copyright