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'''Search Pubmed:''' [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Placenta+Development Placenta Development] | [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Placental+Development Placental Development] | [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Placental+Membranes Placental Membranes]
'''Search Pubmed:''' [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Placenta+Development Placenta Development] | [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Placental+Development Placental Development] | [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Placental+Membranes Placental Membranes]
==Terms==
* '''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.
* '''Hofbauer cells''' - Cells found within [[P#placenta|placental]] villi connective tissue. Have a role as macrophages of mesenchymal origin with potentially additional functions (remodeling, vasculogenesis, regulation of stromal water content).


==Additional Images==
==Additional Images==

Revision as of 15:15, 26 May 2010

Human Placental Membranes

Introduction

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.

During that 9 month period it provides nutrition, gas exchange, waste removal, endocrine and immune support for the developing fetus. (More? Placental Overview | Histology).

There are essentially 3 separate aortic/venous circulatory systems: umbilical, systemic and vitelline. The umbilical system is lost at birth, the vitelline contributes to the portal system and the systemic (embryonic) is extensively remodelled to fom the the cardiovascular system.


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

| original page

System Links: Introduction | Cardiovascular | Coelomic Cavity | Endocrine | Gastrointestinal Tract | Genital | Head | Immune | Integumentary | Musculoskeletal | Neural | Neural Crest | Placenta | Renal | Respiratory | Sensory | Birth

Reading

File:Fetal circulation overview.jpg
Fetal circulation overview
  • Human Embryology (2nd ed.) Larson Chapter 7 p151-188 Heart, Chapter 8 p189-228 Vasculature
  • The Developing Human: Clinically Oriented Embryology (6th ed.) Moore and Persaud Chapter 14: p304-349
  • Before we Are Born (5th ed.) Moore and Persaud Chapter 12; p241-254
  • Essentials of Human Embryology Larson Chapter 7 p97-122 Heart, Chapter 8 p123-146 Vasculature
  • Human Embryology Fitzgerald and Fitzgerald Chapter 13-17: p77-111

Placental Classification

Classification of placenta is on the basis of histological (microscopic) structural organization and layers between fetal and maternal circulation.

Three main groups:

  1. Haemochorial - placenta where the chorion comes in direct contact with maternal blood (human).
  2. Endotheliochorial - maternal endometrial blood vessels are bare to their endothelium and these comes in contact with the chorion (dogs, cats).
  3. 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.

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.

Canada - guidelines for the management of vasa previa.[1]

  • 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: Placental Abnormalities

Placental Cord Abnormalities

Placental cord cross-section

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.

  • 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.

Links: Placental Abnormalities | WebPath - umbilical cord knot 1 | WebPath - umbilical cord knot 2 | WebPath - Pseudoknot of umbilical cord, gross | WebPath - Torsion of umbilical cord, gross | WebPath - Torsion of umbilical cord, with fetal demise, gross

Placental Infections

Malaria (plasmodium falciparum)
  • 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.

References

  1. <pubmed>19772710</pubmed>

Reviews

Articles

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  • Placenta Development - All (10032) Review (1896) Free Full Text (2435)
  • Placental Development - All (9103) Review (1762) Free Full Text (2219)
  • Placental Membranes - All (10083) Review (748) Free Full Text (1728)

Search Pubmed: Placenta Development | Placental Development | Placental Membranes

Terms

  • 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.
  • 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).

Additional Images

see all online Placental materials

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Cite this page: Hill, M.A. (2024, March 28) Embryology Placenta Development. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Placenta_Development

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© Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G