The feto-placental unit

EMBRYOLOGY AND ANATOMY:

EMBRYOLOGY AND ANATOMY:

Moore & Persaud: The developing human- Clinically oriented embryology

EMBRYOLOGY AND ANATOMY:

Moore & Persaud: The developing human- Clinically oriented embryology

EMBRYOLOGY AND ANATOMY: FETAL SURFACE

EMBRYOLOGY AND ANATOMY:MATERNAL SURFACE

HISTOLOGY: UMBILICAL CORD

HISTOLOGY: MEMBRANES
Decidua

Chorion
Amnion

HISTOLOGY: PLACENTAL DISC

HISTOLOGY: PLACENTAL DISC-FETAL SURFACE

HISTOLOGY: PLACENTAL DISC- MATERNAL SURFACE

HISTOLOGY: VILLOUS ARCHITECTURE

Moore & Persaud: The developing human- Clinically oriented embryology

HISTOLOGY: VILLOUS ARCHITECTURE

FUNCTIONS OF THE PLACENTA

Moore & Persaud: The developing human- Clinically oriented embryology

Placental Endocrine Functions : Steroid Hormones

MOTHER

PLACENTA

LDL Cholesterol
Cholesterol
(Blood)

LDL Cholesterol

FETUS
LDL
(Blood)

Progesterone

DHEAS
(Adrenal)

DHEAS

DHEAS
(Adrenal)

Sulfatase
3 Beta OH steroid DH
Aromatase

Estrone
Estradiol

Key:
DHEAS

: Dehydroepiandrosterone sulfate

3 Beta OH steroid DH

: 3 beta hydroxy steroid dehydrogenase

Figure modified from: Carr, BR, The maternal-fetal-placental unit. In: Becker KL,
rd
ed. Principles and Practice of Endocrinology and Metabolism, 3 ed. Lippincott
Williams & Wilkins, Philadelphia. 2001: 1061.

DEVELOPMENTAL PROBLEMS

ECTOPIC IMPLANTATION

Moore & Persaud: The developing human- Clinically oriented embryology

PLACENTA PREVIA & PLACENTA ACCRETA

Moore & Persaud: The developing human- Clinically oriented embryology

MECHANICAL
PROBLEMS
MECHANICAL PROBLEMS

CORD KNOTS & TWISTS

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CORD: VELAMENTOUS INSERTION

Kaplan: Color atlas of gross placental pathology.

ABNORMAL MEMBRANE ATTACHMENT

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MEMBRANE RUPTURE: AMPUTATIONS

INFLAMMATION: CHORIOAMNIONITIS

12

Acute Funisitis

Candida Funisitis

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Candida Funisitis

Normal membranes

Decidua

Chorion
Amnion

14

Acute chorioamnionitis

Meconium

15

Acute villitis
Acute intervillositis.

Placental infection: Listeria

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Listeriosis

Placental Microabscesses
Villous necrosis
Heavy growth of Listeria in postmortem cultures

TRANSPLACENTAL (TORCH) INFECTIONS

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Parvoviral inclusions in villi

Cytomegalovirus: Characteristic nuclear inclusions

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Chronic Villitis (non-specific)

VASCULAR PROBLEMS

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VASCULAR: THROMBOSIS IN FETAL VESSELS

VASCULAR: FETOMATERNAL HEMORRHAGE

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Vascular: Pre-eclampsia

Vascular: Pre-eclampsia - fibrinoid change, foamy histiocytes

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Vascular: Placental Infarct

Vascular: Placental Infarct

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Vascular: Placental Abruption

Vascular: Placental Abruption

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NEOPLASIA

CHORANGIOMA

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CHORANGIOMA

HYDATIDIFORM MOLES

COMPLETE = Diploid
2 Pat, 0 Mat.
PARTIAL = Triploid
2 Pat, 1 Mat

25

MULTIPLE GESTATIONS

Twin placenta- fused discs

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Dichorionic Diamnionic placenta

Monochorionic Diamnionic placenta

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Monochorionic twins with Vascular anastomosis

Twin-Twin transfusion syndrome

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Twin placenta- Monoamnionic, with entangled cords

Twin placenta- fetus papyraceus

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The feto-placental unit

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