Placental Developoment

1. Development of the Chorion and Decidua

 the trophoblasts at the deepest pole of the blastocyst proliferate to form the chorion frondosum
 meanwhile the villi facing the endometrial cavity are restricted in blood supply and stop growing
 by the end of the 3rd month the chorion and amnion are in intimate contact

2. Trophoblast Invasion of the Endometrium

3. Decidual Spiral Artery Invasion

 The capillary network of the most superficial portion of the endometrium is invaded by cytotrophoblasts
 Subsequently the arterioles and then spiral arteries are invaded, and the walls of the vessels are
destroyed
 During implantation, the spiral arteries acquire a lining of cells within the endothelium that is derived from
invading cytotrophoblasts – during this, degenerative changes take place in the arterial wall –
affecting all layers, but the most striking is that vascular smooth muscle becomes unrecognizable
 Cytotrophoblasts that invade the spiral arteries can pass several cm along the vessel lumen; these
vascular changes are not seen in the decidua parietalis
 Intraluminal cytotrophoblasts diminish at term
 Invasion of maternal vascular tissue by trophoblasts involves only the decidual spiral arteries, not the
decidual veins

4. Establishment of Maternal Blood Flow
 at approximately 1 month, maternal blood enters the intervillous space from the spiral arteries and
bathes the syncytiotrophoblasts

5. Villous Branching
 some villi of the chorion frondsoum exted to the decidua to serve as anchoring villi
 most villi however, end short of this and just end in the intervillous spae
Placental Growth and Maturation

Placental Growth
 in the first trimester placental growth is faster than fetal
 by 17 wks, the weights are equal
 at term placental weight = 1/6 of fetal
 Individual cotyledons grow in size, but same number is maintained
 At term, on average: 185mm in diameter, 23 mm in thickness, average volume of 497 ml, and weight of
508g

Placental Maturation
 Placental Aging – the villi continue to branch and the terminal ramifications become smaller and the
volume and prominence of the cytotrophoblasts decrease
 As the syncitium thins, the vessels become more prominent and lie closer to the surface
 Stroma also becomes denser packed and the cells more spindly
 Hofbauer cells appear in the stroma – these are like fetal macrophages – round with vesicular, eccentric
nuclei and very granular or vacuolated cytoplasm
 By 4 months the apparent continuity of the cytotrophoblasts is broken, and the syncitium forms knots on
the more numerous smaller villi

Fetal and Maternal Blood Circulation in the Mature Placenta

Fetal Circulation

 fetal deoxygenated blood or ‘venous-like’ blood flows to the placenta through two umbilical arteries
 At the juncture of the umbilical cord with the placenta, the umbilical vessels branch repeatedly beneath
the amnion and again within the dividing villi
 Blood with significantly higher oxygen content returns from the placenta to the fetus through a single
umbilical vein
 The vessels on the placental surface (chorionic plate) are responsive to vasoactive substances – but
they are curious…
 Chorionic arteries always cross over the chorionic veins
 Immediately after entering the chorionic plate, the two umbilical arteries are connected transversely by
the Hyrtl Anastomosis (rarely missing)
 The 2 umbilical arteries then separate to supply branches to the cotyledons – there are 2 patterns of
branching – disperse (65%) – which are a fine network of vessels that go to the cotyledons, and
magistral (35%) which are arteries that traverse the placenta without appreciable decrease in the
diameter of the vessel
 truncal arteries are the perforating branches of the surface arteries that ass through the chorionic plate
– each supplyine one cotyledon – these arteries have decreased smooth muscle
 At ~10 post conceptional weeks the pattern of umbilical blood velocity waveforms changes
considerably i.e before this time, there is no end diastolic frequency
 ‘definitive’ chorionic plate is formed by 8-10 weeks as the amnion and the primary chorionic plate
mesenchyme fuse with each other