placenta

Lady Wizia, Bd
what will we learn
• difinition
• function
• delevopment
what is placenta?
• a unique organ that connects the fetus to the uterine wall, while
providing essential support functions like nutrient uptake and oxygen
exchange for the developing fetus throughout gestation
• Remarkable organ originating from trophoblast layer of fertilized
ovum.
• a feto-maternal organ that has fetal and maternal regions
• development begins in the second week
• fully established by 8-10 weeks
• fullsize by the fourth month
the functions
• transport role
• Immunological role
• endocrine role
• Metabolic role
• Barrier function (molecular as heparin, syphilis, toxoplasma)
transport roles
substances transported via mecanism description
respiratory gases (oxygen and carbon the rate of delivery is dependent on maternal and fetal blood flow. any factors
dioxide) that impede uterine or fetal blood flow can lead to fetal hypoxia. inhaled
anaesthetics readily cross the placenta to the fetus, as does carbon monocxide
produces from the incomplete cmbustion of cigarette smoke
nutrients these consitute the bulk of substances rapidly. small amounts of free fatty acid
are transferred, while there is little or no transfer of maternal cholesterol,
phospolipid or triglycerides. transferrin, an iron transport protein crosses the
placenta and delivers iron to the fetus
hormones steroid hormones cross freely. protein hormones are generaly not transpored to
the fetus, but small amounts of thyroid hormones cross slowly
waste product carbon dioxide, urea, uric acid ad bilirubin are all transpored quickly across the
placenta
electolytes fleey exchanged. this includes any intravenous fluids given to the mother, which
can interfere with fetal fluid balance
 cautions!
normal celular transport mechanisms of simple and facilitated diffusion,
active transport and pinocytosis allow movement of these substante
between the maternal and fetal circulation. however, many harmful
substances can also pass freely the the same mecanism. these include :
• drugs. almost all drugs can pass freely and many result in compromise for
the fetus, example : alcohol can cause fetal alcohol syndrome, narcotic
may result in heroin addiction in the newborn, sedative and analgetics
such as petidine can cause respiratory depression in the newborn
• infectious agents. several viruses can across the placenta and cause fetal
infction, example : rubella, poliomyelitis, measles, HIV. and in some cases,
severe cgenital malformations may result.
Immunological role
• the fetus is a semi-allogenic graft., which means it consists of foreign
tissue from the same species but has differents antigens
• the placenta provides an effective barrier againts large bacterial
microorganisms --> most viruses and some smaller bacteria can pass
the fetus
• protection is afforded by maternal antibodies, which across placenta
and provide passieve immunity against some disease
endocrine role
• several hormones that maintain pregnancy are synthesised in the palenca :
oestrogens, progresterone, hCG and human placenta lactogen (hPL)
• At the beginning of the pregnancy the synthesis of estrogen and
progesterone is ensured by the corpus luteum graviditatis that is
maintained by the human chorion-gonadotropin (HCG), a product of the
trophoblast. The activity of the corpus luteum decreases progressively with
the beginning of the 8th week in order to be entirely replaced by the
placenta at the end of the 1st trimester.
• During the pregnancy the hormone concentration in the maternal blood is
regulated by the cooperation of the placental, hypophysial and fetal
suprarenal hormones as well as hormones from the gonads
metabolic role
• placenta synthesis glycogen, cholesterol, fatty acids and enzymes,
which are used by the embryo and the plaacenta --> important in
early pregnancy.
aterm placenta
• seperti cakram dengan diameter
15-25 cm dengan tebal 3cm dan
berat 500-600 gram
• pada sisi maternal tampak 15-20
kotiledon yang dilapisi selais tipis
desidua basalis
• sisi janin dilapisi lempeng korion,
terdapat sejumlah vena dan
arteri besar yang mengumpul
kearah ali pusat
real pic of placenta
placenta circulation

kotiledon menerima darah 80-100 arteri spiralis yg menembus lempeng

desidua --> tekanan arteri -->masuk ke ruang antar vilus--> membasahi
percabangan dan vilus kecil dengan darah O2 --> tekanan berkurang -->
darah mengalir balik dari lempeng korion menuju desidua --> masuk ke vena
endometrium
placenta development
how it begin?
• First off there is ovulation. Ovulation is when the egg leaves the ovary to make
its way through the fallopian tubes in order to be fertilized. Day 0.
• Next, there is fertilization. Fertilization is when there is the fusion of a
spermatozoid with the ovulated egg to begin the formation a new baby. The egg
is now known as zygote. Day 1.
• In the next few days, this newly fertilized egg completes many cell divisions in
the fallopian tube to end up with a total of 32 cells. All these cells are known as
totipotent, which means that they can each become an individual baby. Day 2-4.
• Once the zygote reaches the uterus cell divisions continues and the zygote
becomes a blastocyst. At this stage, the cells are no longer totipotent and begin
to differentiate into either the developing baby, or the placenta. Day 5.
• The next step is implantation. Implantation is known as the stage where
theblastocyst embeds itself in the endometrium, the inner membrane of the
uterus.This usually occurs near the top of the uterus. Day 6-8. The process of
implantation is complete at about 9-10 days after ovulation.
 The trophoblast
• Trophoblasts are cells forming the outer layer of a
blastocyst, which provides nutrients to the embryo,
and develops into a large part of the placenta
• devided into syncytiotrophoblast and The
cytotrophoblast
• syncytiotrophoblast is diffuse tissue with no cell
membance -->releasing proteolytic enzymes, which
breakdown the maternal tissues and produce HCG
• cytotrophoblast --> consists of an irregular layer of
ovoid, mono-nucleated cells and lies directly below
the syncytiotrophoblast
endometrium preparation
• When the morula reaches the
endometrium , it is in the
secretory phase
• After the implantation of the
embryo, the uterine
endometrium is called the
decidua
• After implantation , features of
the endometrium in secretory
phase are intensified- stromal
cells enlarged , become
vacuolated and store glycogen
and lipids. This change in stromal
cells is called decidual reaction
 decidua
• The portion of the decidua where the
placenta is to be formed ( deep to the
developing blastocyst ) is called decidua
basalis

• Part of the decidua that separates the

embryo from the uterine lumen is called
decidua capsularis

• Part of the decidua lining the rest of the

uterine cavity is called decidua parietalis
placenta’s development
• The formation of the placenta starts off
when the baby is a blastocyst. At this
stage, it was mentioned that the cells
are no longer totipotent and have
begun to differentiate. There are 2
different types of cells that can be
found, the trophoblast cells and the
inner cell mass.
• The trophoblast cells are a layer on the
outside of the blastocyst and will
become the placenta as well as other
membranes while the inner cell mass is
located on the inside and will give rise
to the baby.
steps of implanation
• the trophoblast differentiates into two layers : the outer
syncytiotrophoplast (maternal sideof placenta) and the inner
cytotrophoplast (fetal side of placenta)
• the cytotrophoblast forms new synctial cells, the chorionic villi and
the amnion
• the syncytiotrophoplast extend throught the endometrial epithelium
and connective tissue --> releasing proteolytic enzymes --> break
down the maternal tissues --> allows the blastocyst into endometrium
--> its not rejected by the mother, possibly because it does not have
transpantation antigens
• blastocyst is nourished by glycogen
and lipids that diffuse from the stromal
cells and glands of the eroded tissue
• by day 9,degradation by the
proteolytic enzymes --> spaces
(Lacunae) to appear in the
syncytiotrophoplast
• Spaces form in the trophoblast
Subsequently, due to the erosion of
the maternal capillaries, blood gets
into the vacuoles, engendering the
maternal sinusoids.
development of villi
primary villus
• Between the 11th and 13th day
cytotrophoblast cells penetrate into
the cords of the syncytiotrophoblast
creating the primary trophoblast villi
• Primary villus with the
cytotrophoblast, which penetrates
into the processes of the
syncytiotrophoblast, forming the
primary trophoblast villi.
 secodandary villus
• After the 16th day the extra-embryonic
mesoblast also grows into this primary
trophoblast villus, which is now called a
secondary villus
• Secondary villi with extra-embryonic
mesoblast in the center, surrounded by
cytotrophoblast and syncytiotrophoblast.
• and expands into the lacunae that are
filled with maternal blood. As was
already mentioned, the ST forms the
outermost layer of every villus.
tertiary villi • At the end of the 3rd week the villus mesoblast
differentiates into connective tissue and blood
vessels. They connect up with the embryonic blood
vessels. Villi that contain differentiated blood vessels
are called tertiary villi
• Tertiary villi with extra-embryonic mesoblast (EEM)
in the center and additional embryonic blood
vessels. The EEM remains in this stage, still
surrounded by cytotrophoblast. The outer envelope
of the villus is still formed by the ST.
• From this time on gases, nutrients, and waste
products that diffuse through the maternal and fetal
blood must pass through a total of four layers:
Capillary endothelium of the villus, Loose
connective tissue that surrounds the endothelium,
Cytotrophoblast,Syncytiotrophoblast
free villi
After the 4th month the
cytotrophoblast in the tertiary
villi disappear slowly, the villi
divide further and become very
thin, whereby the distance
between the intervillous space
with maternal blood and the fetal
vessels gets smaller. The villi that
arise in this way are called free
villi.
invasion to maternal arteries
• Over the course of the 4th month the
cytotrophoblast cells slowly disappear out
of the villus wall and the chorionic plate.
• They persist, however, in the
cytotrophoblast layer. The cytotrophoblast
cells penetrate into the decidua and the
myometrium and also colonize the wall of
the spiral arteries close to their openings
• This invasion of the maternal vessels by the
cytotrophoblast leads to the destruction of
the smooth muscle layer and to a partial
replacement of the endothelial cells
• It is responsible for the change in elasticity
of the spiral arteries, whereby the blood
circulation of this fetoplacental unit is
adapted to the rapid growth of the fetus
something to discuss ?
thanks for the attention