‫أعوذ بالله من الشيطان الرجيم‬

‫بسم الله الرحمن الرحيم‬

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‫ون أ ُ َمّ َه ِ‬ ‫َي ْ‬
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‫ات ثَ َال ٍ‬
‫ص َرفُون‬ ‫إِ َل َه إِ َالّ ُه َو فَأَنَّى تُ ْ‬

‫سورة الزمر اية ‪6‬‬

Placental development and function
 Blastocyst during Lacunar stage ( 8-9 days post
implantation(7-8 days)
prelacunar stage conception)

Blastocyst - day 12(implantation Day 14(differentiation of extravillous

completed, embryo completely trophoblast)
surrounded by placenta)
 Early villous stage
1- Primary villi : syncytial side branches filled with
cytotrophoblast.
2- Secondary villi: mesenchymal cells surrounded by
cytotrophoblast and syncytiotrophoblasts.
3- Tertiary villi : around day 20 new vessels develop within
the mesenchymal core. The vessels later will be
connected to vessel system of the embryo through the
umbilical cord.
During early weeks cytotrophoblast breaks through
peripheral layer of syncytium and spread to
underlying decidua.
These cells form endovascular trophoblasts, they
replace the endotheliam and invade the wall of
intradecidual portions of the spiral vessels and
destroy muscular and elastic tissue of the media.
The wall is replaced by fibrinoid material, Leading to
destruction of the vessels to form flask shape vessels
to carry more blood.
As a result these vessels are dilated under pressure of
maternal blood.
The placenta by the 21st day of gestation is a
vascularised villus organ.
Utero-placental circulation system

1- Umbilical arteries
2- Umbilical vein
3- Fetal capillaries
• Between 21st day and end of 4th month
these villi that are oriented toward uterine
cavity degenerate and form chorion leave.

• The opposite side (the side of chorion toward

the decidua basalis proliferate and progress to
form chorion frondosum which together with
decidua basalis will form the definitive
placenta.
By the beginning of the 4th month, the placenta
has 2 components:
1-Fetal portion formed by the chorion
frondosum.
2-Maternal portion formed by the decidua
basalis.

On the fetal side the placenta is bordered by the

chorionic plate. On the maternal side it is
bordered by the decidual plate. Between the 2
plates are the intervillous spaces which are
filled with maternal blood.
1.Decidua capsularis
2. Uterine wall
3. Uterine cavity
4. Placenta
5. Decidua parietalis
6. Decidua basalis
7. Chorion leave
8. Embryo
9. Connecting stalk
10. Yolk sac
11. Chorion frondosum
12. Amnion
13. Chorionic cavity
14. Amniotic cavity
During the 4th & 5th months the
decidua forms a number of decidual
septa, which divides the placenta
into a number of compartments,
cotyledons 15-20. As a result of
uterine expansion the placenta
enlarges. It covers 15 to 30% of
uterine surface.
 Full term placenta
Diameter: 15-25 cm., 3cm thickness, 500-600g weight.
when the placental is viewed from its maternal side,
cotyledons covered by decidua basalis are seen and
grooves between the cotyledon which formed from
decidual septa.
The fetal surface is covered by chorionic plate.
Chorionic vesseles converge towered the umbilical
cord. The chorion is covered by the amnion.
Umbilical cord attachement usually eccentric.
 The layers of a delivered placenta from the fetal
to the maternal side comprise
1. Avascular amnion.
2. Vascularized chorionic plate.
3. Villous trees directly connected to chorionic
plate.
4. Maternal blood in the intervillous space.
5. Basal plate.
 Placental Function
1. Transfer of nutrients and waste products
b\n the mother & fetus. Respiratory,
excretory, nutritive.
2. Produces or metabolizes the hormones &
enzymes necessary to maintain the
pregnancy.
3. Barrier function. Protective barrier to the
fetus against noxious agents circulating in
maternal blood.
Placental transport
The placenta acts as a relative barrier to most
substances but the speed of exchange and
concentration of the substances exchanges depends
upon:
1. The concentration on each side of the placenta.
2. The molecular size of the substance.
3. Lipid or water solubility.
4. Degree of Ionization.
5. placental surface area thickness and permeability.
6. materno-fetal blood flow rate.
The mechanism involved in the placental exchange
includes:
1-simple diffusion:
This is a passive process from area of high concentration to
area of low concentration according to chemical or
electrochemical gradient.(O2, CO2, fat soluble vitamins,
Na, Cl).
2-Facilitated diffusion:
Transport is facilitated by a carrier molecule within the
membrane: it is more quickly and does not require
energy. ( glucose).
3-Active transport:
Involve a carrier also, occur against chemical gradient and it
needs energy. ( amino acids & calcium).
4-Bulk transport:
It is for water, it is more quickly than simple one ,it
occurs in response to osmotic or hydrostatic
pressure gradient.
5-pinocytosis:
The substance is enveloped by the cell membrane to
form a vesicle which transports across the
membrane. ( IgG )
6-villous damage:
small break in the villous surface allow the fetal
blood to enter maternal circulation. This is thought
to be the mechanism where by some
bacteria ,protozoa cross the placenta.
PLACENTAL HORMONES
-Estrogen (E), Progesterone (P), Human Chorionic
Gonadotropin (HCG), Human Chorionic Somammotropin
(hCS)
or Placental Lactogen (hPL), Others like TSH, a hormone
resembling ACTH and possibly relaxin.

Human Chorionic Gonadotropin (hCG):

pregnancy hormone
Double chain glycoprotein. It resembles LH, TSH, FSH
and differs in the terminal portion of beta subunits.

The hCG hormone starts to be released at about 6-8

days after conception.
The hCG blood level will initially start as very low
(5 mIU/ml), but then rapidly increase, doubling
every 2 to 3 days.
HCG excreted in urine.
Levels peak at 60-70 days then remain at a low
plateau for the rest of pregnancy.

FUNCTION:
1. Maintain CL function to secrete E + P for growth of
endometrium.
2. stimulates leydig cells of male fetus to produce
testosterone.
3. Suppresses maternal immune function & reduces
possibility of fetus immunorejection.
Human Chorionic Somammotropin (hCS)
Structure similar to growth hormone. Single
chain polypeptide (191) aa. Increase steadily
throughout pregnancy and reach plateau at 36th
week. Its function:
1-Mobilization of free fatty acid .
2-Inhibition of gluconeogenesis.
3-Inhibition of peripheral uptake of cellular glucose
and insulin.
4-Increase uptake of amino acid and ketone bodies by
placenta and transport to fetus.
Estrogen (E)
FORMS: estriol, estradiol & estrone .
Estriol most important . Levels increase
throughout pregnancy and reach peak just
before labor. 90% produced by
syncytiotrophoblast.
Effects of placental estrogens:
-Stimulate growth of the myometrium and antagonize
the myometrial-suppressing activity of progesterone.

- Stimulate mammary gland development (ductal and

alveolar growth).
Progesterone (P)
Levels increase throughout pregnancy. Produced early
by the corpus luteum,and later, the placenta become
responsible for the secretion of progesterone hormone
which is like estrogen reaches a peak before labor.

Progesterone functions during pregnancy:

-Support endometrium to provide an environment for

fetal survival. If the endometrium is deprived of
progestins, the pregnancy will inevitably be
terminated.

-Suppression of contractility in uterine smooth muscle.