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Examination of Placenta and Umbilical Cord

March 12, 2024Lab TestsPathology

Table of Contents

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  • Placenta and Umbilical Cord
        • How do you get a sample of the Placenta and Umbilical Cord?
        • Indications for the examination of the placenta:
        • How will you define the placenta?
        • Discuss Placenta structure?
        • How would you describe the umbilical cord?
        • What are the Placenta functions?
        • What are the Placental hormones?
        • How will you examine the placenta?
        • How will you Examine the umbilical cord?
        • When will you send the placenta for histopathology?
        • What are the abnormalities of the placenta?
        • What is the abnormality of the umbilical cord?
        • What are the causes of Inflammation of the placenta?
        • What are the complications of placental abnormalities?
      • Questions and answers:

Placenta and Umbilical Cord

How do you get a sample of the Placenta and Umbilical Cord?

  1. This is the histopathological study of the fetus on gross and microscopic examinations.
  2. This is an autopsy of the Foetus to find any abnormality.
  3. Examine the placenta.

Indications for the examination of the placenta:

  1. In the case of premature birth.
  2. In intrauterine growth retardation.
  3. In the case of asphyxia.
  4. In the case of prenatal death.
  5. In the case of third-trimester bleeding.
  6. In the case of fetal or maternal infection.

How will you define the placenta?

  1. The placenta grows throughout the pregnancy. It is delivered through the birth canal immediately after birth.
  2. It is an organ that the placenta develops in the uterus during pregnancy.
  3. The placenta provides oxygen and nutrients to the growing fetus and removes waste products from the fetus’s blood.
  4. The placenta attaches to the wall of the uterus.
  5. The umbilical cord connects the placenta with the fetus.
Placenta and fetus

Placenta and fetus

Discuss Placenta structure?

  1. Normally, the placenta measures about 22 cm, and its thickness is 2 to 2.5 cm.
  2. Usually, the placenta weight is around 470 G (500 to 600 Grams) and 15 to 20 cm in diameter.
  3. The maternal surface is dark brown, and it is divided into lobules.
  4. It is a collection of fetal blood vessels called villi, surrounded by intervillous spaces in which maternal blood flows.
  5. The fetal surface is gray and shiny.

How would you describe the umbilical cord?

  1. At birth, the umbilical cord is 55 to 60 cm in length and 2 to 2.5 cm in diameter.
    1. It has two Arteries and one vein.
Placenta structure

Placenta structure

What are the Placenta functions?

  1. It keeps maternal and fetal circulation separate.
  2. It nourishes the fetus.
  3. It eliminates fetal waste.
  4. It produces hormones that are vital for maintaining pregnancy through the production of the placental hormones.
  5. Maternal immunoglobulins (IgG) cross the placenta by receptor-mediated endocytosis.
    1. Because of long-life IgG, the newborn has protection for 6 months.
  6. The placenta is an effective barrier to large proteins and hydrophobic compounds bound to plasma proteins.
Placenta and Umbilical Cord: Placenta functions

Placenta and Umbilical Cord: Placenta functions

What are the Placental hormones?

  1. Placental lactogen.
  2. Chorionic gonadotropin.
  3. Steroid hormones are:
    1. Progesterone.
    2. Estradiol.
    3. Estriol.
    4. Estrone.

How will you examine the placenta?

  1. Note the size, shape, and color, and check for any smell.
    1. Check for the completeness of the placenta.
    2. Check for accessory lobes.
    3. Any placental infarcts.
    4. Any hemorrhage.
    5. Presence of tumors or nodules.

How will you Examine the umbilical cord?

  1. It’s the length.
  2. Point of insertion.
  3. Check for the presence of any knot.
  4. If one artery is absent, then renal agenesis is possible.
  5. Presence of any thrombosis.
  6. Evaluate the fetal membranes.
  7. Check for the presence of Wharton’s jelly.

When will you send the placenta for histopathology?

  1. Send the placenta for histopathological examination.
    1. When there is prematurity.
    2. Intrauterine growth retardation.
    3. Asphyxia.
    4. Perinatal death.
    5. The third trimester is bleeding and suspected fetal or maternal infection.
  2. If needed, also do the culture.
  3. In some cases, ultrasonography may be advised.

What are the abnormalities of the placenta?

  1. Multi-lobes or bilobed placenta.
    1. Bipartite. The membrane connects two lobes, and the umbilical cord is inserted into one of the lobes.
  2. Accessory lobes.
    1. Succenturiate. It has second or third lobes, and these are very small in size.
  3. Placenta accreta. This placenta grows into the uterine wall. After the birth, it remains inside the uterus.
  4. Placenta percreta. This grows into the uterus and sometimes may involve the urinary bladder.
  5. The Circumvallate placenta is on the fetal-placental side. This is a placental abnormality and causes the membranes of the placenta to fold back around its edges.
  6. Placental infarcts.
  7. Chorioangioma.
  8. Hydatidiform mole.
Placental abnormalities

Placental abnormalities

What is the abnormality of the umbilical cord?

  1. The cord may be short or long.
    1. The short cord is less than 40 cm in length.
    2. The long cord is more than 100 cm in length.
  2. Cord knot.
  3. An abnormal number of vessels.
  4. Thrombosis of the vessels.
  5. Different smell indicates infection.

What are the causes of Inflammation of the placenta?

  1. Ascending infections are the most common. These are:
    1. Bacterial associated with premature birth.
    2. Premature rupture of the membrane.
    3. Infection beyond the membrane involves the umbilical cord.
  2. Through blood is a transplacental infection;
    1. Most commonly, villi are involved.
    2. There are chances of TORCH in the fetus.

What are the complications of placental abnormalities?

  1. Any abnormality of the placenta or the umbilical cords may lead to:
    1. Perinatal morbidity.
    2. There will be abnormal fetal development.

Questions and answers:

Question 1: What are the complications of the abnormal placenta?
Show answer
There may be perinatal morbidity and abnormal fetal development.
Question 2: What is the abnormality of the umbilical cord?
Show answer
The umbilical cord may be short in length, have cord knot, an abnormal number of vessels, and infections.

Possible References Used
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Comments

MUHAMMAD KASHIF Reply
March 24, 2020

EXCILENT

Dr. Riaz Reply
March 24, 2020

Thanks, I will try to add more

Sabeeha Basharat Reply
March 11, 2024

Assalamualaikum sir how are you. Hopefully you are doing well. I have a request. Kindly sir gave me permission and access to placenta examination checklist

Dr. Riaz Reply
March 12, 2024

Wailkum salam. You are welcome to use my website.

MUHAMMAD KASHIF Reply
March 24, 2020

PLZ MORE INFORMATION SEND THE WED

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