Placenta and Umbilical Cord

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

1. This is a histopathological study of the fetus, with gross and microscopic examinations.
2. This is an autopsy of the Foetus to find any abnormalities.
3. Examine the placenta.

What are the Indications for the examination of the placenta?

1. In the case of premature birth.
2. 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 the organ in which 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.

How will you discuss the placenta’s structure?

1. Normally, the placenta measures about 22 cm and is 2 to 2.5 cm thick.
2. Usually, the placenta weighs around 470 g (500-600 G) and is 15-20 cm in diameter.
3. The maternal surface is dark brown and 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.

1. It keeps maternal and fetal circulation separate.
2. It nourishes the fetus.
3. It eliminates fetal waste.
4. It produces hormones vital to maintaining pregnancy, including placental hormones.
5. Maternal immunoglobulins (IgG) cross the placenta by receptor-mediated endocytosis.
   1. Because IgG has a long half-life, the newborn is protected for 6 months.
6. The placenta is an effective barrier to large proteins and hydrophobic compounds bound to plasma proteins.

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 determine whether placental function is normal or predict impending fetal death?

1. You can check:
2. Uriner estriol.
   1. Estriol is an estrogenic hormone produced by the placenta, derived from the adrenal cortex and fetal liver.
3. Check urine total estrogens.
   1. Urine glucose falsely increase result.
   2. Total estrogen levels in urine indicate placental function.
4. Serum unconjugated estriol.
5. Serum placental lactogen.
   1. This hormone is produced by the placenta.
   2. Its metabolic activity is similar to that of prolactin and growth hormone.

How will you examine the placenta?

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

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 associated with 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 in the uterus and may sometimes 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 size:
   1. Small placenta.
   2. Large placenta.
7. Placental infarcts.
8. Chorioamnionitis.
9. Chorioangioma.
10. Hydatidiform mole. Molar pregnancy.

What are the causes of Inflammation of the placenta?

1. Ascending infections are the most common. These are:
   1. Bacteria 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: