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.

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.

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

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.

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.

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