DEVELOPMENT OF PLACENTA

Discoid organ; approx. 15 20 cm diameter

Approx. weight = 500 grams
Two components:
1. Fetal part develops from chorionic sac; chorion frondosum
2. Maternal part derived from the endometrium; decidua basalis
Fetal blood flows to the placenta via the two umbilical arteries carry venous blood
Oxygenated blood via umbilical vein
Three main functions:
1. Metabolism during early pregnancy, synthesis of glycogen, cholesterol, and fatty acids source
of nutrient and energy for fetus
2. Transport of gases and nutrients
3. Endocrine secretions HCG, human placental lactogen, human chorionic thyrotropin, human
chorionic corticotropin
Other functions:
1. Transmission of maternal antibodies (IgG)
2. Production of steroids (estrogen and progesterone)
May serve as conduit for transfer of harmful substances/microorganisms from mother to fetus

Development:
As early as 72 hours after fertilization blastula composed of 58 cells
o 5 cells embryo
o 53 cells trophoblast proliferate and invade the gravid endometrium
DECIDUA gravid uterus
o 3 regions:
1. Decidua basalis directly beneath the site of implantation
2. Decidua capsularis superficial part overlying the developing conceptus; degenerates by
4th month of pregnancy
3. Decidua vera/decidua parietalis rest of the decidua; lines the uterus
o Decidua vera & decidua basalis each composed of three layers:
1. Zona compacta surface or compact zone
2. Zona spongiosa middle portion or spongy zone
3. Zona basalis basal zone; remains after delivery & gives rise to a new endometrium
o Zona compacta & spongiosa form functional zone (zona functionalis)

STAGES IN THE DEVELOPMENT OF THE PLACENTA

A. Prelacunar stage
From conception to day 8 post-conception
Fertilization zygote blastocyst
o Outer cell mass (trophoblast) placenta
o Inner cell mass (embryoblast) embryo, umbilical cord, and amnion
o Blastocoele cavity primitive yolk sac or exocoelomic cavity
Major development on 8th day: blastocyst partially embedded in the decidua
o Outer cell mass (trophoblast) differentiates into two layers:
1. Syncytiotrophoblast outer layer consisting of multinucleated syncytium
2. Cytotrophoblast inner layer consisting of mononucleated cells
o Inner cell mass (embryoblast) differentiates into two layers:
1. Epiblast ectodermal layer; columnar cells
2. Hypoblast endodermal layer; cuboidal cells
EPIBLAST + HYPOBLAST = BILAMINAR GERM DISC
Small cavity appears in epiblast become the AMNIOTIC CAVITY
o Lined by epiblast cells called AMNIOBLASTS
B. Lacunar stage (Day 8 13 post conception)
Blastocyst more deeply embedded in the endometrium; epithelial gap closed by a fibrin coagulum
Changes:
1. Formation of lacunar stage of trophoblast
Day 8: appearance of vacuoles in syncytiotrophoblastic mass fuse to form lacunae
Separated by bands of syncytiotrophoblasts (trabeculae)
2. Formation of Heusers membrane (exo-coelomic membrane)
Formed by flattened cells originating from hypoblast at the abembryonic pole
Lines the inner surface of the cytotrophoblast
Together with hypoblast line the exocoelomic cavity or primitive yolk sac
11th 12th day:
o Changes:
1. Establishment of utero-placental circulation
Lacunae become continuous with maternal sinusoids maternal blood
enter lacunar system
2. Uterine epithelium closes over implantation site
3. Cytotrophoblastic cells extend into the trabeculae
 4. Formation of Extraembryonic Mesoderm & Coelom (Chorionic Cavity)
New population of cells (derived from yolk sac cells) appear between inner
surface of cytotrophoblast & outer surface of exocoelomic cavity form the
extraembryonic mesoderm (fine, loose connective tissue)
Large cavities develop in the extraembryonic membrane become
confluent coelom (chorionic cavity) surround primitive yolk sac &
amniotic cavity
Extraembryonic membrane lining the cytotrophoblast extraembryonic
somatopleuric mesoderm origin of chorionic plate
Covering the yolk sac extraembryonic splanchnopleuric mesoderm
5. Decidual reaction
Produced in endometrial stroma as a result of the invading trophoblast
Stromal cells become enlarged & pale due to presence of glycogen & lipid
droplets in cytoplasm
Tissues become edematous
6. Formation of trophoblastic shell (Day 12)
Cytotrophoblasts extend into trabeculae
Distal ends of trabeculae join together form outermost layer of the
trophoblast (trophoblastic shell) later becomes the basal plate (base of
IVS + maternal & placental tissues that adhere to it)
C. Early Villous Stage (Day 13 to 28 Post-conception)
Changes:
1. Formation of primary stem villi
Cells of cytotrophoblast proliferate penetrate into syncytium form cellular columns
surrounded by syncytium (primary stem villi)
Outer layer of syncytiotrophobast + core of cytotrophoblast
2. Formation of secondary/definitive yolk sac
Hypoblast cells proliferate migrate along the inside of Heusers membrane form
new cavity within exocoelomic cavity (secondary or definitive yolk sac)
Smaller than primary yolk sac
Exocoelomic cysts pinched off portions of exocoelomic cavity formed during formation
of secondary yolk sac found in chorionic cavity
3. Formation of the connecting stalk
Extraembryonic coelom expands form large cavity (chorionic cavity)
Extraembryonic membrane lining the inside of the cytotrophoblast called chorionic plate
Extraembryonic mesoderm traverses the chorionic cavity area called connecting
stalk
Connecting stalk connects embryo with trophoblast
Once connecting stalk develop blood vessels within become the umbilical cord
14th day of development
1. Embryonic mesenchyme spreads around inner surface of blastocyst cavity & cytotrophoblast
layer form the chorionic plate
Mesenchyme, cytotrophoblast + syncytiotrophoblast
2. First villous outgrowths form from the trabeculae trabeculae called villous stems later
become the stem villi
3. Lacunar system transformed into intervillous space
2nd week of development referred to as the week of 2s
1. Blastula composed of 2 layers outer cell mass and inner cell mass
2. Trophoblast differentiates into two syncytiotrophoblast and cytotrophoblast
3. Embryoblast differentiates into two layers epiblast and hypoblast
4. Two cavities form amniotic cavity and primitive yolk sac (exocoelomic cavity)
5. Extraembryonic mesoderm splits into two somatopleuric mesoderm and splanchnopleuric
mesoderm
D. Development of the Villi
Lacunae filled with maternal blood develop in the trophoblast
o Trophoblast-lined labyrinthine channel is formed forms the intervillous space
Cytotrophoblasts proliferate towards syncytiotrophoblast forming columns lined by
syncytiotrophoblast form the primary stem villi
Mesodermal cells penetrate core of primary villi & grow toward decidua form secondary villi
Mesodermal cells differentiate into blood cells & small blood vessels form tertiary or definitive
placental villi make contact with intraembryonic circulatory system
14th day: maternal blood starts to enter intervillous spaces
Beginning of 5th week: utero-placental circulation is established; fetal and maternal blood vessels
functional
Villi in contact with decidua basalis proliferate forming the leafy chorion (chorion frondosum) fetal
component of placenta
Villi in contact with decidua capsularis undergo almost complete degeneration greater part of
chorion (denuded villi) form the smooth or bald chorion (chorion laevae)
 Some villi of the chorion frondosum extend from chorionic plate to the decidua serve as anchoring
villi
Most villi branch from the sides of the stem & end freely in the intervillous space without reaching the
decidua floating/ free/terminal villi
As placenta matures, early stem villi branch repeatedly forming greater numbers of increasingly
smaller villi
Each of the main stem villi & its ramifications form a placental cotyledon
E. By 4th month post-conception
Growing sac fills the uterine cavity
Decidua capsularis degenerates
Chorion laevae comes in contact with the decidua vera obliterate lumen of uterus
Only functional layer of chorion is chorion frondosum

CHORIONIC VILLI
Site where all maternofetal and fetomaternal exchange takes place
Only components of the placenta with dual blood supply
Basic structure: syncytiotrophoblast (epithelial surface layer), villous cytotrophoblasts (Langhans cells),
villous stroma

SYNCYTIOTROPHOBLAST
Continuous, normally uninterrupted layer syncytium (single, continuous structure)
Involved in complex, active maternofetal transfer mechanisms
Synthesize hormones HCG, human chorionic somatotropin, human placental lactogen, human
growth hormones, estrogen, progesterone

VILLOUS CYTOTROPHOBLAST (LANGHANS CELLS)

Beneath syncytiotrophoblast
Early pregnancy nearly complete
Late pregnancy becomes discontinuous
Cuboidal, polyhedral, or ovoid cells with large, lightly staining nuclei

PLACENTAL MEMBRANE/BARRIER
Extra-fetal tissue separating maternal and fetal blood
Until 20th week four layers: syncytio (ST), cyto (CT), connective tissue of villus, endothelium of fetal
capillaries
After 20th week, cytotrophoblastic cells become discontinuous three layers

FETAL MEMBRANES (AMNION AND CHORION)

bag of waters in which the fetus is enclosed
Function include turnover of water and enzymatic activity during initiation of labor
Structure remains constant from 4th month until term
AMNION (fetal side):
o Epithelium derived from fetal ectoderm single layer of flat, cuboidal to columnar cells
o Functions:
1. For structural integrity & junctional permeability
2. Permeability barrier to anionic macromolecules
3. Role in initiation and maintenance of uterine contractions
4. Turnover of amniotic fluid
5. Regulation of fetal Ph
CHORION (next to uterine wall)
o Chorion laeve
o Tough fibrous layer carrying the fetal blood vessels
o Separated from amnion by a spongy layer
Result of incomplete fusion of amnionic and chorionic mesoderm
o Layers: chorionic mesoderm containing chorionic vessels, basal lamina

PLACENTAL ABNORMALITIES
A. Implantation abnormalities
1. Placenta accreta
Abnormal adherence with absence of decidua basalis; least invasive
Chorionic villi in direct contact with myometrium
Common cause for post-partum hysterectomy
2. Placenta increta attachment deep into uterine wall, penetrating into uterine muscle; placenta
grows into the myometrium
3. Placenta percreta placental villi penetrate myometrium & through uterine serosa; most invasive
4. Placenta previa placenta overlies internal os of uterus covers the birth canal
B. Other abnormalities:
1. Succenturiate placenta
With accessory lobes having vascular connections between them
Due to focal non-involution of chorionic laevae
2. Battledore placenta
Umbilical cord inserted at the margin of the placenta
Club-like appearance
3. Velamentous insertion of cord
Umbilical cord attached to chorion and amnion
Vessels branch between the membranes before they extend over the placenta
4. Circumvallate placenta
Membranes extend over placenta to form a ring before doubling back toward the margin