Northwestern University

COLLEGE OF ALLIED HEALTH SCIENCES

DEPARTMENT OF NURSING
Laoag City

NCM 101
THE PLACENTA

DIMENSION
DISCOID: 15 20 cm in diameter, and 2 3 cm in thickness
LOCATION: in the uterus, anteriorly or posteriorly near the fundus

FETAL SIDE:
Covered with amnion; beneath it the fetal vessels course with the arteries passing over the
veins.
AMNION: .02 to .5mm in thickness; a sac that engulfs the growing fetus.
AMNIOTIC FLUID: clear fluid that collects within the amniotic cavity.

MATERNAL SIDE:
Divided into irregular lobes; consists of fibrous tissue with sparse vessels confined mainly to
the base.
Average weight at term: 500 gm
Feto-placental weight ratio at term: 6:1
Placenta is formed by the union of the chorionic villi and decidua basalis.

DECIDUA: the endometrium in pregnancy; thickens in pregnancy with depth of 5-10mm

DECIDUA BASALIS: portion of decidua directly beneath the site of implantation, under
the imbedded ovum.

DECIDUA CAPSULARIS: the portion overlying the developing ovum; separated ovum
from the rest of the uterine cavity; most prominent by the 2nd month.

DECIDUA VERA/DECIDUA PRIETALIS: lines the remainder of the uterus. Initially,

the decidua capsularis and decidua vera are separated by a space because the gestational
sac does not fill the entire uterine cavity; by the 4th month, the growing sac fills the
uterine cavity.

LAYERS of DECIDUA BASALIS and DECIDUA VERA:

ZONA COMPACTA: uppermost/surface layer made up of compact cells.

ZONA SPONGIOSUM: middle, spongy layer; with glands and small blood vessels

ZONA BASALIS: lowermost/basal layer. The zona basalis and zona spongiosum form the
functional layer (zona functionales). Implantation is up to the level of the spongiosum. The
zona basalis remains after delivery/placental separation.

DECIDUAL AGING
NITABUCHS LAYER - a zone of fibrinoid degeneration, is where invading trophoblast
meets the decidua. This layer is usually absent whenever the decidua is defective.

PLACENTAL MATURITY:
12 weeks or 3 months functions most effectively through 40 4 weeks; believed
dysfunctional beyond 42 weeks.
PLACENTAL FUNCTIONS
NUTRITIVE: transports nutrients and water-soluble vitamins to fetus.
FLUID/GAS TRANSPORT:
o DIFFUSION: O2, CO2, water and electrolytes move from greater to lesser
concentration.
o FACILITATED TRANSPORT: glucose
o ACTIVE TRANSPORT: amino acid, calcium, iron
o PINOCYTOSIS: fat, gamma globulin, albumin
o Leakage allows fetal and maternal blood to mix slightly because of placental
defects; normally, there is no mixture of fetal and maternal blood.
o Excretory with the amniotic fluid as the medium of excretion
o Respiratory organ of the fetus
o The placenta acts as a protective barrier to some substances and organisms like
heparin and bacteria; ineffective for virus, alcohol, nicotine, antibiotics,
depressants, and stimulants.

ENDOCRINE
Secretes hormones estrogen, progesterone, human chorionic gonadotrophin (HCG), and
human placental lactogen (HPL), also called human chorionic somatomammotropin
(HCS).
Estrogen and progesterones major source of production after the first 2 months is the
placenta.

HUMAN CHORIONIC GONADOTROPIN (HCG)

Secreted as early as 8-10 days after fertilization; detected in serum as early as the time of
implantation by the most sensitive pregnancy test, the radioimmunoassay (RIA); and the
detected in urine 10 days (2 weeks) after missed period by simple pregnancy test.

FUNCTIONS of HCG
Prolongs the life of the corpus luteum
Serves as basis for pregnancy tests

HUMAN CHORIONIC GONADOTROPIN (HCG)

The hormone found elevated in excessive vomiting
Normal value: 400,000 I.U./24 hours

HUMAN CHORIONIC SOMATOMAMMOTROPIN (HCS) or HUMAN PLACENTAL LACTOGEN

(HPL)
Secreted by 3rd week after ovulation
Influences somatic cellular growth of the fetus; resembles the growth hormone
The principal diabetogenic factor as it is the major insulin antagonist, or glucose sparing
hormone
Prepares the breast of the mother for lactation

UMBILICAL CORD/FUNIS
Length: 55 cm
Parts: one umbilical carries oxygenated blood to the fetus, two umbilical arteries carries
deoxygenated blood from fetus to placenta.
WHARTONS JELLY: gelatinous substance
o WHARTONS JELLY
Specialized connective tissue, an extension of the amnion; surrounds the
umbilical cord to prevent cord compression
The blood volume in the cord also helps prevent cord compression.
FUNCTION of the UMBILICAL CORD
To transport oxygen and nutrients to the fetus and to return metabolic wastes including carbon
dioxide from the fetus to the placenta.

THE AMNIOTIC FLUID

Clear, straw colored fluid in which the fetus floats.
ORIGIN: both fetal and maternal; amniotic epithelium maternal serum and in later part (10th
week), fetal urine; constantly being replaced so there is no dry labor in premature rapture of
BAG of WATER.

AMNIOTIC FLUID
AMOUNT: 500 1000ml at term; polyhydramnios excessive amount of amniotic fluid,
greater than 1000 1500ml; oligohydramnios amount less than 300 500ml.
REACTION: neutral to alkaline (Ph 7 7.25)
ABNORMAL COLORS: green-tinge in non-breech presentation is sign of fetal distress;
golden colored fluid maybe found in hemolytic disease.

AMNIOTIC FLUID FUNCTIONS

Serves as a protective cushion
To separate the fetus from membranes allowing symmetrical growth and free movement
Act as medium of excetion

AMNIOTIC FLUID FUNCTIONS

Serves as fetal drink (if there is an abnormality in the deglutition center of the brain or if there
is esophageal atresia that the fetus could not swallow, amniotic fluid accumulates
(polyhydramnios).
Serves as specimen for periodic diagnostic exams to determine fetal wellbeing or its absence.

AMNIOTIC FLUID FUNCTIONS

Maintains fetal temperature
Equalizes uterine pressure and prevents marked interference with placental circulation during
labor.

STAGES of INTRAUTERINE DEVELOPMENT

THE OVUM:
From fertilization to 2 weeks
The period of pre-differentiation of organs
When the ovum is exposed to a teratogen, the all or non-law applies, meaning the ovum is
damaged and is out in spontaneous abortion or it is not affected at all continues to grow
normally.

THE EMBRYO:
From 2 weeks to 2 months
The period of organ differentiation (organogenesis)
Most dangerous period: a teratogen introduced at this stage may result in severe organ
malformation and dysfunction.

THE FETUS:
From 8 weeks to birth
The period of post differentiation of organs
When exposed to a teratogen, a malformation is least likely to occur. If ever the fetus is
affected, the effects will most likely be alteration in size or function.