Function of placenta

 The placenta is circular organ in mammals that is developed during pregnancy to transfer nutrient and waste products between mother and fetus . The placenta is attached to uterine wall and establishes connection between mother and fetus through umbilical cord .

The Placenta is developed from Two Surfaces :  The fetal part which develops from chorion frondosum and maternal component consists of decidua basalis .  It begins at 6th week and is completed by 12th week of pregnancy.

Functions of placenta : 

The main function of placenta are :
  1. Transfer of nutrients and waste product b/w Mother and fetus

2. Respiratory Function :  


fetal respiratory movements are observed as  early as 11th weeks there is no gaseous exchange . Intake of oxygen and outpot of co2 takes place by simple diffusion across fetal membrane . The Oxygen supply to fetus is at the rate of 8ml/kg/min and this is achieved by cord blood flow of 165-330 ml/min

3. Excretory Function :  

Waste product from fetus such urea, uric acid and creatinine are excreted to maternal blood by simple diffusion.

4. Nutritive Function : 

The  fetus obtains nutrient from maternal blood

Glucose

It is principal source of energy is transferred to the fetus by Facilitated diffusion . There are transporter proteins ( GLUT 1) for facilitated diffusion.

Lipids : 

Lipids  for fetal growth and development are transferred across the fetal membrane or synthesizedin the fetus. Triglycerides and fatty acids are directly transported from the mother to the fetus in early pregnancy


Amino acids : 

Amino acids  are transferred by active transport  through enzymatic mechanism (ATPase). Amino acid concentration is higher in the fetal blood than in the maternal blood. 


Water and Electrolytes  : 

such as sodium, potassium and chloride cross through the fetal membrane by simple diffusion, whereas calcium, phosphorus and iron cross by active transport

Hormones : 

Insulin, steroids from the adrenals, thyroid, chorionic gonadotrophin or placentallactogen cross the placenta at a very slow rate, so that their concentration in fetal plasma are appreciably lower than in maternal plasma. Neither parathormone nor calcitonin crosses the  placenta

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5. Enzymatic Function : 

(1) Diamine oxidase which inactivates the circulatory pressure (or pressor) amines.

2.  Oxytocinase which neutralizes the oxytocin, 

(3) phospholipase A2 which synthesizes arachidonic acid . 

6. Barrier Function : 

Antibody and antigens in immunological quantities can traverse across the placental barrier in both directions. The transfer of the larger molecule is probably facilitated by pinocytosis. The race of drug transfer is increased in late pregnancy.


Structure of Placenta : 

The  Placenta consists of Two plates :
1. The Chorionic plate lies internally . It is lined by the amniotic  membrane. The umbilical cord is attached to this plate
2. The basal plate lies to the maternal aspect. Between the two plates lies the intervillous space containing the stem villi with their branches, the space being filled with maternal blood. 
Structure and function of placenta

AMNIOTIC MEMBRANE

It consists of single layer of cubical epithelium loosely attached to the adjacent chorionic plate. It takes no part in formation of the placenta.

CHORIONIC PLATE: 

From within outward, it consists of 

(i) primitive mesenchymal tissue containing branches of umbilical vessels

 (ii) a layer of cytotrophoblast and 

(iii) syncytiotrophoblast. The stem villi arise from the plate.

BASAL PLATE: 

It consists of the following structures from outside inwards.

 (1) Part of the compact and spongy layer of the decidua basalis

 (2) Nitabuch’s layer of fibrinoid degeneration of the outer syncytiotrophoblast at the junction of the cytotrophoblastic shell and decidua.

 (3) Cytotrophoblastic shell

(4) Syncytiotrophoblast

INTERVILLOUS SPACE:

It is bounded on the inner side by the chorionic plate and the outer side by the basal plate, limited on the periphery by the fusion of the two plates. It is lined internally on all sides by the syncytiotrophoblast and is filled with slow flowing maternal blood. Numerous branching villi which arise from the stem villi project into the space and constitute chief content of the intervillous space.

STEM VILLI: 

These arise from the chorionic plate and extends to the basal plate. With the progressive development — primary, secondary and tertiary villi are formed .

Functional unit of the placenta is called a fetal cotyledon or placentome, which is derived from a major primary stem villus. These major stem villi pass down through the intervillous  space to anchor onto the basal plate. 

Functional subunit is called a lobule, which is derived from a tertiary stem villi. About 60 stem villi persist in human placenta. Thus, each cotyledon (total 15–29) contains 3–4 major stem villi. The villi are the functional unit of the placenta. The total villi surface, for exchange, approximately varies between 10 square meters and 14 square meters.

Intervillous  Haemodynamics

Volume of blood in mature placenta      :     500 ml 

Volume of blood in intervillous space    :     150 ml

Blood flow in intervillous Space             :     500- 600 ml/min

Pressure in intervillous space  

            During Uterine contraction                    :  30- 50 mm Hg

            During Uterine Relaxation                     :   10 – 15 mm Hg

Pressure in the supplying Uterine Artery    :  70 – 80 mm Hg 

Pressure in the draining uterine vein           :  8 mm Hg 




Fetal  Haemodynamics :  

Fetal blood flow through the placenta     :    400 ml per minute 

Pressure in the umbilical Artery               :      60 mm Hg

Pressure in the umbilical Vein                   :    10 mm Hg

Fetal capillary presure in villi                    :   20 – 40 mm Hg

                                                             umbilical artery                       umbilical Vein
O2 saturation                                       50- 60%                                        70 – 80%
PO2                                                        20 -25  mm Hg                              30 – 40 mm Hg



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