Placental Circulation & Functions: A Complete Guide for Medical Students

1. Placental Development

Definition:

The placenta is a temporary organ that develops during pregnancy to exchange nutrients, gases, and waste between the mother and fetus.

Formation of the Placenta:

  • Develops from trophoblast cells of the blastocyst.
  • Fully functional by 12 weeks of gestation.

Anatomy of the Placenta:

  • Fetal Side: Covered by the amnion, contains umbilical cord.
  • Maternal Side: Adheres to the uterus, composed of cotyledons (15–20 lobes).

2. Placental Circulation

Fetal Circulation (Umbilical Cord)

  • Umbilical Arteries (2): Carry deoxygenated blood from fetus to placenta.
  • Umbilical Vein (1): Carries oxygenated blood from placenta to fetus.

Maternal Circulation

  • Uterine Arteries: Supply oxygenated blood to intervillous spaces of placenta.
  • Uterine Veins: Drain deoxygenated blood back to the maternal circulation.

Mechanism of Exchange

  • Oxygen, nutrients, and hormones diffuse from maternal blood to fetal blood.
  • CO₂, urea, and waste products move from fetal blood to maternal blood for elimination.

3. Functions of the Placenta

1. Exchange of Gases & Nutrients

  • Oxygen & Glucose → Transferred to fetus for growth.
  • CO₂ & Waste Products → Removed via maternal circulation.

2. Hormone Production

  • Human Chorionic Gonadotropin (hCG) → Maintains corpus luteum.
  • Estrogen & Progesterone → Maintains pregnancy.
  • Human Placental Lactogen (hPL) → Promotes fetal growth & maternal glucose metabolism.

3. Immune Protection

  • Transfers maternal IgG antibodies → Provides passive immunity.
  • Acts as a barrier against infections (Limited protection).

4. Waste Elimination

  • Excretes fetal waste products (Urea, Bilirubin) into maternal circulation.

5. Protection Against Toxins

  • Prevents some harmful substances from reaching fetus (But some drugs, alcohol, and viruses can cross).


4. Clinical Conditions Related to Placental Circulation

1. Placental Insufficiency

Causes:

  • Preeclampsia, Hypertension, Diabetes, Smoking.
    Effects:
  • Intrauterine Growth Restriction (IUGR), Fetal Hypoxia, Oligohydramnios.

2. Placenta Previa

Definition:

  • Placenta implants over the cervical os, causing painless vaginal bleeding.
    Management:
  • Avoid vaginal exams, C-section for delivery.

3. Placental Abruption

Definition:

  • Premature separation of placenta from uterus, causing painful vaginal bleeding.
    Management:
  • Emergency C-section if fetal distress.

Summary Table: Placental Circulation & Functions

Feature

Details

Umbilical Arteries

Carry deoxygenated blood from fetus to placenta

Umbilical Vein

Carries oxygenated blood to fetus

Hormones Produced

hCG, Estrogen, Progesterone, hPL

Major Functions

Gas exchange, Nutrient transfer, Immune protection, Waste elimination

Placental Abnormalities

Placenta previa, Placental abruption, Insufficiency

Key Takeaways

  • Placenta develops by 12 weeks and supports the fetus until birth.
  • Oxygen & nutrients flow from mother to fetus; CO₂ & waste return to the mother.
  • Placental hormones regulate pregnancy (hCG, Estrogen, Progesterone).
  • Placental insufficiency leads to IUGR & fetal distress.

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