Thursday, 10 September 2015

Placenta

Placenta 10 points [MRP=must remember points]
1. Weighs 500gm, 20 cms, 3cm thick. Placenta is from both maternal and fetal tissue; at term 80% is fetal origin
2. Maternal placenta:
1. 20% of placenta weight
2. Made of decidua basalis, margins of spongy decidua, cotyledons
3. Fetal portion placenta
1. Made of villi
2. Fetal surface is covered by amnion
4. Circumvillete:
1. circum marginate
2. Predispose to premature marginal seperation, IInd TM APH
5. Succenturate lobe:
1. Accessory cotyledon
2. Cause for PPH
6. placenta previa
1. Implanted lower than normal, in lower uterine segment, near zone of effacement
2. Mostly in parous females
3. Present as sudden painless profuse bleeding in IIIrd TM
7. Battledore placenta
1. Umbilical cord inserted in margins
2. Cord entanglement is risky
8. Membraneacea placenta
1. Decidua capsularis is vascularised, chorion does not show atrophy
9. Bi partite placenta
1. Divided placenta
2. Retention may lead to PPH, sepsis
10. Placenta accreta
1. Abnormal adherence to uterine muscle, decidua deficiency
2. Seen in Placenta previa, prev CS, prev DC, grand multi para
3. Placenta increta: invade myometrium
4. Placenta percreta: perforate myometrium

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