Special types of placenta

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Introduction:

  • Human placenta is discoid (a placenta in which the chorionic villi are arranged in a circular fashion)
  • Human placenta is hemochorial (a placenta in which the maternal blood is in direct contact with the chorion).

Components:

The placenta functions as a fetomaternal organ with two components:

  1. The fetal placenta (Chorion frondosum)
  2. The maternal placenta (Decidua basalis).

Placenta susceptible to postpartum hemorrhage (PPH):

  1. Placenta bilobata:
    • The placenta is divided into lobes
    • Division is incomplete and vessels of fetal origin extends from one lobe to the other before uniting to form umbilical cord. 
  2. Placenta succenturiata:
    • The placenta consists of a large lobe and a smaller one connecting together by membranes
    • Umbilical cord is inserted into the large lobe and branches of its vessels cross the membranes to small succenturiate (accessory) lobe
    • It can cause PPH due to retained placental segment.
  3. Battledore placenta:
    • Umbilical cord is located on the periphery,

Types of adherent placenta:

  1. Accreta: Attached to the superficial myometrium (MC)
  2. Increta: Invade the myometrium
  3. Percreta: Penetrate through the myometrium.

Anomalous insertion of cord:

  1. Velamentous cord insertion:
    • Normally, the umbilical cord inserts into the middle of the placenta as it develops
    • In velamentous cord insertion, the umbilical cord inserts into the fetal membranes and then travels within the membranes to the placenta.
  2. Circumvallate Placenta:
    • Fetal membranes (chorion and amnion) “double back” on the fetal side around the edge of the placenta.
    • After delivery, a circumvallate placenta has a thick ring of membranes on its fetal surface.

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