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Anatomical variations of the placenta and the cord.pptx
- 1. Anatomical variations of the placenta and the cord
- 2. Succenturiate lobe of placenta • This is the most significant of the variations in conformation of placenta. • A small extra lobe is present, separate the from the main placenta, and joined to it by blood vessels that run through the membranes to reach it.
- 3. Succenturiate lobe of placenta
- 4. • The danger is that this small lobe may be retained in utero after the placenta is born, and if it is not removed it may lead to infection and haemorrhage. • The midwife must examine every placenta for evidence of a retained succenturiate lobe - hole in the membranes with vessels running to it
- 5. Circumvallate placenta In this situation an opaque ring is seen on the fetal surface of the placenta. It is formed by a doubling back of the chorion and amnion and may result in the branes leaving the placenta nearer the centre instead of at the edge as usual.
- 7. Battledore insertion of the cord • The cord in this case is attached at the very edge of the membrane of the placenta in the manner of a table tennis bat
- 8. Velamentous insertion of the cord • The cord is inserted into the membranes some distance from the edge of the placenta. • The umbilical vessels run through the membranes from the cord to the placenta. • If the placenta is normally situated, no harm will result to the fetus but the cord is likely to become detached upon applying traction during active management of the third stage of labour.
- 9. Velamentous insertion of the cord
- 10. • If the placenta is low lying, the vessels may pass across the uterine os. The term applied to the vessels lying in this position is vasa praevia. In this case there is great danger to the fetus when the membranes rupture and even more so during artificial rupture, as the ves sels may be torn, leading to rapid exsanguination of the fetus.
- 11. Bipartite placenta Two complete and separate parts are present, each with a cord leaving it. The bipartite cord joins a short distance from the two parts of the placenta. This is different from the two placentas in a twin pregnancy, where there are also two umbilical cords, but these do not join at any point.