Abnormal placenta

Knowledge on variations of abnormal placenta helps you to detect abnormal placenta and take necessary action in clinical settings.

1. PRESENTED BY: SRUJANI SWETSINA DASH NURSING TUTOR GNM INTITUTE, ANMMCH, GAYA ABNORMALITIES OF PLACENTA

2. OBJECTIVES VARIATIONS OF ABNORMAL PLACENTA ASSIGNMENT BIBLIOGRAPHY

3. LIST OF ABNORMAL PLACENTA LARGER & HEAVIER BATTLEDORE PLACENTA SMALLER & LIGHTER VELAMENTOUS PLACENTA SYPHILITIC PLACENTA INFARCTED PLACENTA EDEMATOUS PLACENTA TUMOUR F PLACENTA PLACENTA SUCCENTURIATE HEMATOMA OF PLACENTA PLACENTA SPURIA PLACENTA CYST PLACENTA EXTRACHORIALIS: PLACENTA MEMBRANACEA CIRCUMVALLATE PLACENTA PRAEVIA MARGINATE PLACENTA CRETA: LOBULATED PLACENTA: PLACENTA ACCRETA BIPARTITE PLACENTA INCRETA TRIPARTITE PLACENTA PERCRETA

4. VARIATIONS OF PLACENTA LARGER & HEAVIER: Placenta is larger and heavier than normal placenta SMALLER & LIGHTER: Placenta is smaller and lighter than normal placenta LARGER NORMAL SMALLER

5. VARIATIONS OF PLACENTA SYPHILITIC PLACENTA : Abnormally large, pale and yellow grey placenta EDEMATOUS PLACENTA : Mushy, thick and pale and fluid can be squeezed from it.

6. VARIATIONS OF PLACENTA PLACENTA SUCCENTURIATE : Presence of one or more small lobes of placenta, size of a cotyledon, placed at varying distance from main placenta margin. And the lobes has communicating blood vessels. PLACENTA SPURIA: Presence of one or more small lobes of placenta, size of a cotyledon, placed at varying distance from main placenta margin. And the lobes doesn’t have communicating blood vessels.

7. VARIATIONS OF PLACENTA PLACENTA EXTRACHORIALIS : Presence of thick hite ring on fetal surface of placenta which gives the impression that the central portion is somewhat depressed. It is of two types- a. CIRCUMVALLATE: The white ring is situated at a variable distance between margin and centre of placenta. b. MARGINATE or CIRCUM MARGINATE: The white ring is located at the margin of placenta.

8. CIRCUMVALLATE MARGINATE

9. VARIATIONS OF PLACENTA LOBULATED PLACENTA : Presence of multiple placenta or one placenta divided into two or more parts either completely separated or joined for a single baby. Its type is based on the number of placenta or its division. a. BIPARTITE: Two divisions b. TRIPARTITE: Three divisions

10. VARIATIONS OF PLACENTA BATTLEDORE PLACENTA: Umbilical cord is inserted at the margin of placenta. VELAMENTOUS PLACENTA: Umbilical cord is inserted into membranes at a varying distance from placenta.

11. VARIATIONS OF PLACENTA INFARCTED PLACENTA : Infarction of cotyledons of placenta due to reduced blood supply. TUMOUR OF PLACENTA : Presence of tumour in placenta

12. VARIATIONS OF PLACENTA HEMATOMA OF PLACENTA : Presence of hematoma in placenta. CYST OF PLACENTA : Presence of cyst in placenta.

13. VARIATIONS OF PLACENTA PLACENTA CRETA: Placenta invades beyond the level of decidua mostly due to absence of Nitabuch’s membrane. Based on the depth of invasion , it is of three types- PLACENTA ACCRETA : Placenta attaches to uterine wall but not too deeply to myometrium . PLACENTA INCRETA : Placenta attaches too deeply to the myometrium . PLACENTA PERCRETA : Placenta not only attaches too deeply into uterus but also invades another organ like bladder.

14. VARIATIONS OF PLACENTA PLACENTA MEMBRANACEA: Placenta is unduly large and thin. PLACENTA PRAEVIA: Placenta is implanted partially or completely over lower uterine segment adjacent to or internal os .

15. ASSIGNMENT Prepare colored diagram of abnormal variations of placenta with description.

16. BIBLIOGRAPHY Dutta D.C, “Textbook Of Obstetrics”, New Central Book Agency(P)LTD, 6 th edition, Pg.28-29 Jacob Annamma , “A Comprehensive Textbook of Midwifery”, Jaypee Brothers Medical Publishers(P)LTD, 2 nd edition, Pg.75-78 Myles, “ Textbook for Midwives”, Churchill Livingstone Publishers, 13 th edition, Pg.143-147

17. EVALUATION 1. Identify the type of placental variation: i . ii. iii.

18. Contd...... iv. v. 2. Fill in the blanks: Presence of one or more lobes of placenta placed at varying distance from placental margin without communicating vessel is called as _________. ________ limits further invasion of trophoblast into uterine wall. Placenta implanted partially or completely over lower uterine segment on internal os is called as ________. Presence of white thick ring on margin of fetal surface of placenta is called as ___________. Umbilical cord is inserted at the margin of placenta is called as ________.

19. ANSWER KEY 1. Identify the type of placental variation: i . Placenta Creta ii . Velamentous Placenta iii. Circumvallate Placenta

20. iv. Placenta Succenturiate v. Tripartite Placenta 2 . Fill in the blanks: Presence of one or more lobes of placenta placed at varying distance from placental margin without communicating vessel is called as placenta spuria . Nitabuch’s membrane limits further invasion of trophoblast into uterine wall. Placenta implanted partially or completely over lower uterine segment on internal os is called as Placenta praevia . Presence of white thick ring on margin of fetal surface of placenta is called as Placenta marginata . Umbilical cord is inserted at the margin of placenta is called as Battledore Placenta .

21. THANK YOU