The term placenta seems to come from a Latin word that means “Circular Cake” and apparently was introduced in 1559 by a doctor called Realdus Columbus. The truth is that the placenta is a rounded disk-shaped structure about 25 cm in diameter and about 2.5 cm thick (towards the end of pregnancy) that attached to the inner side of the womb allows the baby to be nourished by the extraction of the necessary elements from maternal blood.

The baby is attached to the placenta by the Umbilical Cord, which is a vascular conduit responsible for carrying the blood (with waste and without oxygen) from the baby to the placenta, so that the necessary exchange with the mother is made and return oxygenated and Rich in nutrients towards the baby. The exchange occurs through the placenta but functioning as a very effective barrier that only allows the passage of well-determined substances and without mixing the blood of the baby with that of its mother

The placenta is a structure of fetal origin, the placenta belongs to the baby and not the mother, in fact, the genetic characteristics of the placenta are identical to that of the baby in training. It is rather ugly, say horrifying, devoid of aesthetics and for many something worthy of repulsion: it is a round cake, purple, bloody, flaccid … but as we will see below it is a wonderful and fundamental organ for there to be some possibility of pregnancy!

Origin

A few days after the fertilization of the ovule, a microscopic cell mass that looks like a blackberry (multiple pellets) is formed. A few days later, this blackberry separates into two cellular masses that give birth to the baby and its placenta. The placental cell mass is moving away from the baby and is strongly attached to the mother’s womb, keeping the baby together through the umbilical cord.

What is the structure of the Placenta:

The placenta is an organ that behaves like a filter of fetal blood with multiple compartments (cotyledons) that bathed by maternal blood allow the exchange between maternal and fetal circulation avoiding their direct contact, but in such close and intimate relationship that they allow the nutrients and waste are exchanged without inconvenience.

The “impure” blood is sent to the placenta thanks to the baby’s heartbeat through two (2) umbilical arteries (inside the umbilical cord) that divide into the placenta many times to form capillaries that are bathed by maternal blood In these capillaries or vascular balls the feto-maternal exchange occurs in a matter of fractions of a second. The “purified” blood is led back by multiple veins that are joined on the placental surface to form a (1) single vein that entering the umbilical cord brings the blood back to the baby: this blood carries everything the baby needs , is oxygenated, loaded with nutrients and “clean”. It is a dialysis unit that cleans, oxygenates and nourishes fetal blood.

Placenta functions:

Nutrition : as we have said the placenta is an organ that allows the uninterrupted feeding of the developing fetus. When maternal and fetal circulations are found (separated by the placenta), the baby extracts from the maternal blood all the elements that are necessary for its existence: Oxygen, Amino Acids (proteins), Fatty acids (fats) and Glucose (carbohydrates). What you eat will never reach the baby directly, you will never be hungry and you will always get food even when you have not eaten. A perfect system, at least for the baby.

Elimination of waste : the fetus transfers to its mother the waste products that are produced by its metabolism and that it can not eliminate on its own, given that its organs are immature and that it is found in a cloister isolated from the outside world; thus, it could be said that the placenta allows the fetus to purify its blood using the maternal organs. Being aggressive we could see the baby as a small waste factory that you should clean.

Endocrine functions : the placenta produces hormones that allow the permanence of pregnancy and modify the metabolism and maternal physiological functions for the survival of the growing baby. The best-known placental hormone is the one that gave rise to the pregnancy test. Yes, the pregnancy test is positive because the placenta produces Human Chorionic Gonadotropin (hCG), a hormone that allows pregnancy in its early stages (and other multiple functions later on the mother) and that secondarily allows us to detect a pregnancy before we can even see it by Ecosonography.

Immunological tolerance : the placenta and the profound immunological changes that pregnancy imprints on the mother allow the fetus not to be attacked by the mother’s defense system. The placenta plays a fundamental role in “hiding” the baby from the mother’s immune system and preventing its rejection: if this were not true, the immune system would activate its antibodies and defense cells to attack the baby and “eliminate” it from the maternal ward. .

Biological protection : the placenta behaves like an excellent filter that prevents the passage of many substances, parasites, viruses and bacteria that could affect the baby. The placenta is not perfect in this aspect and unfortunately an important list of agents can gain access to the baby and cause important damages: alcohol, cigarette, fetotoxic drugs, rubella, toxoplasmosis, syphilis, etc.

Physical protection : the placenta, the membranes of the “Bag of Waters” and the amniotic fluid that they encompass provide a closed, sterile and temperature controlled environment that keep the baby completely isolated from the physical factors that could cause problems: bumps, changes sudden temperature, bacterial infections, etc.

That’s right, the placenta allows the fetus to parasitize its mother so it can nourish itself, live, grow and maintain its own pregnancy. The baby does not give anything to his mother from a biological point of view, but allows him to deliver, finally, the miracle of life …

What conditions are associated with deterioration or placental insufficiency?

There are many and varied causes but maternal diseases such as Diabetes Mellitus, Chronic Arterial Hypertension , Preeclampsia , Chronic Kidney Disease and Autoimmune diseases predispose with relatively frequent placental dysfunction and mothers who suffer one or more of these conditions should be closely monitored .

What is placental aging?

This is a term we use quite frequently to find placentas whose normal process of calcification has occurred earlier than expected. Previously it was taken as evidence of disorders of the placental function Insufficiency) but nowadays it has lost importance since in most of the cases, and in the absence of important risk factors, it is not associated with alterations in the basic tests and / or advanced fetal health. Doppler is more sensitive to detect placental problems

Are there other placental disorders?

Yes, there are different variants in the number (Multiple Pregnancies), the shape, size and structure of the placenta, in the number of placental nuclei, the uterine invasion of the placenta and in the insertion of the cord but perhaps the terms that most often You will hear those from Placenta Previa (PP) and Placenta Premature Detachment (DPP).

Placenta Previa : is the abnormally low insertion of the placenta so that once the pregnancy progresses one of its edges totally or partially occludes the internal hole of the cervix obstructing the vaginal output of the baby and being exposed generates profuse bleeding of origin maternal that can lead to Prematurity of the baby due to early termination of pregnancy. Maternal health can be compromised according to the severity of the bleeding and its complications.

Premature Placental Detachment (DPP) : this is an even more serious condition since the placenta normally inserted is partially or totally detached from the uterus during pregnancy (it is normal to detach after the birth of the baby). This generates two serious problems: (1) It dangerously reduces the maternal-fetal exchange surface so that the baby can run out of nutrients and oxygen immediately, this can kill the baby in a matter of minutes and (2) Retroplacental haemorrhage that can severely compromise the health and life of the mother and therefore further compromise the precarious situation of the baby. Fortunately, this is an infrequent but observed condition mainly in women with chronic diseases, patients with pre-Eclampsia, cocaine users and large smokers.

How can I prevent placental problems?

Although some situations are unpredictable or with few therapeutic options, the truth is that most pregnancies are normal and we will not find placental problems in their evolution. What can you do? It is in your hands to initiate early prenatal control, have an adequate diet, report and eliminate manageable risk factors (cigarette, cocaine, unsafe behavior), report and treat your chronic diseases (Hypertension, Diabetes, Rheumatism, Nephropathy), report immediately episodes of genital bleeding, continuous abdominal pain or decrease in fetal movements, attend all your controls and follow all the instructions of your obstetrician.