Linggo, Abril 21, 2013

Clinical Chemistry Blog Notes 10cB



Have you ever wondered how do babies inside the mother’s womb be able to breath, eat, eliminate waste, in short, able to survive without food and air? Well, if you don’t know the answer yet, I guess it’s about time you should know it by now.


Science had been taught to us eversince we started going to school. So basic anatomy and physiology of the human body is not new to us.


Before going to the real deal, I would like to share first what my favorite breakfast is. Pancakes. Hmmmm. Topped with chunks of your favorite fruit or sweets then sizzled with generous amount of maple and chocolate syrup. Yuuumeeeeh! Speaking of pancakes, did you know that the Latin word for pancake is Placenta?


This organ is the one responsible for the nutrient uptake, waste elimination, and gas exchange of a growing fetus. In short, without the placenta, a baby will not able to survive inside a mother’s tummy. It serves as the lungs, kidneys and gastrointestinal tract for the growing fetus.


In addition, placenta is the most striking change in the endocrine system during pregnancy.most of us already know that an endocrine organ produces large amounts of different hormones. Estrogen, progesterone, hCG (human chorionic gonadotropin), relaxin and prostaglandins are hormones produced by the placenta.


How does a placenta look like? I have previously mentioned that placenta is the Latin word for pancake, which is descriptive of its actual appearance. The average size of placenta is 22 cm in length and 2-2.5 cm in thickness. It most likely weighs 500 grams. This dark-reddish blue organ is connected to the fetus by an umbilical cord of 55-60 cm in length that has two arteries and one vein. Here’s an actual picture of a freshly expelled placenta.




Now the big question is, how do the nutrient uptake, waste elimination, and gas exchange take place? the answer is, through the blood supply of the mother.


About 100 maternal uterine arteries supply blood to the placenta. Blood vessels branch out over the surface of the organ. These vessels are further divided to form a network. Network of vessels will then form into a villuos tree-like structure called chorionic villi. As the number of chorionic villi increases with pregnancy, intervillous spaces also becomes larger and are separated by septa or segments. Approximately 30 segments called cotyledons can be seen in a mature placenta. These what makes the maternal side of the placenta look rough and uneven. The fetal side on the other hand, is smooth and shiny. An image below shows how does a placenta looked like inside a mother’s womb while it is connected to the baby.





A more detailed picture for you to visualize the anatomical parts of a placenta.




Like any other organ in the human body, placenta also has a few and rare diseases that associates with it. Here’s a list of some of diseases of the placenta:


1.Placenta abruptio. It is the separation of the placenta from its attachment to the uterus wall of the mother prior to the delivery of the baby. The exact cause of is hard to determineand direct cause is said to be rare. Injury to the belly area and sudden loss of uterine volume are believed to directly cause this disease.


2.Choriocarcinoma. An uncommon form of cancer that occurs in a woman's uterus during pregnancy. It is a type of gestational trophoblastic disease and very often curable cancer. The fetus may or may not develop normally if the mother suffers from this disease.





 Very high magnification micrograph of choriocarcinoma. H&E stain.
3.Hydatidiform mole. Also known as molar pregnancy, is a  "rare mass or growth that forms inside the uterus at the beginning of a pregnancy." It is also a  type  of gestational trophoblastic disease. This condition results from the over-production of the tissue that is intended to develop into a placenta later on. This how a mass looks like inside the tummy of a pregnant woman.




4.Placenta previa. A  problem during pregnancy wherein the placenta grows in the lowest part of the uterus and covers the opening to the cervix. Normal delivery would be impossible for the placenta blocks the opening of the birth canal.



Reference/s:
Pillitteri, Adele, (2007) Maternal and Child Health Nursing:Care of the Childbearing and Childrearing Family, 5th Edition

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