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Basics

Outline


BASICS

Overview!!navigator!!

  • Shape—diffuse; normal placenta covers entire endometrial surface; see exceptions in section Villi
  • Origin—allantochorionic; fusion of fetal allantois and chorion
  • Degree of invasion—epitheliochorial; fetal tissue directly apposes maternal endometrium. Endometrial cups only fetal extensions into maternal tissue
  • Vascular structure—microcotyledonary/villous; maternal and placental vessels in near apposition
  • Degree of attachment—adeciduate; no loss of maternal tissue during placental formation or expulsion

Chronology!!navigator!!

  • Conceptus mobile to day 16 post conception (day 0); spherical until day 35; thereafter ellipsoid
  • Endometrial cup formation by days 36–38
  • Pregnancy maintenance by allantochorionic placentation experimentally from day 70
  • Placenta contacts entire endometrial surface by day 77; development complete by day 150

Endometrial Cups!!navigator!!

  • Fetal trophoblast invades endometrium—days 36–38; peak function day 70
  • Cups necrose day 120–150, slough and form allantochorionic pouches
  • Produce equine chorionic gonadotropin; support formation/function of accessory corpus luteum

Examination!!navigator!!

  • Placenta ruptures at cervical star; allantochorion usually passed with allantois exposed
  • Complete examination requires observing chorionic surface, amnion, and umbilical cord
  • Identify body and uterine horns; lay out as capital F
    • Confirm horn tips are present
    • Where torn, match allantoic blood vessels
  • Tip of nonpregnant horn most likely part retained—identify in all examinations
  • Cervical star—site of fetal exit; examine remnants
    • Allantochorionic thickening/exudates should be sampled
  • Assess amnion—uniformity, color, fecal staining
  • Assess umbilical cord—length, degree of twisting, signs of vascular compromise
  • Healthy Thoroughbred—placenta 11% of foal birth weight

Villi!!navigator!!

  • Up to 5 normal chorionic avillous areas
    • Endometrial cup sites (may be absent at term)
    • Cervical star
    • Ostium (horn tips)
    • Site of umbilical cord attachment
    • Invaginated/redundant folds from umbilical cord traction
  • Pathologic avillous areas
    • Placental apposition (twin pregnancy)
    • Placentitis—allantochorionic detachment from endometrium, cervical star (ascending placentitis), body, and pregnant horn (nocardioform sp.)
    • Endometrial fibrosis—degenerative change prevents villous formation
  • Endometrial cysts—degenerative change prevents allantochorionic apposition to endometrium

Allantochorion!!navigator!!

Normal

  • Chorion has “red velvet” appearance due to diffuse microvilli over entire surface
  • Tip of pregnant horn thick and edematous compared with nonpregnant horn

Abnormal

  • Abnormal if:
    • Thickened
    • Edematous
    • Exudate
  • Ascending placentitis
    • Cervical star, adjacent placental body
  • Nocardioform placentitis
    • Localized changes—placental body, horn base
  • Demarcation may be prominent.
  • Other causes usually more diffuse inflammatory changes
  • Gross edema or thickening—vascular disturbance, fescue toxicosis

Amnion!!navigator!!

Normal

  • Completely separate from allantochorion
  • White; translucent; highly vascular
  • Focal proliferative areas, small discrete plaques may occur

Abnormal

  • Discolored/edematous—fetal distress (e.g. fetal diarrhea)
  • Thickened—amnionitis
  • Widespread edema/thickening may indicate fetal compromise—decreased nutrient and gaseous exchange; umbilical cord blood flow compromise

Umbilical Cord!!navigator!!

Normal

  • Allantoic and amniotic portions (60–83 cm in length)
  • Normal twists—up to 4 reported

Abnormal

  • Length
    • >100 cm—increased risk of fetal strangulation, torsion
    • <30 cm—excessive traction on fetal body wall; increased risk of fetal umbilical/urachal abnormalities, hemorrhage
  • Torsion—hypoperfusion; congestion, thrombosis, mineralization of allantochorion
  • Abortion—autolysis, vascular damage, thrombi (abnormal, excessive twisting), urachal tearing
  • Neonate—patent urachus, elongated umbilical remnant from excessive traction in utero

Allantoic Fluid!!navigator!!

  • Clear/amber—hypotonic urine; fetal excretions
  • Hippomane (allantoic calculus)—concentric layers of cellular debris; rubbery; brown, green, tan

Amniotic Fluid!!navigator!!

Translucent—respiratory and buccal secretions.

Miscellaneous

MISCELLANEOUS

Suggested Reading

Bucca S, Fogarty U, Collins A, Small V. Assessment of feto-placental well-being in the mare from mid-gestation to term—transrectal and transabdominal ultrasonographic features. Theriogenology2005;64:542557.

Klewitz J, Struebing C, Rohn K, et al. Effects of age, parity, and pregnancy abnormalities on foal birth weight and uterine blood flow in the mare. Theriogenology 2015;83:721729.

Morresey PR. How to perform a field assessment of the equine placenta. Proc Am Assoc Equine Pract 2004;50:409414.

Renaudin CD, Troedsson MH, Gillis CL, et al. Ultrasonographic evaluation of the equine placenta by transrectal and transabdominal approach in the normal pregnant mare. Theriogenology 1997;47:559573.

Author(s)

Author: Peter R. Morresey

Consulting Editor: Carla L. Carleton