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, 6th edition, Pg.28-29
 Jacob Annamma, “A Comprehensive Textbook of
Midwifery”, Jaypee Brothers Medical
Publishers(P)LTD, 2nd edition, Pg.75-78
 Myles, “ Textbook for Midwives”, Churchill
Livingstone Publishers, 13th 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:
i. Presence of one or more lobes of placenta placed at varying distance from
placental margin without communicating vessel is called as _________.
ii. ________ limits further invasion of trophoblast into uterine wall.
iii. Placenta implanted partially or completely over lower uterine segment on
internal os is called as ________.
iv. Presence of white thick ring on margin of fetal surface of placenta is called as
___________.
v. 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:
i. Presence of one or more lobes of placenta placed at varying distance from
placental margin without communicating vessel is called as placenta spuria.
ii. Nitabuch’s membrane limits further invasion of trophoblast into uterine wall.
iii. Placenta implanted partially or completely over lower uterine segment on
internal os is called as Placenta praevia.
iv. Presence of white thick ring on margin of fetal surface of placenta is called as
Placenta marginata.
v. Umbilical cord is inserted at the margin of placenta is called as Battledore
Placenta.