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Congenital anomalies of placentation 2

Part 2 of 2
Published on December 31, 2025   15 min

A selection of talks on Clinical Practice

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0:00
My name is Eric Jauniaux. I'm a professor at the Institute for Women's Health at University College London, and thank you for listening to the second part of my presentation on congenital anomalies of the placenta and the umbilical cord. I will start this second part with normal placentation.
0:21
You may have seen my previous lecture on the normal placenta, and you may remember that in normal placentation, you have a typical migration of trophoblastic cells that are detaching from the anchoring villi, which are those villi that attach to the decidua of the uterine wall, and they will migrate quite deeply through the entire decidua and the superficial layer of the myometrium, which is called the junctional zone. You see on those diagrams exactly what happens with these extravillous trophoblastic cells, which are referred to as EVT, going through the decidua and reaching the junctional zone.
1:05
This migration, of course, is not uniform. It starts in the middle, and then progressively it will migrate to the periphery of the placenta.
1:16
The role of these extravillous trophoblastic cells is linked to the remodeling of the spiral artery. But it affects only the distal part. These spiral arteries need to enlarge to a maximum diameter to allow maximal blood flow to enter the placenta, and this is essential, of course, for the normal development of the fetus. But this is also regulated by hormones, mainly estradiol and relaxin, which will generate a dilatation of the entire utero-placental circulation, and it actually starts during the end of the cycle, just soon after the placenta starts to develop inside the uterine cavity.

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