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Placenta Flashcards

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1
Q

What are the functions of the placenta

A

storage of nutrients, hormone production, protection of baby, excretion of waste, nutrition, and O2 and CO2 exchange

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2
Q

What is battledore or marginal cord insertion?

A

when the cord inserts within 2 cm of the placental edge

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3
Q

What is velamentous placenta

A

the cord inserts into the membrane before entering the placenta

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4
Q

What is it called when vessels cover the internal os of the cervix

A

vasa previa

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5
Q

Is vasa previa serious?

A

Yes it requires a c-section because a vaginal delivery will result in life-threatening hemorrhage for the fetus.

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6
Q

How thick is the placenta before 23 weeks?

A

usually 2-3cm but should not exceed 4 cm.

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7
Q

What is Chorion frondosum? Does it have villi

A

fetal part of placenta; contains villi

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8
Q

What is Chorion laeve? Does it have villi

A

nonvillious part of chorion around
gestational sac

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9
Q

What is Chorion plate

A

fetal surface of placenta

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10
Q

What is Basal plate

A

maternal surface of placenta

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11
Q

What is placentomegaly

A

an enlarged placenta with a diameter of >4 cm

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12
Q

What is a placental lake? Is it normal?

A

an anechoic area in the placenta that is often a normal finding

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13
Q

What is the vascularity like in a placental lake

A

color doppler will not detect such slow blood flow, but real-time might show swirling flow

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14
Q

What placental issue might present with painless, bright red vaginal bleeding in third trimester?

A

25% of patients present with bleeding with placenta previa

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15
Q

What is Vasa Previa and is it serious?

A

Vasa previa is a potentially life-threatening complication when fetal vessels run across cervical os

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16
Q

What are the most common causes of vasa previa

A

velamentous insertion amd succenturiate lobe

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17
Q

What could the bladder be a pitfall in the third trimester?

A

a full bladder could be a pitfall since it might make the cervix look longer or give the impression of placenta previa

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18
Q

how should the uterine artery’s waveforms appear in the first and second trimester?

A

high resistance in the 1st trimester and low in the second trimester

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19
Q

about how long does the placenta measure

A

15-20 cm

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20
Q

what is placental invasion?

A

abnormal prenetration of the placental tissue beyond the endometrial lining of the uterus

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21
Q

what are risk factors for placental invasion?

A

almost all cases are women with prior c-section that have an anterior placenta previa. Another risk is multiparity

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22
Q

What is placenta accreta?

A

chorionic villi attach to myometrium

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23
Q

What is placenta increta?

A

chorionic villi extend into myometrium

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24
Q

What is placenta percreta?

A

penetration of the villi all the way through the myometrium into uterus and possibly bladder

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25
What is another word for morbidly adherent placenta? What kind is most dangerous and why?
placental invasion. the most dangerous are increta and percreta due to hemorrhage
26
What is placental abruption
premature separation of normally implanted placenta prior to term delivery
27
what kind of bleed is associated with a retroperitoneal abruption?
high pressure bleeds from rupture of spiral arteries
28
What is the most common type of abruption
marginal abruption
29
What is a marginal abruption
low-pressure subchorionic bleed from tears of the marginal veins
30
Where should you scan to confirm a marginal abruption
around the placental edge
31
What is the result of intraplacental hemorrhage caused by breaks in the villous capillaries? Is this serious?
intervillous thrombosis. it usually has little risk to the fetus
32
what is a placental infarct
a focal lesion caused by necrosis
33
What is gestational trophoblastic disease associated with? Are they benign or malignant?
molar pregnancy. they can be benign or malignant
34
what is the most common "tumor" of the placenta? is it benign or malignant?
chorioangioma. it is a benign vascular tumor
35
When does the umbilical cord form
week 5
36
what grows faster the abdomen or intestines? Why do we know this
intestines grow faster. we know this because they herniate at 7 weeks
37
How many arteries and veins are included in the umbilical cord? What brings blood to the fetus?
2 arteries and 1 vein. The arteries bring blood out and vein brings blood in.
38
What substance surrounds the umbilical cord?
wharton's jelly
39
What is the normal length of the umbilical cord? Do we measure it?
40-60 cm. It is difficult to assess with ultrasound
40
Where do the umbilical arteries arise from? What type of blood do they carry
fetal internal iliac arteries. deoxygenated blood
41
What joins the fetal left portal vein? What kind of blood does it carry
the umbilical vein. oxygenated blood
42
at what point is a cord considered "short"
when it measures <35
43
Which direction does a cord typically coil
left
44
IF there is a cystic mass in the end of the umbilical cord, what would you suspect it to be
omphalomesenteric
45
Where does an omphalocele come from and what is it
It is the failure of intestines to return to abdomen. It is a hernia that contains bowel or intestines
46
what is gastroschisis
defect of the umbilical wall where the bowel escapes through the defect. it is NOT covered by membranes
47
Are omphalomesenteric cysts most common in boys or girls
girls
48
What is hemangioma of the umbilical cord
nodule surrounded by edema and degeneration of Wharton’s jelly
49
Does hematoma of hte cord have a good or bad prognosis?
poor. 47-52% of hematomas result in death
50
What is occlusion of one or more cord vessels called? Where does it primarily occur?
Thormbosis of umbilical vessels. It primarily occurs in the umbilical vein.
51
What is the prognosis of a fetus with umbilical vein thrombosis?
very poor prognosis
52
What might be a cause of a true knot of the cord?
long cords, polyhydraminos, monoamnio twins.
53
what might a false knot of the cord look like?
vessels fold over on themselves and produce Nodulatoins on the cord surface
54
What is the most comon cord entanglement in a fetus?
nuchal cord
55
what is nuchal cord?
when multiple coils of the cord are around the fetal neck.
56
What is aneurysm of the umbilical cord?
focal dilation of umbilical artery
57
What is varix of the umbilical cord?
focal dilation of umbilical vein. has a good prognosis
58
What produces amniotic fluid
umbilical cord, kidneys, lungs, skin
59
What are the functions of amniotic fluid
it acts as a cushion, allows for movement, prevents membrane from adhering to fetus, maintains a constant temp
60
When does production of urine and swallowing begin?
between weeks 8 and 11
61
Is abnormal umbilical flow more common in patients with oligo or poly hydraminos
oligohydraminos
62
What single pocket and AFI measurements determine oligohydraminos??
single pocket less than 2cm or AFI total less than 5
63
At what gestational age is Premature Rupture of Membranes determined?
it's not at a specific gestational age
64
At what gestational age is Preterm/Spontaneous Premature Rupture of Membranes determined?
before 37 weeks
65
What is amniotic band syndrome? does it cause fetal malformations?
fibrous bands from the amniotic sac tangle the fetus and can cause indentations and defects
66
what is an amniotic sheet? does it cause fetal malformations?
folds of thicker amniotic bands floating through the amniotic cavity. they do not cause fetal malformations
67
what is the most likely cause of amniotic sheets? What is the name of the syndrome when this pathology causes infertility?
uterine synechiae. when this causes infertility, it is called Asherman's syndrome
68
What is the functional part of the placenta
villi
69
How early can the palcenta be visualized?
8 weeks
70
Where is gastroschisis is usually seen in relation to the umbillicus
It is usually to the right of the umbillicus
71
What does ductus venosus do
shunts blood between the umbillical vein and IVC
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