12 - Placental Pathophys Flashcards
when does implantation into the uterus occur for a embryo?
from day 6-8 to 11-12
decidua
endometrium that has been hormonally changed by pregnancy
placenta creta - in general, types, when/why does it happen
abnormally deep implantation of embryo
onto myometrium - accreta
into - increta
through - percreta
happens when embryo implant in an area of deficient or absent decidua - lower uterus, cornua, scar (prev c section), fibroid, etc
who is more at risk for uterine rupture during labor/delivery?
pts who have had a c section
placenta previa
placenta partially or completely covers cervix
presents with antenatal painless vaginal bleeding
obligate c section delivery
problems with long and short umbilical cords
long >70 cm - increased cord accidents
short < 35 cm - problematic at delivery, reflect poor fetal mvmt (may be underlying problem)
velamentous cord insertion
when the umbilical vessels insert into the placenta from within the fetal membranes instead of from within the amniotic cavity as normal. makes them more prone to rupture at delivery
nl umbilical cord spiraling
7:1 left (ccw)
difference btwn cyto and syncytio trophoblast
cyto - progenitor cell
syncytio - terminal cell, acts as both epi and endothelium
twin transfusion syndrome
unequal bloodflow btwn monochorionic twins
donor twin doesnt get enough blood > growth restriction
recipient twin gets too much > cardiac overload
how do you get conjoined twins
ovum divides after 13 d
placental changes in preeclampsia
small placenta
usually multiple infarcts of different ages
accelerated maturation of villi
abruptio placenta
clinical dx w/ 2 or more of: antepartum hemorrhage after 20 wks retroplacental hematoma uterine pain or tenderness / no relaxation btwn contractions fetal distress or death
risk to fetus from gestational diabetes
fetal overgrowth, macrosomia
cardiomyopathy
hypoglycemia at birth
inc risk for resp distress
MCC late pregnancy loss (think broad)
placental problems
