2P - Placental Abnormalities Flashcards
The basal plate lies against the uterine wall which is divided into portions by what?
Cotyledons
This is the fetal surface of the placenta where the umbilical cord inserts?
Chorionic plate
What variant of the placenta has one or more disparately smaller accessory lobes?
Succenturiate
Which variants of the placenta poses a higher risk for hemorrhage due to formation of previa?
Succenturiate and membranacea
Succenturiate is more significant with fetal hemorrhage, uterine atony, hemorrhage and endometritis
This variant of placenta is characterized by having a ring shape?
Placenta membranaceae
antepartum and
postpartum hemorrhage and fetal growth restriction.
variant of placenta where Central portion of a placental disc is missing?
Placenta fenestrata
common defect - only involves villous tissues;
rare defect - Actual hole in the placenta
This placental abnormality is characterized as a placenta thicker than 40mm and May be secondary to maternal diabetes or severe
maternal anemia, or to fetal hydrops, anemia, or infection
caused by syphilis, toxoplasmosis, parvovirus, or
cytomegalovirus?
Placentomegaly
This condition happens when the chorionic plate fails to extend to its periphery?
Extrachoral placentation
This extrachoral placentation is characterized sonographically by double fold can be seen as a thick,
linear band of echoes extending from one placental edge
to the other?
Circumvallate
This extrachoral placentation is associated with increased risk for antepartum bleeding,
abruption, fetal demise, and preterm birth.
Circumvallate
This extrachoral placentation is shown with Fibrin and old hemorrhage lie between the placenta and
the overlying sheer amniochorion
Circummarginate
This maternal placental blood flow disruption is Caused by slowing of maternal blood flow within theintervillous space?`
Subchorionic firbin deposition
This maternal placental blood flow disruption is caused by Stasis of maternal blood flow around an individual villus and results in fibrin deposition and can lead to
diminished villous oxygenation and necrosis of
syncytiotrophoblast
Pervillous fibrin deposition
Cross section: small, yellow-white placental nodules
are within the parenchyma
This is the extreme form of perivillous fibrin deposition
Maternal floor infarction
Thick, yellow or white, rim with corrugated surface
that impedes normal maternal blood flow into the
intervillous space
An intervillous thrombus which is colored red is recent or old?
Recent
White-yellow: older
Intervillous thrombus is Not associated with adverse fetal sequelae
1st week of placental hematoma appear?
Hyper or isoechoic
1-2 weeks: hypoechoic
After 2 wks: anechoic
What placental hematoma is also called as subchorionic hemorrhage
marginal hematoma
Hematoma between the placenta and its adjacent decidua?
Retroplacental hematoma
Also called as Breus mole or massive subchorionic hematoma?
Subchorial thrombus
Fetal blood flow disruption where affected portions of the placenta become non functional and the affected parts are mostly the villi, This is mainly caused by preeclampsia?
Fetal thrombotic vasculopathy
Fetal blood flow disruption most commonly occurring during the third stage of labor when cord traction ruptures a vessel near the cord insertion?
Subamnionic hematoma
Condition wherein there is § Increased number of capillaries within terminal
villi?
Chorangiosis
Requires ≥ 10 capillaries to be present in ≥ 10
villi in ≥10 fields viewed through a 10x
microscopic lens
Increased capillary number in stem villi, but
terminal villi are spared
Chorangiomatosis
Linked with fetal-growth restriction and
anomalies
Calcium salts, when present in placenta are most commonly seen where?
Basal plate
Grading of placenta? Placenta is homogenous, flat, smooth with no calcifications
Grade 0
Placental grading? Placenta has echogenic stippling at the basal plate
Grade 2
Placental grading? Placenta has scattered echogenicities and subtle chorionic plate
Grade 1
Placental grading? Placenta has echogenic indentations from the chorionic plate to the basal plate which create discrete components that resemble cotyledons. Basal plate densities also increased
Grade 3
Patient has a well circumscribed, rounded hypoechoic lesion near the chorionic plate and protruding into the amnionic cavity. What is the diagnosis?
Chorioangioma
What sized of chorioangioma can can symptoms start to show?
4 cm
What are the sequelaes of chorioangioma?
hydramnios, preterm delivery, and fetal growth restriction
What tumor marker is increased in chorioangioma?
MSAFP
What cardiac sequelae can result from chorioangioma?
fetal heart failure
treated with digoxin
Tumor metastasis towards the fetus is common? T or F?
False. Usually confined to the intervillous space
Most common metastatic tumor to the placenta altho still rare?
Melanoma
Chorioamnionitis usual routes of infection are ascending or descending?
Ascending
How many hours post rupture will the fetus be considered septic?
12 hours
What prevents the ascending infection of the upper reproductive tract of a woman?
Mucus plug
Infection of the full thickness of the placental membranes is called?
Chorioamnionitis
Infection of the chorionic plate and the umbilical cord is called?
Funsitis
What is the gross indicator of infection of the placental membranes?
Clouding of membranes
Placental lesion consisting of numerous small, light tan
nodules on amnion that overlies the placenta and is considered hallmark of prolonged and severe
oligohydramnios?
Amnion Nodosum
This disruption in fetal development causes formation of strings that entrap the fetus and cause amputation?
Amnion bands; amniotic band syndrome
What is the umbilical cord length at delivery?
40-70 cm
Cord length increases with increase in amniotic fluid
volume and fetal mobility
Fetus with down syndrome has short cords or long cords?
Short cords
Fetus with macrosomia usually has what kind of umbilical cords?
Large diameter cords
This is the number of complete coils divided by the length of
the cord in centimeters?
Umbilical cord index
Hypercoiling of the umbilcial cord is associated with?
Fetal demise
Hypocoiling of the umbilical cord is associated with?
IUGR and fetal acidosis and asphyxia
Most common aberration in umbilical vessel number?
Single umbilical cord artery
caused by secondary
atrophy of a previously normal umbilical artery
A single umbilical artery greatly increases what risk?
Aneuploidy
Amniocentesis is recommended
Most frequent anomalies are cardiovascular and
genitourinary
A condition wherein there is a connection between two umbilical arteries within approximately 3 cm of the placental insertion of the
cord?
Hyrtl Anastamosis
Anastomosis acts as a pressure equalizing system
between umbilical arteries
Epithelium-lined remnants of allantois and may
co-exist with a persistently patent urachus
True cyst
This may form from local degeneration of Wharton jelly
Pseudocyst
Cord insertion at placental margin is sometimes referred
to as a?
Battledore placenta
Cord is normally inserted at or near center of fetal surface of the placenta
Of little site normal, but umbilical vessel lose
protective Wharton jelly shortly before insertion
Umbilical vessels spread within membranes at a
distance from placental margin, which they reach
surrounded only by a fold of amnion.
Velamentous insertion
During sonography, a hanging noose sign was seen? What is the diagnosis?
Cord knots
These are knots from focal redundancies of a vessel or Wharton
jelly, with no clinical significance?
False knots
These knots are common among monoamniotic twins caused by active fetal movements?
True Knots
Focal narrowings of the diameter that usually develop near the fetal cord insertion site characterized by absence of Wharton jelly, stenosis or obliteration of cord and vessels at the narrow segment?
Stictures
Cord around the neck is called?
nuchal cord
This presentation occurs when the umbilical cord is the presenting part in labor ?
Funic presentation
Associated with fetal malformation
Rare and generally follow
rupture of an umbilical vessel,
usually the vein, and bleeding
into the Wharton jelly.
Cord hematoma
Umbilical cord vessel thrombosis are usually venous, arterial or both?
Venous
Marked focal dilatation that may develop within intra- amniotic part of umbilical vein or within its fetal intra- abdominal portion?
Umbilical vein varix
increased rates of fetal
demise, structural anomalies,
and aneuploidy
Rare congenital thinning of vessel wall with diminished
support from wharton jelly?
Association with single umbilical artery, trisomy
Umbilical Artery Aneurysm
