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OBSTETRIC PATHOLOGY > ABNORMAL UMBLICAL CORD > Flashcards

ABNORMAL UMBLICAL CORD Flashcards

1
Q

Umbilical cord length in the first trimester

A

Is same length as CRL

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2
Q

Normal cord length

A

40 -60cm

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3
Q

Short umbilical cord length

A

< 35cm in length

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4
Q

Absence of cord twisting indirect sign of

A

Decreased feral movement

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5
Q

Obstetric problems seen with short umbilical cord

A

Preterm delivery
Decrease heart rate during delivery
Meconium staining

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6
Q

If - cord completed atretic

A

Fetus attached directly to placenta at umbilicus emphalocele is always present

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7
Q

Long umblicalcord

A

> 80cm

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8
Q

Long umblical cord associated with

A

Nuchal cord
True cord knots
Card compression
Cord presentation
Prolapse of cord
Umbilical cord stricture or torsion
Due to excessive feral motion

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9
Q

Variations in card diameter attributed to

A

Defuse accumulation of Wharton’s jelly

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10
Q

Umbilical cord masses

A

-cystic mass
Omphalocele
Gastroschisis
Umbilical herniation
Teratoma of umbilical cord
Aneurysm
Varix of cord
Hematoma
True knot of the cord
Angioma
Thrombosis

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11
Q

Omphalocele

A

Failure of - intestines to return to abdomen
Single loop of bowel or most of intestine

Covered by epithelium of cord

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12
Q

Gastroschisis

A

A right paralumbical defect involving all layers of abdominal wall

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13
Q

Castroshisis measurement

A

2-4 Cm

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14
Q

Castroshisis

A

Small bowelalway eviscerates through defect خارج می‌شود
Loops of bowel never covered by membrane

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15
Q

What blood factor is elevated in Gastroshisis
And why

A

AFP is elevated BCS gastroshisis directly exposed to AF

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16
Q

Umbilical herniation

A

When intestine return a normally in abdominal cavity
Prenatally or postnatally
Through inadequately
Closed umbilicus

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17
Q

At the cord insertion level using color Doppler
The umbilical arteries entering the abdomen in a normal location that excludes

A

Diagnosis of emphalocele

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18
Q

Omphalamesentric cyst

A

Cystic lesion of cord caused by persistence and dilation of segment of emphalo mesentric duct
Lined by epithelium of gastrointestinal

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19
Q

Cord cyst affect females over males
Closer to feral Cord insertion

A

Omphalamesentric cyst

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20
Q

Associated with the condition of Meckels diverticulum

A

Omphalomesentric cyst

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21
Q

Hemangioma of the cord

A

From transepitherial cells of vessels of umbilical cord
Surrounded by edema and myxomatous degeneration of Whartons jelly حاوی موکویید

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22
Q

Sites of origin of hemangioma of the cord

A

Main vessels of umbilical cord
Involve more than one vessel

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23
Q

What abnormality of the umbilical cord may develop nonimmune hydros

A

Hemangioma of the cord

24
Q

Hematoma of the cord

A

If blood clot new, mass is hyperechnic
If old, hype ethnicand separated
47% to 52% with feral mortality

25
Q

Thrombosis of the umbilical vessels

A

Occlusion of one or more cord vessels

26
Q

Thrombosis of the umbilical vessels primarily occurs in

A

Umbrical vein

27
Q

Thrombosis of the umbilical vessels incidence higher in

A

Infants of diabetic mother

28
Q

Thrombosis of the umbilical vessels secondary to

A

Torsion
Knotting
Looping
Compression
Hematoma

29
Q

Thrombosis of the umbilical vessels
Look for

A

Aneurysmal dilation of cord
Presense of feral hydros

30
Q

Umbilical cord knots divided

A

True knots
False knots

31
Q

Cord knots increase

A

Incidence of congenital anomalies

32
Q

Cord knots associated with

A

Long cords
Polyhydramnios
IUGR
Mono-amniotic twins
Decreased velocity in the blood flow

33
Q

False knots of the cord

A

Blood vessels are longer than cord

34
Q

Often folded on themselves und produce modulations on surface of cord

A

False knots of the cord

35
Q

Most common cord entanglement in fetus

A

Nuchal cord

36
Q

Umbilical cord insertion Abnormalities

A

Marginal insertion
Circumvallate placenta
Velamentous
Succenturiate lobe

37
Q

Battledore or marginal insertion of the cord complications

A

When cord inserted near internal os
Labor may cause cord to prolapse
Become compressed during contractions

38
Q

Membranous or velamentous cord insertion Iî risk of

A

Thrombosis
Cord rupture during delivery
Vasa previa

39
Q

Vasa previa and prolapse of The cord is high risk when

A

Fetus in transverse or breech presentation

40
Q

Vasa previa and prolapse of The cord meaning

A

Presence of umbrical cord vessels crossing internal OS

41
Q

Vasa previa and prolapse of The cord reason for high mortality rate

A

Ranging from 60 to 70%
Caused from rupture of vessels and fetal
Exsanguination

42
Q

Single umbilical Artery more frequent

A

Miscarriage
Autopsy series

43
Q

Single umbilical artery associated anomalies affected other organs such as

A

Musculoskeletal
Genitourinary
Cardiovascular
Gastrointestinal
Central nervous

44
Q

Single umbilical artery complications and risks

A

Congenital anomalies
Increase incidence of IUGR
Prenatal mortality
Incidence of chrome sal abnormality
Trisomy 18,13,21
Turner’s syndrome
Triploidy

45
Q

Varix of the umbilical vein

A

Aneurysm and Varix
Focal dilation umbilical cord vessels
Artery and vein

46
Q

Focal dilation of the umbilical vein always

A

Intraabdeminal
Extrahepatic

47
Q

Regression of right umbilical vein happens in

A

By 6 weeks
Umbilical vein enters refi portal vein directly

48
Q

Sonographic diagnosis of persistent right umblical vein is

A

Umbilical vein curves towards the stomach
Fetal GB is medially to the umbilical vein
Btw the stomach and
The umbilical vein

49
Q

single umbilical artery

This finding is associated with:

C

A

This finding is associated with:
a. fetal demise
b. premature labor
c. multifetal gestations
d. maternal diabetes mellitus

50
Q
  1. Which of the following is the most common placental location for deposits of fibrin to collect?
A
  1. Which of the following is the most common placental location for deposits of fibrin to collect?
    a. basal plate
    ***b. subchorionic
    c. within a placental lake
    d. within the retroplacental complex
51
Q

•Cystic mass

A

•Cystic mass
› cord usually omphalomesel
allantoic in origin
Generally small (<2 cm)
•Near fetal end of cord
Resolve by second trimester
Cysts that persist beyond first trimester us associated with other fetal anomalies and aneuploidy

52
Q

Angioma of the cord
(well-circumscribed echogenic

A

Angioma of the cord
(well-circumscribed echogenic mass that may cause cardiac failure and hydrops; alpha-fetoprotein level is increased; associated with a cyst caused by transudation of fluid from a hemangioma)

53
Q

Thrombosis of cord

A

secondary to compression or kinking, focal cord mass, true cord knots, velamentous cord insertion, cord entanglement in monoamniotic twins (commonly seen with fetal demise)

54
Q

Omphalomesenteric Cyst

A

Omphalomesenteric Cyst
• Is closer to fetal cord insertion
• Varies in size (up to 6 cm)
• Affects females over males with ratio of 5:3
• May be associated with the condition of Mecke diverticulum

55
Q

Hemangioma of the Cord

A

•Sites of origin are main vessels of umbilical cord;
may involve more than one vessel.
Rare
• When found near placental end of cord, size varies from small to large (up to 15 cm).
• Fetus may develop nonimmune hydrops.

56
Q

Membranous or Velamentous Insertion of

A

• Associated with:
• Higher risk of low birth weight
Small for gestational age
Preterm delivery
Low Apgar scores
Abnormal intrapartum fetal HR pattern

57
Q

Cord Presentation and Prolapse

A

Conditions predisposing to cord presentation and prolapse are as follo
Abnormal fetal presentation
•
•
Nonengagement of fetus because of prematurity
Long umbilical cord
• Abnormal bony pelvic inlet
• Leiomyomas
Polyhydramnios v
Vasa previa
Velamentous insertion of cord
Marginal insertion of cord in low-lying placenta
• Incompetent cervix with PROM

OBSTETRIC PATHOLOGY (7 decks)

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