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OB 2 > Abnormalities of the Placenta and Cord > Flashcards

Abnormalities of the Placenta and Cord Flashcards

1
Q

Low-lying placenta is considered when the inferior margin is how far away from the os?

A

Within 2cm

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2
Q

Increased placental thickness can be caused by?

A
  1. Maternal diabetes
  2. Immune hydrops
  3. Placental abruption
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3
Q

Decreased thickness of the placenta can be caused by?

A
  1. Maternal hypertension
  2. Preeclampsia
  3. IUGR
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4
Q

What can simulate placental thickening?

A
  1. Myometrial contractions
  2. Fibroids
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5
Q

What is the term for selective loss of parts of the placenta and growth of other parts?

A

Trophoblastic trophotropism

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6
Q

What is the term for a bilobed placenta?

A

Succenturiate

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7
Q

What is the term for a placenta where the fetal membrane insertion is flat?

A

Circummarginate

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8
Q

What kind of placenta has a rolled edge?

A

Circumvallate

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9
Q

Are succenturiate lobes clinically significant? Why or why not?

A

Yes, because they can cause postpartum hemorrhage and infection

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10
Q

When can placental shelves be detected on ultrasound?

A

Early second trimester

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11
Q

Risk factors for placenta previa?(4)

A
  1. Advanced maternal age
  2. Previous c-section
  3. Multiple gestations
  4. Cocaine or smoking
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12
Q

Why is it important that the bladder isn’t too full when evaluating the placenta?

A

If the bladder is too distended, it can squish the placenta and make it look as if it is closer to the os than it really is

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13
Q

What does MAP stand for?

A

Morbidly adherent placenta

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14
Q

MAP encompasses what three types?

A
  1. Accreta
  2. Increta
  3. Percreta - the most severe
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15
Q

Why has placenta accreta risen 10 fold in the past 50 years?

A

Due to increased rates of c-sections

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16
Q

What is the most common reason for an emergency postpartum hysterectomy?

A

Placenta accreta

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17
Q

When is delivery planned in cases of MAP?

A

34-35 weeks

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18
Q

What are the two most common risk factors for placenta accreta?

A
  1. Placenta previa
  2. Previous c-section
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19
Q

The loss of visualization of what structure indicates a MAP?

A

Retroplacental complex

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20
Q

When there is multiple vascular lacune present within the placenta, what may this be caused by and in what trimester?

A

Placenta accreta and in the third trimester

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21
Q

Do venous lakes within the placenta increase or decrease with GA?

A

Increase

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22
Q

Irregular anechoic structures within the placenta and found beneath the chorionic plate signify what?

A

Venous lakes

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23
Q

What causes subamniotic cysts?

A

Rupture of fetal vessels near umbilical cord insertion into the placenta

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24
Q

What are the two primary nontrophoblastic tumors of the placenta?

A
  1. Chorioangioma
  2. Teratoma
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25
Q

T or F? Small solitary chorioangiomas are of little clinical significance

26
Q

If there is a chorioangioma seen with vascular flow and measures 4cm, is it clinically significant?

A

No, it is reported that it may cause complications when >5 cm

27
Q

What is the term for the premature separation of all or part of the placenta from the myometrium?

A

Placental abruption

28
Q

What are the three types of placental abruption?

A
  1. Marginal
  2. Partial
  3. Complete
29
Q

Risk factors of placental abruption?(3)

A
  1. Maternal cocaine use and smoking
  2. Hypertension
  3. PROM
30
Q

What abnormality is thought to be cause by the rupture of the chorion without rupture of the amnion?

31
Q

What does PMD stand for?

A

Placental Mesenchymal Dysplasia

32
Q

What abnormality may be mistaken for a molar pregnancy and appears as “grape-like” vesicles in the placenta?

33
Q

What side is most common to see SUA?

34
Q

What trisomies can be seen with SUA?

35
Q

In a persistent RUV, the umbilical vein curves toward what rather than toward what?

A

L-sided stomach rather than the liver

36
Q

In what abnormality does the umbilical vein curve toward the left sided stomach rather than the liver?

A

Persistent RUV

37
Q

Body stalk anomaly vs. limb-body wall complex

A

Body stalk = NO umbilical cord

Limb-body wall = short umbilical cord

38
Q

What is body stalk anomaly associated with? (hint: cause)

A

Maternal cocaine use

39
Q

What length is a short umbilical cord defined as?

A

35cm or less

40
Q

In cases of vasa previa, when is hospitalization recommended?

A

32 weeks onward

41
Q

T or F? Bleeding from vasa previa is from maternal origin

A

False: it is from fetal origin

42
Q

In cases of umbilical cord cysts, the fetus is more likely to be abnormal when?

A

The cyst is located near the placenta of fetal extremity or if the cyst persists over 12 weeks GA

43
Q

Where are TRUE umbilical cord cysts located?

A

Near the cord insertion into the fetal abdomen

44
Q

T or F? True umbilical cysts have no increased risk of chromosomal anomalies

45
Q

What can Edematous whartons jelly be confused with?

46
Q

Imaging an umbilical cord that appears to contain a large mass with cystic areas, solid components, and calcifications indicates what pathology?

A

Edematous Whartons Jelly

47
Q

A nuchal cord is describes as what?

A

The umbilical cord wrapped around the fetal neck one or more times

48
Q

When does a true umbilical cord knot occur?

A

When the fetus passes through a loop of cord

49
Q

Fetuses with true knots are at fourfold risk of what?

A

Stillbirth

50
Q

Cord entanglement is a complication in what kind of pregnancies?

A

Monoamniotic

51
Q

What abnormality typically occurs in long umbilical cords, hypercoiled cords, and highly active fetuses?

A

Cord stricture

52
Q

T or F? Umbilical artery doppler is always assessed

A

False: It is only assessed when clinically indicated

53
Q

When should umbilical artery doppler NOT be done?

A

In low risk pregnancies

54
Q

In umbilical artery doppler, how many measurements should be taken and what is reported?

A

At least 3 S/D ratios should be taken and the LOWEST one should be reported

55
Q

T or F? When performing cord doppler, the waveform should always be monophasic in a healthy fetus

A

TRUE - waveform doesn’t dip below the baseline

56
Q

A placenta is considered abnormal when it measures what?

A

> 4cm before 24 weeks

57
Q

If the placenta measures 5cm at 30 weeks, is this normal or abnormal?

A

Normal. It is abnormal if pregnancy is less than 24 weeks

58
Q

If the placenta measures 5cm at 30 weeks, it this normal or abnormal?

A

Normal. It is abnormal if pregnancy is less than 24 weeks

59
Q

With a morbidly adherent placenta, what does the placental tissue invade?

A

The decidua basalis and myometrium (accreta) and uterine wall (percreta)

60
Q

Patient presents with acute abdominal and pelvic pain and vaginal bleeding. On ultrasound you visualize a non-vascular subchorionic hematoma. What is the likely diagnosis?

A

Placental abruption - will NOT be vascular

61
Q

What 2 trisomies are most commonly associated with a SUA?

A

Trisomy 13 (P) and trisomy 18 (E)

OB 2 (20 decks)

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