Amsterdam protocol for placenta Flashcards
Surrogate for placental function
Placental weight
This has been suggested as a possible indicator of adequacy of placental reserve capacity in fetal growth restriction (FGR)
Fetoplacental weight ratio
Fixation of the placenta will affect its weight with an increase of _% to _%
-3% to 6%
This is the maximal liner dimension of the placenta
Length
This is the greatest dimension of the axis perpendicular to this linear measurement
Width
Three dimension measurements of the placenta include:
- Length
- Width
- Mural minimal and maximal thickness
Description of the umbilical cord should include (5):
- Average diameter of the cord
- Length
- Site of insertion in relation to the center/margin of the placenta
- the presence of strictures
- whether the cord appears to be hypocoiled or hypercoiled
How is the site of insertion in relation to the center/margin of the placenta determined?
by measuring the distance between the:
- insertion site
- nearest placental margin
Thin umbilical cords are associated with:
FGR
Thick umbilical cords are associated with (2):
- Maternal diabetes
- Fetal hydrops
Marginal insertion of the umbilical cord:
<1 cm from the nearest margin
Peripheral insertion of the umbilical cord:
<3 cm from the nearest margin
Umbilical cord insertions that are associated with an increased risk of adverse pregnancy outcomes including preterm delivery (2)
- Marginal
- Velamentous
Definition of Hypocoiling of umbilical cord
<1 coil per 10 cm
Definition of Hypercoiling of umbilical cord
> 3 coils per 10 cm
This feature in hypercoiled cords has been associated with stillbirth, and should be reported
Deep grooves between coils
Most common umbilical cord twist
Left twist
This twist is defined as diagonal seams running from upper left to lower right
Left twist
Minimum blocks to be submitted
4 blocks
Where should you get the roll of extraplacental membranes?
from the rupture edge to the placental margin, including part of the marginal parenchyma
Two cross sections of the umbilical cord that must be submitted?
- Fetal end
- approx. 5cm from the placental insertion end
Where should you get the full thickness samples of the placental disc?
central two-thirds
Upper third placental disc section includes (2)
- chorionic plate
- subjacent tissue
Lower third placental disc section includes
Basal aspect
A full-thickness sample should be taken from close to the umbilical cord insertion site to document (2)
- Fetal vascular ectasia
- Fetal and/or maternal inflammatory response
