Amsterdam protocol for placenta

Question 1

Surrogate for placental function

Answer 1

Placental weight

Question 2

This has been suggested as a possible indicator of adequacy of placental reserve capacity in fetal growth restriction (FGR)

Answer 2

Fetoplacental weight ratio

Question 3

Fixation of the placenta will affect its weight with an increase of _% to _%

Answer 3

-3% to 6%

Question 4

This is the maximal liner dimension of the placenta

Answer 4

Length

Question 5

This is the greatest dimension of the axis perpendicular to this linear measurement

Answer 5

Width

Question 6

Three dimension measurements of the placenta include:

Answer 6

• Length
• Width
• Mural minimal and maximal thickness

Question 7

Description of the umbilical cord should include (5):

Answer 7

• 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

Question 8

How is the site of insertion in relation to the center/margin of the placenta determined?

Answer 8

by measuring the distance between the:

• insertion site
• nearest placental margin

Question 9

Thin umbilical cords are associated with:

Answer 9

FGR

Question 10

Thick umbilical cords are associated with (2):

Answer 10

• Maternal diabetes

- Fetal hydrops

Question 11

Marginal insertion of the umbilical cord:

Answer 11

<1 cm from the nearest margin

Question 12

Peripheral insertion of the umbilical cord:

Answer 12

<3 cm from the nearest margin

Question 13

Umbilical cord insertions that are associated with an increased risk of adverse pregnancy outcomes including preterm delivery (2)

Answer 13

• Marginal

- Velamentous

Question 14

Definition of Hypocoiling of umbilical cord

Answer 14

<1 coil per 10 cm

Question 15

Definition of Hypercoiling of umbilical cord

Answer 15

> 3 coils per 10 cm

Question 16

This feature in hypercoiled cords has been associated with stillbirth, and should be reported

Answer 16

Deep grooves between coils

Question 17

Most common umbilical cord twist

Answer 17

Left twist

Question 18

This twist is defined as diagonal seams running from upper left to lower right

Answer 18

Left twist

Question 19

Minimum blocks to be submitted

Answer 19

4 blocks

Question 20

Where should you get the roll of extraplacental membranes?

Answer 20

from the rupture edge to the placental margin, including part of the marginal parenchyma

Question 21

Two cross sections of the umbilical cord that must be submitted?

Answer 21

• Fetal end

- approx. 5cm from the placental insertion end

Question 22

Where should you get the full thickness samples of the placental disc?

Answer 22

central two-thirds

Question 23

Upper third placental disc section includes (2)

Answer 23

• chorionic plate

- subjacent tissue

Question 24

Lower third placental disc section includes

Answer 24

Basal aspect

Question 25

A full-thickness sample should be taken from close to the umbilical cord insertion site to document (2)

Answer 25

• Fetal vascular ectasia

- Fetal and/or maternal inflammatory response