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OB GYN REGISTRY > Ch. 17 The Placenta and Umbilical Cord > Flashcards

Ch. 17 The Placenta and Umbilical Cord Flashcards

1
Q

which side of the placenta is rough and irregular in nature

A

The maternal surface

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2
Q

The fetal surface of the placenta is smooth and covered by which membranes

A

chorionic and amniotic

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3
Q

List functions of the placenta

A

Secretion of progesterone
secretion of hCG
exchange of oxygen, waste products and nutrients between the fetus and mother

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4
Q

What is the fetal side of the placenta called

A

Decidua frondosum

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5
Q

What is the maternal side of the placenta called

A

Decidua basalis

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6
Q

Each functional unit of the placenta is known as a

A

Cotyledon (12-20 per placenta)

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7
Q

Describe the placental grades

A

Grade 0 - up to aprox 28-31 weeks, no calcs, smooth chorionic surface

Grade 1 - up to aprox 31-36 weeks, scattered calcs, slight contouring of chorionic surface

Grade 2 - up to aprox 36-38 weeks, basal layer calcs

Grade 3 - 38+ weeks, basal calcs, interlobar septal calcs (cotyledon formations), infarcts

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8
Q

Type of placenta that is characterized by a small central chorionic ring surrounded by thickened amnion and chorion. May predispose to abruption, ante bleeding, threatened ab

A

Circumvallate placenta

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9
Q

Type of placenta with a central attachment of the membrane without a central ring

A

Circummarginate placenta

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10
Q

An accessory lobe with vascular connections to the main placenta

A

Succenturiate placenta

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11
Q

Placenta divided into two lobes but united by primary vessels and membranes

A

Bilobed/ bipartite placenta

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12
Q

A ring shaped placenta

A

Annular placenta

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13
Q

Placenta thickness is usually less than

A

5 cm AP

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14
Q

List some causes of an increased placental thickness

A

GDM
maternal infection
chorioangioma
multiple gestation
maternal anemia
hydrops fetalis
sacrococcygeal teratoma
partial mole
chromosomal abnormalities
abruption (appears thick due to retroplacental clot)

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15
Q

List causes of a decreased placental thickness

A

Preeclampsia
IUGR
PGDM
Intrauterine infection
Poly (it appears thinner)

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16
Q

What measurement is considered a decreased placental thickness

A

<1.5 cm

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17
Q

List causes that may predispose a patient to placenta previa

A

Multiparous women
previous C-section
myomectomy
Multiple D&C causing uterine scarring

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18
Q

Most common symptom of placenta previa

A

Painless vaginal bleeding

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19
Q

Not a type of previa in which the placenta is within 2 cm from the internal os

A

Low lying placenta

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20
Q

Premature separation of all or part of a normally implanted placenta from the myometrium

A

Placental abruption

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21
Q

List predisposing conditions or factors of placental abruption

A

Maternal hypertension
AMA
mulitparity
maternal vascular disease
cigarette smoking
trauma
cocaine use
leiomyomas

22
Q

Symptoms of placental abruption

A

ABD PAIN with or without BLEEDING

23
Q

What are the two types of placental abruption?
Describe each

A

Concealed - hemorrhage is confined to the uterine cavity, detachment may be complete and consequences are severe, may be seen on US

External - blood drains through the cervical os. can be difficult to see on US if there is no more blood in retroplacental space

24
Q

Sono finds of placental abruption

A

evaluation of the plac from the uterine wall
retroplacental fluid collection of varying echogenicity (depending on age)
normal or thickened appearing plac

25
Q

Chorionic villi penetrate/perforate the myometrium

A

Placenta percreta

26
Q

Chorionic villi are in direct contact with the myometrium but do NOT invade

A

Placenta accreta

27
Q

Chorionic villi invade the myometrium

A

Placenta increta

28
Q

Sono finds of placenta accreta/percreta/increta

A

loss of normal hypoechoic retroplacental clear zone
excessive lacunae
hypervascularity

29
Q

What are placental lakes

A

pools of maternal venous blood within the placenta

30
Q

Pooling of maternal blood in the subchorionic space

A

Fibrin deposition

31
Q

Caused by fetal bleeding into the intervillous space with an increased incidence with associated Rh incompatibility

A

Intervillous thrombosis

32
Q

T or F, placental infarcts will demonstrate color flow with both color and power doppler

A

F, infarcts will have NO blood flow

33
Q

An accumulation of blood beneath the chorion

A

Subchorionic hematoma aka submembranous hematoma

34
Q

Vascular tumor of the placental tissue that is rare

A

Chorioangioma

35
Q

Large chorioangiomas (>5cm) may cause complications such as

A

Poly, fetal hydrops, it is associated with increased MS-AFP

36
Q

Sono finds of chorioangiomas

A

Solid well circumscribed plac mass, possibly near PCI

37
Q

What surrounds the umbilical cord

A

Whartons jelly and amnion

38
Q

The most commonly encountered umbilical cord abnormality

A

Two vessel cord aka bivascular cord - can be caused by primary agenesis or atrophy

39
Q

Anomalies associated with 2VC

A

GU anomalies
trisomy 13 and 18
cardiovascular anomalies (why Dr Bruner orders echo)
CNS anomalies
omphalocele

40
Q

Type of umbilical cord cyst that is a remnant of a duct and is located away from the fetus

A

Allantoic duct cyst

41
Q

An umbilical cord cyst that is located close to the fetus and contains remnants of GI tissue

A

omphalomesenteric duct cyst

42
Q

Emergent situation in which the umbilical cord protrudes through the cervix or adj to fetal presenting part

A

Cord prolapse

43
Q

Fetal vessels crossing the cervical internal os, passing between the cx and presenting part with the membranes intact

A

vasa previa

44
Q

Vasa previa is commonly associated with what placental anomaly

A

Velamentous insertion

45
Q

Umbilical vein thrombosis may occur in what cases

A

after intrauterine transfusion
during fetal blood sampling
diabetic mothers
non-immune hydrops

46
Q

Sono finds of umbilical vein thrombosis

A

increased echogenicity in the lumen of umbilical vessels
absence of color and spectral doppler

47
Q

True umbilical cord knots are rare, they occur mostly in what cases

A

Mono mono twins

48
Q

Attachment of the cord at the periphery of the placenta, the cord enters directly into the edge of the plac

A

Marginal / Battledore insertion

49
Q

Attachment of the cord to the membranes rather than to the placental mass.

A

Velamentous cord insertion

50
Q

Velamentous cord insertions may be associated with what fetal complications

A

IUGR
preterm birth
congenital anomalies

OB GYN REGISTRY (19 decks)

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