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OB 1 > Chapter 22: Abnormalities of the Placenta and Umbilical Cord > Flashcards

Chapter 22: Abnormalities of the Placenta and Umbilical Cord Flashcards

1
Q

Focal dilation of an artery

A

aneurysm

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2
Q

placenta where the lobes are nearly equal in size and the cord inserts into the chorionic bridge of tissue that connects the two lobes

A

bilobed placenta

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3
Q

fatal condition associated with multiple congenital anomalies and absence of the umbilical cord

A

body stalk anomaly

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4
Q

very rare condition where there is massive subchorionic thrombosis of the placenta secondary to extreme venous obstruction

A

Breus mole

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5
Q

Attachment of the placenta membranes to the fetal surface of the placenta rather than to the underlying villous placental margin

A

extrachorial placenta

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6
Q

bending, twisting, and bulging of the umbilical cord vessels mimicking a knot in the umbilical cord

A

false knot

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7
Q

Periumbilical abdominal wall defect, typically to the right of normal cord insertion that results in free-floating bowel within the amniotic fluid

A

gastoschisis

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8
Q

condition characterized by multiple complex fetal anomalies and a short umbilical cord

A

Limb-body wall complex

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9
Q

occurs when the umbilical cord inserts at the placental margin

A

marginal insertion or battledore placenta

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10
Q

central anterior abdominal wall defect at the site of cord insertion into the fetal abdomen that results in abdominal organs protruding outside the abdominal cavity but contained by a covering membrane consisting of peritoneum, Wharton jelly, and amnion

A

omphalocele

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11
Q

term that refers to a thickened or hydropic placenta

A

placentamegaly

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12
Q

Linear extra-amniotic tissue that projects into the amniotic cavity with no restriction of fetal movement

A

synechia (asherman syndrome)

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12
Q

intraplacental area of hemorrhage and clot

A

thrombosis

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13
Q

result of the fetus actually passing through a loop or loops of umbilical cord creating one or more knots in the cord

A

true knot

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13
Q

vascular structure connecting the fetus and placenta that normally contains two arteries and one vein surrounded by Wharton jelly

A

umbilical cord

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13
Q

Method of assessing the degree of umbilical cord coiling, defined as the number of complete coils per centimeter length of cord

A

umbilical coiling index (UCI)

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14
Q

failure of the normal physiological gut herniation to regress into the abdomen, resulting in a small amount of bowel protruding into the base of the umbilical cord

A

umbilical hernia

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15
Q

tubular, anechoic structures found beneath the chorionic plate that correspond to blood-filled spaces found at delivery

A

venous lakes

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16
Q

Decreased placental thickness is considered when placenta is less than ____

A

1.5 cm

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17
Q

inferior margin of the placenta is within 2 cm of the internal cervical os

A

low-lying placenta

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18
Q

placental tissue entirely covers the internal cervical os

A

placenta previa`

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19
Q

choriona villi adhere directly to but do not invade the myometrium

A

placenta accreta

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20
Q

chorionic villi invade the myometrium

A

placental increta

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21
Q

chorionic villi invade through the myometrium into the uterine serosa and potentially into surrounding tissues

A

placenta percreta

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22
Q

First trimester sonographic markers for ______ are:
gestational sac implantation in the lower uterine segment
multiple irregular vascular spaces within the placental bed
cesarean scar implantation of the gestational sac

A

morbidly adherent placenta

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23
Q

Late second and third trimester sonographer markers for ______ are:
placenta previa
multiple vascular lacunae within placenta
loss of normal hypoechoic retroplacental zone
abnormal uterine serosa-maternal bladder interface

A

morbidly adherent placenta

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23
Q

What is the placenta responsible for?

A

nutritive, respiratory, and excretory functions

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23
Q

used to describe appearance based on amount of placental calcifications and degree of maturation

A

placental grading

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24
Q

The placenta should be between __ cm and __ cm.

A

2
4

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25
Q

“jelly-like placenta”

A

IUGR

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26
Q

The placenta normally develops where chorionic villi interfacing the ______ grow.

A

decidua basalis

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26
Q

selective loss of parts of placenta and growth of other parts
presumed to occur beauce placenta preferentially grows where there is sufficient decidua and vascular supply and atrophies where condition less favorable

A

trophoblastic trophotropism

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27
Q

presence of one or more small accessory lobes that develop in membranes at a distance from periphery of main placenta

A

succenturiate lobe

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28
Q

ring shaped placenta

A

annular placenta

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29
Q

Annular placenta and PM are associated with ______

A

placenta previa

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29
Q

placenta extending beyond limits of chorionic plate with attachment of placental membranes to the fetal surface of the placenta, inward from the edge, rather than to underlying villous placenta margin

A

placenta extrachorialis

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29
Q

2 types of placenta extrachorialis

A

placenta circummarginate
placenta circumvallate

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29
Q

fetal membrane insertion is flat
may be found in 20% of placentas

A

placenta circummarginate

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29
Q

transition where fetal membranes of chorionic plate terminate; has a rolled or raised edge

A

placenta circumvallate

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30
Q

implantation of placenta into lower part of the uterus covering internal cervical os, thus delivering before fetus

A

placenta previa

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31
Q

irregular subchorionic marginal cystic structures or infolding of placental margin with a thick, curled peripheral edge

A

placenta circumvallate

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31
Q

linear structure protruding into fluid-filled amniotic cavity

A

placenta circumvallate

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32
Q

inferior margin of placenta covers internal cervical os

A

placenta previa

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33
Q

inferior margin within 2 cm of internal os

A

low-lying placenta

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33
Q

abnormal implantation of placental into uterine wall

A

morbidly adherent placenta

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34
Q

involves a defect in the decidua basalis; allows chorionic villi to invade the myometrium

A

morbidly adherent placenta

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35
Q

occurs when the chorionic villi becomes abnormally adherent to uterine myometrium rather than uterine decidua; accounts for about 75% of cases

A

placenta accreta

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36
Q

occurs when there is villous infiltration into the myometrial surface; occurs in 18% of cases

A

placenta increta

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37
Q

chorionic villi infiltrate and penetrate through entire myometrium, breaching serosa, potentially invading surrounding maternal organs; occurs in 7% of cases

A

placenta percreta

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38
Q

Most common reason for emergency postpartum hysterectomy

A

morbidly adherent placenta

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39
Q

optimal time for delivery with MAPs

A

34-35 weeks after corticosteroid injection given

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40
Q

Two most important risk factors to MAPs

A

placenta previa
previous c-section

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41
Q

gestational sac embedded into cesarean section scar at level of internal cervical os at base of maternal urinary bladder

A

cesarean section scar implantation

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42
Q

Most common location of MAPs

A

anterior implantation in the lower uterine segment

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43
Q

irregular anechoic structures within placental parenchyma found beneath the chorionic plate

A

placental lakes

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44
Q

speculated to be end result of intervillous and subchorionic thrombosis; results from pooling and stasis of maternal blood in perivillous and subchorionic spaces

A

fibrin depositions

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45
Q

hypoechoic lesions in subchorionic area or within placental mass, or as linear echogenicities streaks within an anechoic lesions

A

fibrin depositions

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45
Q

intraplacental area of hemorrhage and clot

A

intervillous thrombosis

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46
Q

hypoechoic placental lesions of varying size that may contain linear echogenicities representing fibrin deposits

A

intervillous thrombosis

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47
Q

most commonly found midway between subchorionic and basal areas of placenta

A

intervillous thrombosis

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48
Q

massive subchorionic hematoma and thrombosis; heterogeneous and hypoechoic lesions

A

Breus mole

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48
Q

_______ may appear hypoechoic or show placental thinning

A

necrotic infarct

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48
Q

occurs as a result of obstruction of spiral arteries; usually found at periphery of placenta

A

placental infarction

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48
Q

most often found near the umbilical cord insertion under the thin amniotic layer covering the chorionic plate

A

subamniotic cysts/hematomas

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49
Q

result from rupture of chorionic (fetal) vessels close to umbilical cord insertion into placenta

A

subamniotic cysts/hematomas

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49
Q

two primary nontrophoblastic tumors

A

chorioangioma and teratoma

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49
Q

benign vascular malformation of the placenta arising from primitive chorionic mesenchyme

A

chorioangioma

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49
Q

can be associated with:
elevated maternal serum alfa-fetoprotein
beta-human chorionic gonadotropin levels

A

chorangioma

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49
Q

contain arteriovenous shunts that can lead to severe fetal complications

A

chorioangiomas

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49
Q

classifications of placental abruptions

A

retroplacental hemorrhage
intraplacental hemorrhage
marginal hemorrhage
subchorionic blood clot

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49
Q

sonographic diagnosis based on increased vascularity or a large feeding vessel inside tumor with same pulsation rate as umbilical cord

A

chorangioma

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49
Q

well-circumscribed hyperechoic or hypoechoic ovoid mass protruding from fetal surface of placenta near cord insertion

A

chorangioma

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49
Q

very rare; usually benign but can be highly malignant; may contain structures derived from three germ cell layers; complex mass of placenta with cystic and solid components; calcifications may be present

A

Teratoma

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50
Q

vascularization is supplied by fetal circulation through arteriovenous shunts from umbilical cord

A

chorangioma

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50
Q

premature separation of all or part of the placenta from underlying myometrium

A

placental abruption

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50
Q

What artery is the artery that a Doppler measurement taken from to assess chorangioma?

A

middle cerebral artery

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51
Q

Prognosis of placental abruption depends on:

A

degree of placental attachment
gestational age

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52
Q

Gravest prognosis of placental abruption

A

significant retroplacental hemorrhage involving over 30-40% of placenta

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53
Q

amnion is visible as a discrete free-floating membrane separate from the chorion surrounding the fetus

A

sonographic diagnosis of chorioamniotic separation

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54
Q

Most common fetal membrane abnormality structures or conditions

A

chorioamniotic separation
elevation resulting from subchorionic hemorrhage
membranes associated with multiple gestations and blighted ova
intrauterine synechiae

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55
Q

linear, extra-amniotic tissues that project into the amniotic cavity

A

amniotic sheets or intrauterine synechiae

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56
Q

sporadic condition that is thought to occur as a result of rupture of the amnion without rupture of chorion

A

amniotic rupture sequence or amniotic band syndrome

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57
Q

early rupture can result in malformations of cranium, central nervous system, face, and viscera

A

amniotic rupture sequence of amniotic band syndrome

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58
Q

In amniotic band syndrome, bands may tear or disrupt previously normally developed structures leading to:

A

congenital amputations
constriction rings
bizarre nonanatomic facial clefts

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59
Q

designation given to several disorders arising from either normal or abnormal fertilization of an ovum resulting in neoplastic changes in trophoblastic elements of developing blastocyst

A

Gestational Trophoblastic disease

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60
Q

classifications of gestational trophoblastic disease

A

complete or partial hydadatidform mole
metastic disease or choriocarcinoma

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61
Q

chorionic villi that are markedly hydropic and swollen; proliferation of the trophoblast cell resulting in excessive production of beta-human chorionic gonadotropin levels

A

complete hydadatidform mole; molar pregnancy

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62
Q

distention of uterine cavity by a heterogeneous echogenic mass with a snowstorm appearance; enlarged uterus filled with multiple variable-sized small anechoic cysts

A

molar pregnancy

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63
Q

absence of both amniotic fluid and a fetus

A

complete mole

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64
Q

presence of co-existing fetus along with an enlarged, thickened placenta with multiple cystic spaces

A

partial mole

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65
Q

represent deep growth of abnormal tissue into and beyond the myometrium

A

invasive mole

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66
Q

considered locally invasive non-metastasizing neoplasms

A

invasive mole

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67
Q

capable of metastasizing; appear as heterogeneous, echogenic, and hypervascular masses

A

choriocarcinomas

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68
Q

rare vascular placental anomaly; characterized by mesenchymal stem villous hyperplasia; presents as an enlarged placenta; may be mistaken for molar pregnancy

A

placental mesenchymal dysplasia

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69
Q

placentomegaly; dilatation of chorionic vessels; large areas of cystic villous changes along with areas of normal placenta

A

placental mesenchymal dysplasia

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70
Q

The umbilical cord normally contains ___ arteries and ___ veins surrounded by Wharton jelly, all enclosed in a layer of amnion.

A

2, 1

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71
Q

one of the most common congenital anomalies of the umbilical cord

A

single umbilical artery

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72
Q

possible mechanisms of SUA

A

primary agenesis of one artery
atrophy or atresia of a previously present artery
persistence of original allantoic artery in body stalk of embryo

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73
Q

The ____ umbilical artery is more commonly absent.

A

left

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74
Q

presence of more than 3 vessels

A

supernumerary vessels

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75
Q

exclusively associated with conjoined twinning

A

supernumerary vessels

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76
Q

may represent an abnormal splitting of umbilical vessels between the 3rd and 5th week of development

A

supernumerary vessels

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77
Q

condition where right umbilical (portal) vein, rather than left-sided umbilical vein, remains open

A

persistent right umbilical vein

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78
Q

umbilical cord vein curves toward left-sided stomach rather than toward liver; gallbladder located medial to vein rather than lateral

A

persistent right umbilical vein

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79
Q

a focal dilatation of umbilical vein

A

umbilical vein varix

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80
Q

The abdominal vein is greater than __ mm in umbilical vein varix.

A

9

81
Q

Enlargement of the varix of umbilical vein varix of at least ____ larger than diameter of intrahepatic umbilical vein.

A

50%

82
Q

complete absence of umbilical cord

A

body stalk anomaly

83
Q

fatal condition linked to maternal cocaine use

A

body stalk anomaly

84
Q

very short cord

A

limb-body wall complex

85
Q

average normal length of umbilical cord

A

55 cm

86
Q

considered an index of fetal activity and depends on tension created by freely mobile fetus primarily during second and third trimesters

A

length of cord

87
Q

defined as 35 cm or less

A

short cord

88
Q

vascular occlusions predisposal to long cord

A

thrombi and true knots
stricture
nuchal cord
cord entanglement
cord prolapse during labor

89
Q

at or near center of placental disk in over 90% of cases

A

normal insertion of umbilical cord

90
Q

also known as battledore placenta; cord inserts within a centimeter of placental margin rather than centrally

A

marginal insertion

91
Q

umbilical vessels separate and course between amnion and chorion at a distance from placental margin surrounded only by a fold of amnion devoid of Wharton jelly

A

Velamentous cord insertion

92
Q

some of velamentous fetal vessels run in lower uterine segment unprotected by Wharton jelly; traverse within fetal membranes on or near the region of the internal cervical os; easily compressed and prone to rupture occurs

A

vasa previa

93
Q

fetal morbidity of vasa previa with intact membranes

A

50-60%

94
Q

fetal morbidity of vasa previa with ruptured membranes

A

70-100%

95
Q

umbilical cord vessels lose Wharton jelly before entering chorionic plate; vessels exposed to external trauma

A

furcate insertion

96
Q

characterized by discordant fetal size, with polyhydramnios around larger twin and severe oligohydramnios associated with smaller “stuck” twin

A

twin-twin transfusion syndrome

97
Q

echolucent area within umbilical cord with yolk sac defined as separate structure

A

first trimester cystic cord masses

98
Q

The fetus is more likely to be abnormal if an umbilical cyst is located near ________ or persists between ___ weeks gestation.

A

placental or fetal extremity
12

99
Q

result from transient fluid accumulation because of coiling process or herniation of bowel interfering with fluid exchange within cord

A

umbilical cord cyst

100
Q

Umbilical cord cysts are defined as either _____ or _____.

A

true cysts
pseudocysts

101
Q

derviced from embryonic remnants of the allantois and omphalomesenteric duct; have no increased risk of chromosomals anomalies; represent vestigial patency of an embryonic structure; located near cord insertion into fetal abdomen

A

true cysts

102
Q

have no epithelial lining; represent localized edema of Wharton jelly or aneurysm of umbilical artery or vein; positive association with structural and chromosomal abnormalities trisomes 18 and 13

A

pseudocysts

103
Q

extremely rare benign tumors; also referred to as angiomyxoma, myxangioma, hemangiofibromyxoma, myxosarcoma

A

hemangiomas

104
Q

fusiform swellings in cord with presence of antiomatous nodule; usually located near placental insertion of cord; often surrounded by localized cystic degeneration and edema of Wharon jelly distinct from tumor

A

hemangioma

105
Q

benign lesions; very rare; may contain tissues derived from all three germ cell layers

A

teratomas

106
Q

disorganized polymorphic appearance; complex umbilcal mass containing cystic areas, solid components, and internal calcifications

A

teratomas

107
Q

result of either inadvertent laceration at time of amniocentesis or intentional mechanical penetration of umbilical vein during cordocentesis

A

hematoma

108
Q

extremely rare; high perinatal mortality; echogenic material within lumen of blood vessel; single artery umbilical cord with an additional collapsed third vessel

A

umbilical artery and vein thrombosis with occlusion

109
Q

when physiological herniation of midgut into proximal segment of umbilical cord does not resolve by 14th week

A

umbilical hernia

110
Q

small, irregular echogenic soft tissue mass identified in base of umbilical cord

A

umbilical hernia

111
Q

described as having umbilical cord loop around neck of fetus one or more times; appear and disappear throughout pregnancy

A

nuchal cord

112
Q

presence of cord lying around 3 of 4 sides

A

nuchal cord

113
Q

umbilical cord presenting part

A

funic or cord presentation

114
Q

may lead to prolapse of cord during active labor

A

funic or cord presentation

115
Q

defined as presentation of umbilical cord in advance of fetal presenting part during labor

A

cord prolapse

116
Q

occurs when fetus actually passes through a loop or loops of cord

A

true knot

117
Q

“cloverleaf” pattern of cord

A

true knot

118
Q

number of complete coils per centimeter

A

umbilical coiling index

119
Q

Normal umbilical cord index is on average _____

A

.02 coils/c m

120
Q

There is an average of _____ coils in cord

A

10-12

121
Q

Hypocoiled or undercoiled cords umbilical cord index

A

0.1 coils/cm

122
Q

hypercoiled or overcoiled cords umbilcal cord index

A

0.3 coils/cm

123
Q

“mass of umbilical cord”

A

cord entanglement

124
Q

notch in umbilical cord artery flow velocity waveform may identify pregnancies at immediate risk for :

A

cord accidents

125
Q

localized narrowing of cord with disappearance of Wharton jelly; associated torsion of cord or thickening of vessel walls with narrowing of lumen; often occurs with long umbilical cords and hypercoiled cords and in highly active fetuses

A

stricture

126
Q

The placenta increases in both _____ and ______ as gestation processes.

A

volume
thickness

127
Q

The normal placental thickness is generally between __ and __ cm.

A

2
4

128
Q

A _______ is a connected bridge of placental tissue.

A

bilobed placenta

129
Q

A _______ is a mass of placental tissue with a location distant from main placenta/

A

succenturiate lobe

130
Q

Placental extension beyond the chorionic plate with attachment of the placental membranes to the fetal surface of the placenta describes both ______ and ______ placents.

A

circummarginate
circumvallate

131
Q

Implantation of the placenta within 2 cm of the internal cervical os is considered a _____.

A

;low-lying placenta

132
Q

The term _____ refers to an abnormal implantation of the placenta into the uterine wall.

A

MAP

133
Q

A history of prior c-setion increases the risk of ______ development.

A

placenta accretac

134
Q

Anechoic structures inferior to chorionic plate with real-time imaging of swirling jets are normal ______.

A

placental lakesy

135
Q

Hypoechoic _______ are a normal finding in the placenta.

A

fibrin deposits

136
Q

Massive subchorionic hematoma and thrombis of the placenta is a rare occurrence called a _____.

A

Breus mole

137
Q

_____ has an association with placental infarction.

A

IUGR

138
Q

Large chorioangiomas, vascular malformations of the placenta, have an association with _______

A

serious fetal complications

139
Q

______ has a limited diagnosis with ultrasound.

A

placental abruption

140
Q

_______ is the rupture of fetal membranes with potential entrapment of fetal parts.

A

amniotic band syndrome

141
Q

_______ are extra tissue outside the amniotic sac without fetal entrapment.

A

Uterine synechiae

142
Q

_________ mimics a molar pregnancy.

A

placental mesenchymal dysplasia

143
Q

The average umbilical length is ___ cm.

A

55

144
Q

______ covers the outside of the umbilical cord.

A

Wharton jelly

145
Q

An umbilical cord with a ____ is associated with an increased incidence of chromosomal anomalies.

A

SUA

146
Q

Umbilical vein curvature to the left side of the fetal abdomen indicates a possible _______

A

persistent right umbilcal vein

147
Q

An ______ is a focal dilatation of the intra-abdominal umbilical vein that measures greater than 9 mm.

A

umbilical cord varix

148
Q

The umbilical cord may be absent or extremely short in ______ and _____.

A

limb-body wall complex
body stalk anomaly

149
Q

Abnormal cord insertions into the fetal abdomen are caused by either an ______ or ______.

A

ompalocele
gastoschisis

150
Q

Abnormal cord insertions into the placenta include ______, _____, _____, and ______.

A

marginal insertion
velamentous insertion
vasa previa
furcated insertion

151
Q

Cysts of the umbilical cord can be either ____ cysts or ____.

A

true cysts
pseudocysts

152
Q

______ is instrumental in demonstrating a nuchal cord.

A

Color Doppler

153
Q

______ occurs at birth if the cord presents before the fetus

A

cord prolapse

154
Q

Monochorionic/ monoamniotic twins have a significant risk for _______.

A

umbilical cord entanglement

155
Q

Umbilical cord torsion can result in ____ of the umbilical cord

A

stricture

156
Q

Placental hydrops produces a:

A

thick placenta with a “ground-glass appearance”

157
Q

A “jelly-like” placenta is associated with:

A

IUGR

158
Q

A succenturiate placenta:
a. has increased frequency in primigravidas
b . is ring shaped
c. most often have velamentous umbilical cord insertion
d. is edematous

A

c

159
Q

Circumvallate placental tissue is:
a. flat and noted on approximately 20% of placentas
b. associated with a thickened rolled chorioamniotic membrane
c. extremely rare, 1:20,0000 to 40,000 pregancies
d. prone to fetal macrosomia

A

b

160
Q

Risk factors for placenta previa include all except:
a. previous c section
b. multiple gestations
c. previous elective abortions
d. hypertension

A

d

161
Q

A placenta is considered low-lying if the inferior margin is:

A

within 2 cm of the internal os

162
Q

The most infiltrative form of placenta accreta is:

A

percreta

163
Q

Attachment problems of the placenta are known as all except:
a. morbidly adherent placenta
b. placental attachment disorder
c. abnormally invasive placenta
d. infiltrative myometrial placenta

A

d

164
Q

Placental infarction is:
a. visualized at the fetal placental surface
b. owing to obstructed spiral arteries
c. multiple hemorrhages into placental lakes
d. a factor in macrosomia

A

b

165
Q

A benign vascular malformation of the placenta is a:
a. teratoma
b. septal cyst
c. lacunae
d. chorioangioma

A

d

166
Q

Premature separation of all or part of the placenta from the myometrium is:

A

abruption

167
Q

Linear, extra amniotic tissue projecting into the amniotic cavity is noted often in pregnant women with a history of:

A

uterine curettage

168
Q

Amniotic band syndrome is a condition that:
a. involves free-floating membrane
b. is a result of rupture of the amnion without rupture of the chorion
c. is not revealed in the third trimester
d. involves the uterine septum

A

b

169
Q

A condition of pregnancy where the trophoblastic cells produce excessive amounts of beta-human chorionic gonadotropin is:

A

molar pregnancy

170
Q

SUA is associated with all except:
a. cardiovascular malformation
b. central nervous system defects
c. musculoskeletal abnormalities
d. skeletal dysplasia

A

d

171
Q

PRUV, a common vascular variant, describes:

A

open right portal vein

172
Q

TTTS is caused by:

A

monochorionic twin pregnancies sharing a placenta with anastomoses between the umbilical vessels

173
Q

Prenatal management of known umbilical pseudo and true cystss:
a. is not necessary because resolution is imminent
b. typically refers to MRI for evaluation
c. involves serial ultrasound examinations
d. displays echogenic characteristics near the placental insertion

A

c

174
Q

Cord prolapse is defined as:

A

presentation of the umbilical cord in advance of the fetal presenting part during labor and delivery

175
Q

Subamniotic cysts or subamniotic hematomas result from rupture of ______ close to the umbilical cord insertion into the placenta.

A

chorionic (fetal) vessels

176
Q

Selective loss of placental parts and growth of other parts is known as _______.

A

trophoblastic trophoism

177
Q

The ring-shaped annular placenta is related to postpartum _____ mostly owing to poor separation.

A

hemorrhage

178
Q

Acute placental abruption hemorrhage appears highly ______ on ultrasound

A

echogenic

179
Q

Choriocarcinomas appears as _______ , echogenic, and _______ masses.

A

heterogeneous
hypervascular

180
Q

Placenta accreta is mostly located in the _____, _____ uterine segment.

A

anterior implantation
lower

181
Q

Visualization of multiple ______ are highly suggestive of placenta accreta.

A

vascular lacunae

182
Q

Multiple chorioangiomas or those larger than ___ cm are related to maternal and fetal complications

A

5

183
Q

Early detection of fetal anemia is possible where chorioangioma is suspected, through Doppler measurements of the _____.

A

middle cerebral artery

184
Q

Extremely hydropic and swollen chorionic villi are frequently related to _____.

A

gestational trophoblastic disease

185
Q

Molar pregnancies have a characteristic ______ appearance with uterine cavity _____.

A

heterogeneous, echogenic mass
distention

186
Q

The most common reason for emergency postpartum hysterectomy is a ______.

A

morbidly adherent placenta

187
Q

A coexisting fetus with an enlarged thickened placenta revealing multiple small cystic spaces is a _____.

A

partial hydatidform mole

188
Q

The placenta may sonographically appear thickened in some cases of IUGR, with patchy areas of ______ and abnormal texture/

A

hypoechogenicity

189
Q

A two-vessel umbilical cord reveals the presence of a single umbilical _____ and is sometimes associated with congenital anomalies such as cardiovascular malformations, central nervous system defects, _______ or genitourinary defects, and ______ malformations.

A

artery
gastrointestinal
musculoskeletal s

190
Q

The umbilical vessel abnormality seen with conjoined twins is ______ vessels.

A

supernumerary

191
Q

Maternal cocaine abuse leads to the fatal condition _______.

A

body stalk anomaly

192
Q

Velamentous insertion is more frequent in _____ gestations.

A

multiple

193
Q

Compressed umbilical cords place the fetus at risk for _______ or ______ compromise.

A

fetal hypoxia
circulatory

194
Q

A successful method of identifying a nuchal cord is imaging using color Doppler technology.

A

Color Doppler

195
Q

The normal placenta typically increases in _____ and ____ with advancing gestation.

A

thickness
volume

196
Q

______ is sometimes used to describe the appearance based on the amount of placental calcifications and degree of maturation.

A

placental grading

197
Q

Placental size is expressed in terms of thickness in the midportion of the placenta and should be approx ____ cm.

A

2-4

198
Q

The placenta may appear thickened with patchy areas of hypoechogenicity and an abnormal texture

A

IUGR

199
Q

“jelly like placenta”

A

IUGR

200
Q

A ________ is the presence of one or more small accessory lobes that develop in the membranes at a distance from the periphery of the main placenta. It is connected to the main placenta by vessels within the membrane.

A

succenturiate lobe

201
Q

A _______ is distinguished from a bilobed placenta by a bridge of tissue that communicates between the two lobes and the cord insertion is in the chorionic tissue of the bridge.

A

succenturiate lobe

202
Q

Retained accessory lobes can be associated with ______ and _____.

A

postpartum hemorrhage
infection

203
Q

Succenturiate lobes are associated with an increased incidence of ______ insertion of the umbilical cord and _____, which are conditions that have significant maternal and fetal complications.

A

velamentous
vasa previa

204
Q

_______ refers to a ring-shaped placenta that attaches circumferentially to the myometrium and can be associated with antenatal or postpartum hemorrhage.

A

annular placenta

205
Q

the placenta extending beyond the limits of the chorionic plate with attachment of the placental membranes to the fetal surface of the placenta, inward from the edge, rather than to the underlying villous placenta margin

A

placenta extrachorialis

206
Q

fetal membrane insertion is flat

A

circummarginate

207
Q

thickened rolled chorioamniotic membranes peripherally

A

circumvallate

208
Q

associated with:
increased risk of maternal bleeding
placental abruption
premature labor and delivery
IUGR
prenatal death
fetal anomalies

A

complete circumvallation

209
Q

implantation of the placenta in the lower part of the uterus covering the internal cervical os, thus delivering before the fetus

A

placenta previa

210
Q

Four categories of placenta previa

A

complete previa
partial previa
marginal previa
low lying placenta

211
Q

inferior margin of placenta covers internal os

A

Complete previa

212
Q

inferior margin of placenta partial covers internal os

A

partial previa

213
Q

inferior margin of placenta is on the edge of the internal os

A

marginal previa

214
Q

inferior margin of placenta is within 2 cm of internal os

A

low-lying placenta

215
Q

an abnormal implantation of the placenta into the uterine wall

A

morbidly adherent placenta (MAP)

216
Q

chorionic villi adhere directly to the myometrium but do not invade the myometrium

A

placenta accrete

217
Q

chorionic villi invade the myometrium

A

placenta increta

218
Q

chorionic villi invade through the myometrium into the uterine serosa and potentially into surrounding tissues

A

placenta percreta

219
Q

most common reason for an emergency postpartum hysterectomy

A

morbidly adherent placenta (MAP)

220
Q

Sonographic markers for morbidly adherent placenta in the first trimester

A

gestational sac implantation in the lower uterine segment
multiple irregular vascular spaces within the placental bed
cesarean scar implantation of the gestational sac

221
Q

irregular anechoic structures within the placental parenchyma that are found beneath the chorionic plate

A

placental lakes

222
Q

end result of intervillous and subchorionic thrombosis, which results from pooling and stasis of maternal blood in the perivillous and subchorionic spaces

A

fibrin deposition

223
Q

hypoechoic lesions in the subchorionic area or within the placental mass, or as linear echogenic streaks

A

fibrin deposition

224
Q

intraplacental area of hemorrhage and clot

A

intervillous thrombosis

225
Q

hypoechoic placental lesions of varying size that may contain linear echogenicities representing fibrin deposits

A

intervillous thrombosis

226
Q

obstruction of the spiral arteries; usually found at the periphery of the placenta

A

placental infarction

227
Q

associated with retroplacental hemorrhage in up to 25% of term placentas

A

placental infarction

228
Q

rupture of chorionic (fetal) vessels close to the umbilical cord insertion into the placenta

A

subamniotic cysts or subamniotic hematomas

229
Q

most often found near the placental cord insertion under the thin amniotic layer covering the chorionic plate

A

subamniotic cysts or subamniotic hematomas

230
Q

Two primary nontrophoblastic tumors of the placenta

A

chorioangiomas
teratomas

231
Q

benign vascular malformation of the placenta arising from primitive chorionic mesenchyme

A

chorioangioma

232
Q

associated with:
elevated maternal serum alfa-fetoprotein
beta-human chorionic gonadotropin levels

A

chorioangioma

233
Q

contain arteriovenous shunts that lead to severe fetal complications

A

chorioangioma

234
Q

well-circumscribed hyperechoic or hypoechoic ovoid mass with increased vascularity protruding from the fetal surface of the placenta near the cord insertion

A

chorioangioma

235
Q

very rare, usually benign but can be highly malignant, may contain structures derived from the three germ cell layers

A

teratomas

236
Q

complex mass of the placenta with cystic and solid components; calcifications may be present

A

teratomas

237
Q
A

OB 1 (16 decks)

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