Chapter 55 power point Placenta Flashcards

1
Q

Chorion frondosum
Chorion laeve
Chorionic plate
Basal plate

A

Embryogenesis

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2
Q

Forms fetal part of placenta; contains villi

A

Chorion frondosum

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3
Q

Nonvillious part of chorion around gestational sac

A

Chorion laeve

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4
Q

Fetal surface of placenta

A

Chorionic plate

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5
Q

Maternal surface of placenta

A

Basal plate

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6
Q
Respiration
Nutrition
Excretion
Protection
Storage
Hormonal Production
A

Function of the Placenta

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7
Q

Fetal blood continues inferiorly to return to placenta for respiratory and nutrient exchange

By term approximately 40% of fetal cardiac output is directed through umbilical circulation

A

Fetal-Placental-Uterine Circulation

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8
Q

Attachment of cord is usually near center of placenta

Abnormal cordal attachments to placenta are battledore and velamentous placenta

A

Cordal Attachments

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9
Q

Chorion
Amnion
Allantois
Yolk sac

A

Fetal membranes

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10
Q

Permitting fetus room to move
Assisting maintaining constant fetal body temperature
Serving as protective buffer for fetus
Allowing lungs to develop properly

A

AF functions

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11
Q

Forms during first 5 weeks of gestation
Is surrounded by mucoid connective tissue called Wharton’s jelly
Normal umbilical cord has one large vein and two smaller arteries

A

The Umbilical Cord

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12
Q

found in approximately 1% of all singleton births and 7% of twin gestations

Congenital malformations seen in 25% to 50% of infants with SUA

A

Single umbilical artery

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13
Q
Abnormal trophoblastic invasion of spiral arteries of maternal uteroplacental circulation associated with:
Placental insufficiency 
IUGR 
Preeclampsia 
Placental abruption
A

Doppler Evaluation of the Placenta

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14
Q
Normal term placenta has several characteristics 
Measures about 15 to 20 cm in diameter
Discoid in shape 
Weighs about 600 g 
Measures <4 cm in thickness
A

Evaluation of the Placenta After Delivery

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15
Q

> 5 cm thick edge to edge

A

Placentomeglay

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16
Q

Intrauterine growth restriction
Intrauterine infection
Aneuploidy

A

Small Placenta

17
Q

Implantation of placenta over internal cervical os

Normally implants in body or fundus of uterus

In one of 200 pregnancies placenta implants over or near to internal os of cervix

Risk increases with history of cesarean delivery

A

Placenta Previa

18
Q
Advanced maternal age
Smoking 
Cocaine abuse 
Prior placental previa 
Multiparity 
Prior cesarean section 
Uterine surgery
A

factors associated with placenta previa

19
Q
Preterm delivery 
Maternal hemorrhage 
Increased risk of placental invasion 
Increased risk of postpartum hemorrhage 
IUGR
A

Complications of placenta previa

20
Q

may present with painless, bright red vaginal bleeding in third trimester

25% of patients will present with bleeding during first 30 weeks

20% of cases associated with uterine focal myometrial contractions

Abnormal lie also associated with placenta previa

A

Clinical placenta previa

21
Q

Abnormal penetration of placental tissue beyond endometrial lining of uterus

Variants of placenta invasion exist

A

Placental Invasion

22
Q

Chorionic villi attach to myometrium without muscular invasion

Placenta accreta occurs in approximately 1 in 2500 deliveries

A

Placenta accreta

23
Q

penetration of the chorionic villi through the uterus

A

Placenta percreta

24
Q

the chorionic placve of the placenta is smaller than the basal plate, with a flas interface between the fetal membrane and the placenta

A

Circummarginate Placenta

25
Q

condition where the chorionic plate is smaller than the basal plate, the margin is raised with a rolled edge

A

Circumvallate Placenta

26
Q

May occur within or around placenta

Is more commonly seen than placental abruption

Locations include retroplacental, subchorionic, subamniotic, and intraplacental sites

A

Placental Hemorrhage

27
Q

Echogenicity depends on age of the hemorrhage.

Acute bleed similar to echogenicity of placenta

Subacute and chronic bleed becomes more hypoechoic.

Bleed may be retroplacental or subchorionic.

A

Placental Hemorrhage sonographically

28
Q

Results from rupture of spiral arteries and is “high-pressure” bleed

Is associated with HTN and vascular disease

Hematoma is between placenta and uterus

If blood remains retroplacental, patient may have no vaginal bleeding

A

Retroplacental Abruption

29
Q

Most common type of abruption

Known as subchorionic bleeds

Hemorrhage results from tears of the marginal veins and represents “low-pressure” bleed.

Arises from edge of placenta, dissects beneath placental membranes and is associated with little placental detachment

A

Marginal Abruption

30
Q

Focal discrete lesion caused by ischemic necrosis

Is found in 25% of pregnancies, usually small with no clinical significance

Large infarcts may reflect underlying maternal vascular disease.

A

Placenta Infarcts

31
Q

Benign vascular tumor of placenta

Most common “tumor” of placenta

Usually small

Consists of benign proliferation of fetal vessels; majority are capillary hemangiomas that arise beneath chorionic plate

A

Chorioangioma

32
Q

Di/di: pregnancy probably dizygotic (97% chance)

Diamniotic/dichorionic/two placentas can occur in monozygotic pregnancies when division occurs during first 4 days of gestation

Mono/di or mono/mono: from monozygotic pregnancy

A

Placenta in Multiple Gestation

33
Q

Derived from two zygotes
Diamniotic/dichorionic/two placentas
Occurs during first 4 days of gestation

A

Dizygotic (fraternal twins)

34
Q
Derived from one zygote
Diamniotic/dichorionic/two placentas
Monochorionic/diamniotic/one placenta
Occurs during first week of gestation
Monochorionic/monoamniotic/one placenta
Occurs during second week of gestation
A

Monozygotic (identical twins)