examination of the Placenta

Question 1

Why is it important to weigh and examine the placenta after delivery?

Answer 1

It is important to weigh and examine the placenta after delivery to assess its health and potential associations with maternal and fetal conditions.

Question 2

In what order should the placenta be examined systematically?

Answer 2

The placenta should be examined systematically in the following order: umbilical cord, membranes, maternal surface, and fetal surface.

Question 3

What should be noted about the weight of a healthy placenta at term?

Answer 3

A healthy placenta at term typically weighs about 550 grams, which is approximately one-sixth of the infant’s weight.

Question 4

What conditions are associated with a relatively heavy placenta?

Answer 4

Maternal diabetes, syphilis, or Rhesus disease are conditions associated with a relatively heavy placenta.

Question 5

What conditions are associated with a relatively light placenta?

Answer 5

Growth-restricted or wasted infants are associated with relatively light placentas.

Question 6

What major congenital abnormalities can a single umbilical artery be associated with?

Answer 6

A single umbilical artery can be associated with major congenital abnormalities, especially intestinal and renal issues, in 25% of cases.

Question 7

What does yellow staining of the cord suggest?

Answer 7

Yellow staining of the cord suggests Rhesus disease.

Question 8

What complication can a true knot in the umbilical cord cause?

Answer 8

A true knot in the umbilical cord may cause intrapartum hypoxia.

Question 9

What complication can be associated with insertion of the cord into the membranes?

Answer 9

Insertion of the cord into the membranes may cause severe fetal bleeding with rupture of the membranes, a condition known as vasa praevia.

Question 10

Is the site of cord insertion into the placenta important?

Answer 10

No, the site of cord insertion into the placenta is not important.

Question 11

What useful information can be gained from a placental examination?

Answer 11

Chorioamnionitis and amnion nodosum, indicative of severe oligohydramnios, can be diagnosed by examining the membranes, especially when the amnion is peeled away from the chorion.

Question 12

What does chorioamnionitis indicate during placental examination?

Answer 12

Chorioamnionitis is indicated by clouding over the placenta, suggesting inflammation of the fetal membranes.

Question 13

How is amnion nodosum identified during placental examination?

Answer 13

Amnion nodosum is identified by granular changes in the amnion, often associated with severe oligohydramnios.

Question 14

What do discreet, hard, pale infarcts on the maternal surface of the placenta indicate?

Answer 14

Discreet, hard, pale infarcts on the maternal surface indicate poor uteroplacental blood flow.

Question 15

What condition is suggested by retroplacental clots with compression of the placenta?

Answer 15

Retroplacental clots with compression of the placenta are suggestive of abruption.

Question 16

What complication might an area of extrachorial placenta on the fetal surface cause?

Answer 16

An area of extrachorial placenta on the fetal surface commonly causes painless vaginal bleeding, known as antepartum hemorrhage (APH) of ‘unknown cause’.

Question 17

How can histology help in the evaluation of placental abnormalities?

Answer 17

Histology can confirm conditions such as acute chorioamnionitis, chronic congenital intrauterine infection, or uteroplacental ischemia.

Question 18

How can chorionicity be assessed in like-sex twins with an apparent single placenta?

Answer 18

Chorionicity can be assessed by examining whether the vessels of both infants anastomose with one another or overlap the same territory on the fetal surface of the placenta.

Question 19

What distinguishes monochorionic from dichorionic placentation?

Answer 19

In monochorionic placentation, the vessels of both infants anastomose or overlap on the fetal surface of the placenta, while in dichorionic placentation, a clear border is seen between the two halves of the placenta.

Question 20

How can chorionic arteries be distinguished from veins in placental examination?

Answer 20

Chorionic arteries always cross over the veins on the placental surface.

Question 21

What is the significance of chorionicity assessment in twins?

Answer 21

Assessing chorionicity helps determine whether the twins are monozygous (identical) or dizygous (fraternal), which can have implications for their medical management and genetic counseling.