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OB/GYN > Placenta > Flashcards

Placenta Flashcards

0
Q

Placenta

A

Vascular organ
Discoid shape
Weighs 500-600 g

Chorionic plate on fetal side
20 lobes
Basilar plate on maternal side adj to retroplacental complex

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1
Q

What is the earliest the placenta is seen on US

A

Week 12

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2
Q

Major functioning unit of placenta

A

Chorionic Villi

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3
Q

Functions

A

Protection, nutrition, respiration, excretion

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4
Q

Cord should insert

A

Centrally

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5
Q

May ID by 8-10 wks as

A

Focal thickening

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6
Q

Size

A

< or = 5 cm

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7
Q

Visualize retroplacental complex by

A

18 wks

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8
Q

Grading

A

0: smooth no Ca+, homo
1: sm Ca+ randomly dispersed
2: Ca+ of basilar plate
3: Ca+ intentions of pl extending from chorionic plate to basilar plate. See lobes.

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9
Q

Grade 3 < 34 wks inc risk for

A

IUGR, preeclampsia

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10
Q

Grade/calcification delay with, accelerated with

A

Maternal diabetes, Rh blood

HTN, IUGR, smoking, AMA

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11
Q

Bilobate placenta

A

2 lobes both equal in size. Cord inserts between both lobes.

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12
Q

Succentureate Lobe/Accessory Lobe

A

1 or more small lobes connect to main placenta. If retained after delivery, may hemorrhage. Connecting vessels may overly internal os.

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13
Q

Annular placenta

A

Doughnut, ring shape

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14
Q

Placenta membranacea

A

Covers surface of sac, very thin.

Placenta Diffusa: rare, covers most of uterine wall.

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15
Q

Circumvallate placenta

A

Placenta extends beyond chorionic plate. Curled up margins.

Assoc with bleeding and preterm.

16
Q

Synechiae

A

Amniotic sheets/folds, thick band with color flow

17
Q

Amniotic band syndrome/ ADAM complex

A

Rare, thin membrane of amnion freely cross sac. May entangle fetus. Risk of ABS with early amniocentesis

18
Q

Placenta size increase with

A

Diabetes, Rh, CMV, chorioangioma, abruption, twins, hydrops, fetal anemia, triploidy, maternal anemia

19
Q

Placental size decrease

A

IUGR, preeclampsia, infarction, toxemia, maternal cardio renal disease, trisomies, severe diabetes, chronic infection, htn

20
Q

Placenta Previa

A

Placental covers internal os

Complete/Total: covers both sides of cx canal
Partial/Marginal
Low lying: within 2 cm of io

Do c section

Painless vag bleeding

Inc with AMA, smoking, multiparity, c sections, low ut scars, trauma, hx D&C, twins, abnl fetal lie

Premature delivery, maternal hemorrhage, placenta accreta, post partum hemorrhage, IUGR,

Over distended bladder cause false positive

21
Q

Trophotropism

A

Hypertrophy of upper part & atrophy of lower part bc LUS isn’t as vascular

22
Q

Vasa Previa

A

Vessels overly internal os. High fetal mortality. C section.

23
Q

Abruption

A

Premature placenta detachment
Dangerous.

Knife like pain. Bleeding, shock, preterm labor, fetal distress/demise

Assoc with HTN, cocaine, vasc disease, trauma, preeclampsia, short umb cord, fibroids, previa

Hematoma. Retroplacental hemorrhage

24
Q

Placenta Accreta

A

Abnl placental attachment

Accreta: on myometrium, mildest, most common
Percreta: into myometrium
Increta: through serosa, rarest

Hx of c section + previa = 25% chance

25
Q

Chorioangioma

A

MC placental tumor

1%, benign vasc tumor, inc MSAFP, through fetal surface of placenta, solid, complex, usually near cord insert.

Large leads to hydrops, polyhydramnios, hemorrhage, premie, IUGR, demise, cardiomegaly

26
Q

Teratoma

A

Rare, usually benign, malignant very bad, complex mass with shadow.

27
Q

Mets to placenta

A

From mom: Melanoma, Breast cancer, lung cancer. Lung most common.

Fetal: neuroblastoma, leukemia

28
Q

Umbilical cord

A

2 arteries, 1 vein. Mickey Mouse, surrounded by Wharton’s Jelly for protection.

Length: 55cm at term.
Should insert centrally

29
Q

Marginal cord insertion / battledore placenta

A

Inserts within 2 cm of edge of placenta. (Inside placenta)

30
Q

Velamentous insertion

A

Cord inserts a distance away from placenta (cord inserts on membrane)

31
Q

Knotted cord

A

Difficult to ID, hazardous if construction occurs.

32
Q

Nuchal Cord

A

Cord around fetal neck, 20% of deliveries. Nurse unwraps cord when delivering.

33
Q

Cord prolapse

A

Part of cord presents before fetus. May compromise circulation. Dangerous at birth.

34
Q

Single Umbilical Artery / 2 Vessel Cord

A

1 artery at bladder. Mickey Mouse missing ear trvs.

Inc risk IUGR, tri 18, 13, 21

35
Q

Hemangioma

A

Benign vascular hyperechoic umbilical cord mass

36
Q

Teratoma

A

Ca+. Umbilical cord teratoma.

OB/GYN (32 decks)

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