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SONOCAN OB Review > Placenta Complications Notes > Flashcards

Placenta Complications Notes Flashcards

1
Q

What develops into the fetal portion of the placenta?

A

Chorionic leave

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2
Q

What is the chorion around the gestational sac on the opposite side of implantation called?

A

Chorionic plate

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3
Q

What are vascular projections from the chorion at the implantation and placental site?

A

Chorionic villi

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4
Q

What is the term for premature detachment of the placenta from the maternal wall?

A

Abruption placenta

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5
Q

What is the elongated duct that contributes to the development of the umbilical cord?

A

Allantoic duct

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6
Q

What is the placental condition in which the chorionic plate is smaller than the basal plate?

A

Circumvallate placenta

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7
Q

What occurs when the cord is completely wrapped around the fetal neck at a minimum of two times?

A

Nuchal cord

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8
Q

What is the maternal surface of the placenta called?

A

Basal plate

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9
Q

What is the abnormal proliferation of trophoblastic cells in the first trimester called?

A

Molar pregnancy

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10
Q

What is the term for cord insertion into the margin of the placenta?

A

Battledore placenta

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11
Q

What is the term for premature separation of the normally implanted placenta from the uterus?

A

Placental abruption

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12
Q

What are spontaneous uterine contractions occurring throughout pregnancy called?

A

Braxton-Hicks contraction

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13
Q

What is the term for the fetal surface of the placenta?

A

Chorion frondosum

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14
Q

What is placenta increta?

A

Growth of the chorionic villi deep into the myometrium.

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15
Q

What is placenta percreta?

A

Growth of the chorionic villi through the myometrium.

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16
Q

What is placenta previa?

A

Placenta completely covers the internal cervical os.

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17
Q

What is placental migration?

A

As the uterus enlarges and stretches, the attached placenta appears to ‘move’ further from the lower uterine segment.

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18
Q

What is the retroplacental complex? What three things is it composed of?

A
  1. Area behind the placenta
  2. Composed of the decidua, myometrium, and uteroplacental vessels.
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19
Q

What is a succenturiate placenta?

A

Additional placenta tissue (lobes) connected to the body of the placenta by blood vessels.

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20
Q

What is umbilical herniation?

A

Failure of the anterior abdominal wall to close completely at the level of the umbilicus.

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21
Q

What is vasa previa?

A

Occurs when the intramembranous vessels course across the cervical os.

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22
Q

What is Wharton jelly?

A

Mucoid connective tissue that surrounds the vessels within the umbilical cord.

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23
Q

The placenta develops from what? What is it formed by? How is it separated from the uterine myometrium? What is the blood supply to the intervillous spaces?

A
  1. Develops from trophoblastic cells that make up the chorion.
  2. Formed by the decidua basalis and decidua frondosum.
  3. Separated from the uterine myometrium by the retroplacental complex.
  4. Blood supply to the intervillous spaces is supplied by the maternal spiral arteries.
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24
Q

What returns through the placenta to the maternal blood?

A

Carbon dioxide.

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25
Q

What nutrients pass from the maternal blood to the fetal blood?

A

Nutrients.

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26
Q

What waste products cross from the fetal blood to the maternal blood?

A

Waste products.

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27
Q

What barrier does the placenta provide?

A

A barrier between the mother and fetus, protecting the fetus from maternal immune rejection.

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28
Q

What substances are stored in the placenta? 4

A
  1. Carbohydrates,
  2. Proteins
  3. Calcium
  4. Iron.
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29
Q

What hormones does the placenta produce? 3

A
  1. Human chorionic gonadotropin
  2. Estrogens
  3. Progesterone.
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30
Q

What is the vital support organ for the developing fetus?

A

The placenta.

31
Q

What is the major functioning unit of the placenta?

A

Chorionic villus.

32
Q

Where does maternal blood enter in the placenta?

A

The intervillous spaces.

33
Q

What passes through the placenta into the fetal blood?

A

Oxygen.

34
Q

What is the typical thickness of the placenta?

A

Generally, measures 2 to 3 cm in greatest thickness.

35
Q

What is the maximum thickness of the placenta in the second trimester?

A

Should not exceed 4.0 cm.

36
Q

What is the maximum thickness of the placenta in the third trimester?

A

Should not exceed 6.0 cm.

37
Q

What factors can cause premature maturation of the placenta? 4

A
  1. Maternal hypertension
  2. Cigarette smoking
  3. Intrauterine growth restriction
  4. Multifetal gestation.
38
Q

What does premature maturation of the placenta suggest?

A

Placental insufficiency.

39
Q

What is commonly associated with delayed maturation of the placenta?

A

Maternal diabetes mellitus.

40
Q

What characterizes Grade 0 placental maturity?

A

Thickened area of the hyperechoic gestational sac.

41
Q

What are the characteristics of the placenta in the second and third trimesters? 3

A
  1. Solid
  2. Homogeneous medium-gray structure
  3. Smooth edges and borders.
42
Q

What is seen behind the chorionic plate in the placenta?

A

Cystic areas (fetal vessels).

43
Q

What are placental lakes? When is it commonly seen?

A

Anechoic or hypochoic sonolucent areas within the placenta, insignificant and commonly displayed after 25 weeks.

44
Q

What is the appearance of the myometrium posterior to the retroplacental complex?

A

Myometrium appears as a thin hypochoic layer posterior to the retroplacental complex.

45
Q

What is characteristic of Grade 1 placental maturity? When is this most common?

A

Scattered calcifications throughout the placenta, most common up until 34 gestational weeks.

46
Q

Where can the blastocyst implant in the uterus?

A

Any portion of the decidua (endometrium).

47
Q

What are the possible positions of the placenta?

A

Anterior, posterior, fundal, right lateral, left lateral, or a combination (e.g., anterior fundal).

48
Q

What is Grade 2 placental maturity characterized by?

A

Calcifications along the basal plate and a slightly lobular chorionic plate.

49
Q

What defines Grade 3 placental maturity? 3

A
  1. Marked calcifications
  2. Placental lakes
  3. Distinct hyperechoic lobulations extending from the chorionic to basal plate.
50
Q

When is Grade 3 placental maturity usually not apparent?

A

Before 35 weeks’ gestation.

51
Q

What is the grading scale for placental maturity?

A

A scale of 0 to 3.

52
Q

What is placenta previa?

A

Placental placement in front of the fetus relative to the birth canal.

53
Q

What is the primary cause of painless vaginal bleeding in the third trimester?

A

Placenta previa.

54
Q

What are the risk factors for placenta previa? 6

A
  1. Advanced maternal age
  2. Multiparity
  3. Previous cesarean section
  4. Previous therapeutic abortion(s)
  5. Uterine leiomyoma
  6. Closely spaced pregnancies.
55
Q

What are the complications of placenta previa? 3

A
  1. Premature delivery
  2. Life-threatening maternal hemorrhage
  3. Increased risk of placenta accreta, stillbirth, and intrauterine growth restriction.
56
Q

What percentage of cases diagnosed with placenta previa in the second trimester remain at term?

A

Only 5%.

57
Q

What is the most accurate technique for diagnosing placenta previa?

A

Endovaginal technique.

58
Q

What technique can avoid fetal structures obscuring the internal cervical os?

A

Transperineal technique.

59
Q

How do you measure the distance for placenta previa diagnosis?

A

Measure the distance from the lower edge of the placenta to the center of the internal cervical os.

60
Q

What distance is associated with vaginal delivery in placenta previa?

A

A distance greater than 2 cm.

61
Q

What are some differential considerations for placenta previa? 4

A
  1. Overdistention of the urinary bladder
  2. Basal plate area larger than the ‘rolled up’ placental edge
  3. Placental abnormalities
  4. Placenta neoplasms.
62
Q

What forms a molar pregnancy?

A

Molar pregnancy is formed by the confluence of the chorionic veins of the placenta.

63
Q

What is the function of the umbilical vein?

A

The umbilical vein carries oxygenated blood to the fetus.

64
Q

Where do umbilical arteries exit?

A

Umbilical arteries exit at the umbilicus.

65
Q

What do umbilical arteries return to the placenta?

A

Umbilical arteries return deoxygenated (venous) blood from the fetus back to the placenta.

66
Q

What is considered abnormal regarding diastolic flow in umbilical arteries after 18 to 20 weeks gestation?

A

Absent or reversal of diastolic flow is considered abnormal after 18 to 20 weeks gestation.

67
Q

What is the normal insertion point of the umbilical cord?

A

The umbilical cord normally inserts into the center of the placenta and midline portion of the anterior abdominal wall of the fetus (umbilicus).

68
Q

What is the composition of the umbilical cord?

A

The umbilical cord is composed of one vein and two arteries surrounded by myxomatous connective tissue (Wharton jelly).

69
Q

What is the typical length of the umbilical cord during the second and third trimesters?

A

The umbilical cord is typically 40 to 60 cm in length during the second and third trimesters.

70
Q

What is the normal diameter of the umbilical cord?

A

The diameter of the umbilical cord usually measures <2.0 cm.

71
Q

What is the normal diameter of the umbilical vein?

A

The umbilical vein diameter normally measures <9 mm.

72
Q

What is the significance of coiling in the umbilical cord?

A

Coiling of the umbilical cord is normal and thought to aid in resistance to compression.

73
Q

How many spiral turns does the umbilical cord develop by birth?

A

The umbilical cord develops approximately 40 spiral turns by birth.

SONOCAN OB Review (22 decks)

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