Placenta path I Flashcards
what is difference of fetal and maternal surface of placenta
fetal surface is flat
maternal has cotyledons
what is important about looking at placenta post delivery
look at the cotyledons of the maternal size to make sure there isnt anything missing that could still be in mother attached to uterus
what is important about looking at umbilical cord after birth
see how many aa/vv because if 2, 35% assoc with structural and chromosomal abnormalities
when does placental implantation take place after fertilization
1-2 weeks
what are the early functions needed for placental implantation
produce hCG to prevent loss of corpus luteum
re-model spiral aa for nutrition
anchoring villi
absorptive villi
what occurs to endometrium under unfluence of P after ovulation
becomes secretory and blood vessel rich in preparation for implantation of the blastocyst
where does exchange of fetal maternal blood take place
in the intervillous spacec between the choirionc villi surrounded by cytotrophoblasts and syncytiotrophoblasts
what happens to smooth muscle cells of the apiral aa in pregnancy
invaded by endovascular cytotophoblasts which create high P arteriole system and low R lacunar system for the blood to pool and exchange nutrients
abnormalities of the cytotrophoblasts can lead to what condition
preeclampsia
metabolic transfer between mom and fetus occurs through what cells
syncytiotrophoblasts
spontaneous abortions occur when
<12 weeks
risk factors for spont abortions
smoking
inc maternal age
previous spont abortion
what fetal factors could lead to spont abortion
chromosomal abnormalities
hydatidiform mole
neural tube defects
what maternal factors could lead to spont abortion
endocrine disorders luteal phase defect physica uterine abnormalities systemic disorders TORCH infections blood type incompatibility
What are the TORCH pathogens
toxo, other, rubella, CMV, HSV
spont abortion in 1st trimester is usually due to what
chromosomal abnormality
spont abortion in 2nd trimester is usually due to what
mechanical
spont abortion in 3rd trimester is usually due to
fetoplacental unit
can you have bleeding during pregnancy that is okay
yes! painless usually
predisposing conditions to ectopic pregnancies
PID, appendicitis, endometriosis, previous surgery, IUDs
clinical Sx of ectopic pregnancies
severe abdominal pain: hematosalpinx
tubal rupture: intra-abdominal hemorrhage, shock
Dx ectopic pregnancy
beta hCG, US, laparoscopy
what is dichorionic diamnionic pregnancy
fraternal twins, each has on amnion, own chorion
what is dichorionic diamnionic fused pregnancy
fraternal that share septum of chorion
what is monochorionic diamnionic amnion
share chorion, separate amnion
what is monochorionic monoamnionic
share everything– identical
if jelly roll of placenta shows amnion on either side of thick chorion know its what type pregnancy
di di, fraternal twins
if there is one chorion and 2 amnion on jelly roll of placenta
monozygous, identical twins
what condition of twins can lead to death of one or both fetuses
monochorionic because can have disproportionate sharing of fetal circulations
What is placenta previa
implantation in lower uterine segment
abruptio placenta
retroplacental hemorrhage
placenta accreta
placenta infiltrates in myometrium from lack of intervening decidua
placenta cannot detach after delivery
what is the most common cause of antepartum hemorrhage
placenta previa
how do we prevent antepartum hemorrhage in placenta previa
C section
Sx placenta previa
painless bleeding in 3rd trimester
Sx abruptio placenta
painful bleeding
significant complication of abruptio placenta
preeclampsia
bleeding from abruptio placenta requires what Tx
immediate delivery
loss of decidua basalis because placenta attached to myometrium is called what
placenta accreta
complication of placenta accreta
uterine rupture
what are the types of placenta accreta
accreta is most shallow
increta
percreta- deep
predisposing conditions for placenta acreta
endometrial scarring
previous C section
endometrial inflammation
