Placenta path I

Question 1

what is difference of fetal and maternal surface of placenta

Answer 1

fetal surface is flat

maternal has cotyledons

Question 2

what is important about looking at placenta post delivery

Answer 2

look at the cotyledons of the maternal size to make sure there isnt anything missing that could still be in mother attached to uterus

Question 3

what is important about looking at umbilical cord after birth

Answer 3

see how many aa/vv because if 2, 35% assoc with structural and chromosomal abnormalities

Question 4

when does placental implantation take place after fertilization

Answer 4

1-2 weeks

Question 5

what are the early functions needed for placental implantation

Answer 5

produce hCG to prevent loss of corpus luteum
re-model spiral aa for nutrition
anchoring villi
absorptive villi

Question 6

what occurs to endometrium under unfluence of P after ovulation

Answer 6

becomes secretory and blood vessel rich in preparation for implantation of the blastocyst

Question 7

where does exchange of fetal maternal blood take place

Answer 7

in the intervillous spacec between the choirionc villi surrounded by cytotrophoblasts and syncytiotrophoblasts

Question 8

what happens to smooth muscle cells of the apiral aa in pregnancy

Answer 8

invaded by endovascular cytotophoblasts which create high P arteriole system and low R lacunar system for the blood to pool and exchange nutrients

Question 9

abnormalities of the cytotrophoblasts can lead to what condition

Answer 9

preeclampsia

Question 10

metabolic transfer between mom and fetus occurs through what cells

Answer 10

syncytiotrophoblasts

Question 11

spontaneous abortions occur when

Answer 11

<12 weeks

Question 12

risk factors for spont abortions

Answer 12

smoking
inc maternal age
previous spont abortion

Question 13

what fetal factors could lead to spont abortion

Answer 13

chromosomal abnormalities
hydatidiform mole
neural tube defects

Question 14

what maternal factors could lead to spont abortion

Answer 14

endocrine disorders
luteal phase defect
physica uterine abnormalities
systemic disorders
TORCH infections
blood type incompatibility

Question 15

What are the TORCH pathogens

Answer 15

toxo, other, rubella, CMV, HSV

Question 16

spont abortion in 1st trimester is usually due to what

Answer 16

chromosomal abnormality

Question 17

spont abortion in 2nd trimester is usually due to what

Answer 17

mechanical

Question 18

spont abortion in 3rd trimester is usually due to

Answer 18

fetoplacental unit

Question 19

can you have bleeding during pregnancy that is okay

Answer 19

yes! painless usually

Question 20

predisposing conditions to ectopic pregnancies

Answer 20

PID, appendicitis, endometriosis, previous surgery, IUDs

Question 21

clinical Sx of ectopic pregnancies

Answer 21

severe abdominal pain: hematosalpinx

tubal rupture: intra-abdominal hemorrhage, shock

Question 22

Dx ectopic pregnancy

Answer 22

beta hCG, US, laparoscopy

Question 23

what is dichorionic diamnionic pregnancy

Answer 23

fraternal twins, each has on amnion, own chorion

Question 24

what is dichorionic diamnionic fused pregnancy

Answer 24

fraternal that share septum of chorion

Question 25

what is monochorionic diamnionic amnion

Answer 25

share chorion, separate amnion

Question 26

what is monochorionic monoamnionic

Answer 26

share everything– identical

Question 27

if jelly roll of placenta shows amnion on either side of thick chorion know its what type pregnancy

Answer 27

di di, fraternal twins

Question 28

if there is one chorion and 2 amnion on jelly roll of placenta

Answer 28

monozygous, identical twins

Question 29

what condition of twins can lead to death of one or both fetuses

Answer 29

monochorionic because can have disproportionate sharing of fetal circulations

Question 30

What is placenta previa

Answer 30

implantation in lower uterine segment

Question 31

abruptio placenta

Answer 31

retroplacental hemorrhage

Question 32

placenta accreta

Answer 32

placenta infiltrates in myometrium from lack of intervening decidua
placenta cannot detach after delivery

Question 33

what is the most common cause of antepartum hemorrhage

Answer 33

placenta previa

Question 34

how do we prevent antepartum hemorrhage in placenta previa

Answer 34

C section

Question 35

Sx placenta previa

Answer 35

painless bleeding in 3rd trimester

Question 36

Sx abruptio placenta

Answer 36

painful bleeding

Question 37

significant complication of abruptio placenta

Answer 37

preeclampsia

Question 38

bleeding from abruptio placenta requires what Tx

Answer 38

immediate delivery

Question 39

loss of decidua basalis because placenta attached to myometrium is called what

Answer 39

placenta accreta

Question 40

complication of placenta accreta

Answer 40

uterine rupture

Question 41

what are the types of placenta accreta

Answer 41

accreta is most shallow
increta
percreta- deep

Question 42

predisposing conditions for placenta acreta

Answer 42

endometrial scarring
previous C section
endometrial inflammation