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OB/GYN REVIEW > Placenta & Umbilical Cord > Flashcards

Placenta & Umbilical Cord Flashcards

1
Q

What are the functions of the placenta?

A 
Respiration
Nutrition
Excretion
Protection
Storage
Hormone Production
pg. E 160 O 412
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2
Q

What is the placenta formed from?

A

chorionic villi (decidua frondosum) and
maternal decidua basalis
pg. E 160 O 411

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3
Q

What is the functional unit of the placenta?

A

cotyledon

pg. E 160

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4
Q

How many cotyledons are there in the typical placenta?

A

12-20

pg. E 160

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5
Q

What does a grade 0 placenta look like?

A

no calcifications
smooth chorionic surface
up to 28-31 weeks
pg. E 161 O 413

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6
Q

What does a grade 1 placenta look like?

A

scattered calcifications
slight contouring of chorionic surface
31-36 weeks
pg. E 161 O 413

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7
Q

What does a grade 2 placenta look like?

A

basal layer calcifications
lobular chorionic surface
36-38 weeks
pg. E 161 O 413

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8
Q

What does a grade 3 placenta look like?

A 
basal layer calcifications
cotyledon calcifications
infarcts "fallout areas"
38 weeks +
pg. E 161 O413
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9
Q

What is a extrachorial placenta? and what are the names of each?

A

membranous chorion does not extend to edge
2 types: circumvallate and circummarginate
pg. E 162

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10
Q

What is a circumvallate placenta?

A

membranes insert away from placenta edge toward the center
has central chorionic ring surrounded by thickened amnion and chorion
pg. E 162 O 415

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11
Q

What is the sonographic appearance of a circumvallate placenta?

A 
rolled up placenta edge
irregular fold or thickening of placenta
upturned placental edge has cystic spaces
thick placental cord insertion
pg. O 415
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12
Q

What is a circummarginate placenta?

A

central attachment of the membranes without a central ring

pg. E 1162

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13
Q

What can happen with a circumvallate placenta?

A 
early separation from uterine wall 
risk of abruption
IUGR
premature labor
perinatal death
pg. E 162 O 415
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14
Q

What are the accessory types of placentas?

A

succenturiate
bipartite
annular
pg. E 162

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15
Q

What is a succenturiate placenta?

A

results from the lack of adjacent chorionic villi to atrophy
additional placental tissue next to main placenta connects by blood vessels
pg. E 162 O 415

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16
Q

What is a bipartite placenta?

A

placenta divided into 2 lobes but united by vessels and membranes
pg. E 162

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17
Q

What is an annular placenta?

A

ring shaped placenta

pg. E 162

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18
Q

When is a placenta considered to be placentomegaly?

A

> 5 cm AP/ > 4 cm

pg. E 163 O 412

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19
Q

What are the causes of placentamegaly?

A 
gestational diabetes
Rh isoimmunization
maternal infection
chorioangioma
multiple gestation
maternal anemia
hydrops fetalis
sacrococcygeal teratoma
partial mole
chromosome anomalies
abruption
pg. E 163
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20
Q

When is a placenta too thin?

A

< 1.5 cm

pg. E 163

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21
Q

Why might a placenta be too thin?

A 
pre-eclampsia
IUGR
diabetes (before pregnancy)
intrauterine infection
pg. E 163
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22
Q

What is placenta previa? what are the different types?

A 
placenta near/on cervical os
complete
partial
marginal
low lying
vasa
pg. E 163 O 414
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23
Q

What are the risk factors for placenta previa?

A 
advanced maternal age
multiparity
previous C-section
therapeutic abortion ( due to scarring)
closely spaced pregnancies
pg. E 164 O 413
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24
Q

What are the symptoms of placenta previa?

A

painless vaginal bleeding in the 3rd trimester

pg. E 164 O 413

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25
Q

What are complications of placenta previa?

A

premature delivery
maternal hemorrhage
increased risk of placenta accreta, stillbirth, IUGR
pg. O 414

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26
Q

What is a complete previa?

A

placenta completely covers internal cervical os

pg. E 164 O 414

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27
Q

What is a partial previa?

A

placenta partially cover internal cervical os

pg. E 164 O 414

28
Q

What is a marginal previa?

A

edge of placenta abuts cervical os

pg. E 164 O 414

29
Q

What is a low lying placenta?

A

edge of placenta lies within 2 cm of cervical os

pg. E 164 O 414

30
Q

What is a vasa previa?

A

fetal vessels cross over the internal os

pg. O 414

31
Q

What is abruptio placenta?

A

premature separation of all or part of a normally implanted placenta
pg. E 165 O 414

32
Q

What are risk factors for placental abruption?

A 
maternal hypertension
advanced maternal age
multiparity
smoking
trauma
cocaine
fibroids
pg. E 165 O 414
33
Q

What are the symptoms for placental abruption?

A

severe pelvic pain
vaginal bleeding
pg. E 165 O 414

34
Q

What are the sonographic findings of abruptio placenta?

A

elevation of placenta from UT wall
retroplacental fluid collection
thickened placenta
pg. E 165 O 414

35
Q

What is placenta accreta?

A

chorionic vill are in direct contact w/ myometrium but do not invade
pg. E 166 O 414

36
Q

What is placenta increta?

A

chorionic villi invade myometium

pg. E 166 O 414

37
Q

What is placenta percreta?

A

worst; chorionic villi invade UT serosa or bladder

pg. E 166 O 414

38
Q

What are placental lakes?

A

large pools of venous blood within placenta

pg. E 167 O 415

39
Q

What is a placental infarct?

A

Ischemic necrosis of placental villi resulting from interference w/ maternal blood flow to intervillous space
pg. E 167 O 415

40
Q

What are fibrin deposits?

A

pooling of maternal blood in subchorionic space
clinically insignificant
pg E 167 O 415

41
Q

What is an intervillous thrombosis?

A

fetal bleeding into intervillous space
clinically insignificant
pg. E 167 O 415

42
Q

What are the sonographic findings of a placental infarct?

A

anechoic areas in placenta
absence of blood flow on Doppler
pg. E 167

43
Q

What is a subchorionic hematoma?

A

accumulation of blood beneath the chorion

pg. E 168

44
Q

What is a chorioangioma?

A

placental hemangioma
vascular solid tumor of placental tissue
pg. E 168

45
Q

What is choriocarcinoma?

A

malignant form of trophoblastic disease seen as a intraplacental mass
pg. O 416

46
Q

What surrounds the umbilical cord?

A

Wharton’s jelly

pg. E 168 O 416

47
Q

What is the umbilical cord formed from?

A

fusion of the yolk stalk and allantoic ducts

pg. O 416

48
Q

What is the average length of the umbilical cord?

A

1st tri: equal to CRL
2nd and 3rd tri: 40-60 cm
pg. O 417

49
Q

What is the most common umbilical cord abnormality?

A

single umbilical artery

pg. E 169

50
Q

What are the associated abnormalities with single umbilical cord?

A 
GU anomalies
Trisomy 13 and 18
cardiovascular anomalies
CNS anomalies
omphalocele
pg. E 169 O 417
51
Q

What is an umbilical cord cyst?

A

nonvascular anechoic enlargement of umbilical cord

pg. E 170 O 417

52
Q

What is a nuchal cord?

A

cord that wraps around the neck

pg. E 170 O 417

53
Q

What is cord prolaspe?

A

cord protruding through cervix

pg. E 170 O 417

54
Q

What is a velamentous insertion associated with?

A

vasa previa

pg. E 171

55
Q

What is a velamentous cord insertion?

A

umbilical cord inserts into the membranes before the placenta
pg. O 417

56
Q

What is umbilical vein thrombosis?

A

torsion or knotting of cord leading to no flow to fetus (death)
pg. E 171 O 417

57
Q

What is a false knot?

A

coiling of the vessels appearing as a knot

pg. E 171 O 417

58
Q

What is another name for a marginal insertion?

A

battledore insertion

pg. E 172 O 415

59
Q

What is a battledore placenta?

A

cord inserts into the periphery of the placenta

pg. E 172 O 415

60
Q

When taking a RI, what should the umbilical cord S/D ratio be for 25-29 weeks?

A

3.3 S/D ratio

61
Q

When taking a RI, what should the umbilical cord S/D ratio be for 29-33 weeks?

A

2.9 S/D ratio

62
Q

When taking a RI, what should the umbilical cord S/D ratio RI be for 33-40 weeks?

A

2.5 S/D ratio

63
Q

In a normal pregnancy, the placental thickness should be relatively equal to what?

A

Gestational age in weeks + 10mm

URR EXAM

64
Q

Does the umbilical vein carry oxygenated blood or deoxygenated blood?

A

Oxygenated blood from mother to fetus

65
Q

Do the umbilical arteries carry oxygenated blood or deoxygenated blood?

A

Deoxygenated blood from fetus to placenta

66
Q

Where does an allantoic cyst develop?

A

Umbilical cord

OB/GYN REVIEW (16 decks)

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