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Test 1 (Twins & placenta) Flashcards

1
Q

five fetus

A

quintuplets

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2
Q

six fetus

A

sextruplets

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3
Q

seven fetus

A

septuplets

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4
Q

eight fetus

A

octuplets

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5
Q

gestation of singleton

A

40 weeks

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6
Q

gestation of twins

A

37 weeks

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7
Q

gestation of triplets

A

34 weeks

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8
Q

gestation of quadruplets

A

33 weeks

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9
Q

Fetal mortality rates are _________ that of singleton pregnancies

A

3-6 X

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10
Q

Neonatal mortality ______ that of single pregnancies.

A

7 X

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11
Q

why are all muplitple pregnancies have a higher fetal and neonatal mortality?

A

primarly due to much higher incidence of premature labour

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12
Q

what is the most reliable predictor of poor outcome?

A

amniotic fluid discordance

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13
Q

dizygotic fertilization of____ova by __________

A

two ova by two separate spermatozoa

-not identical

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14
Q

features of dizygotic zygotes?

A
  • Two embryos
  • Two chorions
  • Two amnions
  • Two placentas (which may fuse)
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15
Q

increased chance of dizygotic twins if:

A
  • increased maternal age
  • frequent pregnancies
  • pregnancy techniques
  • heredity
  • race
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16
Q

monozygotic develop from _______ and ________ which after _________

A

Develop from one ovum and one spermatazoa which after fertilization split into two

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17
Q

monozygotic twins are always ________

A

same gender

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18
Q

features of monozygotic twins

A
  • Two embryos
  • One or Two chorions
  • One or Two amnions
  • One or Two placentas
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19
Q

what do monozygotic twins have that are the same?

A
  • genes
  • blood group
  • physical features
  • eye and hair colour
  • ear shape and creases
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20
Q

what do monochorionic twins have a higher risk of?

A

3-5 times higher risk of perinatal mortality and morbidity than Dichorionic

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21
Q

what does the chorion form?

A

a septum between the amniotic sac

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22
Q

when is chorionic septum best visualized?

A

1st trimester

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23
Q

chorionic septum thickness dichorionic

A

2-3mm

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24
Q

chorionic septum thickness monochorionic

A

1.4mm

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25
Q

septum sign in di-chorionnic

A

twin-peak sign

lambda sign

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26
Q

septum sign in mono

A

T-SIGN

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27
Q

what are primary complications of multifetal pregnancies?

A
  • premature delivery
  • IUGR
  • demise of a co-twin
  • congenital malformations
  • CHD
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28
Q

since monochorionic twins share one placenta, what do they have a risk of?

A

haemodynamic complications

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29
Q

Discordant Growth

A

a significant size or weight difference between the two fetuses of atwin pregnancy

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30
Q

when is discordant growth more common in?

A

monochorionic pregnancies

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31
Q

What classifies growth discorance?

A
  • weight discordance greater than 15-25%

- EFW of smaller twin is under 10th percentile

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32
Q

equations for discordant growth?

A

larger twin EFW-smaller twin EFW/ larger twin EFW

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33
Q

IUGR

A

characterized by impaired fetal growth and inadequate placental function

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34
Q

the greater the discordance, the greater the liklihood:

A
  • Placental insufficiency
  • Twin-twin transfusion syndrome
  • Higher incidence with avelamentous cord insertion
  • Higher incidence with asingle umbilical artery
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35
Q

sonograpahic features of discordant growth

A
  • difference if CRL
  • EFW difference at 15-25%
  • oligohydramnios
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36
Q

growth differences of discordant growth weeks?

A

most profund >30 weeks

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37
Q

when is twin to twin transfusion only possible?

A

only in identical twins that are monochorionic, diamniotic

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38
Q

what happens to blood vessels in twin to twin transfusion?

A

single placenta contains blood vessel connections between the twins

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39
Q

what is twin to twin not caused by?

A

NOT inherited or genetic

NOT caused by trauma

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40
Q

what is the smaller twin called in TTTS?

A

donor twin (does not get enough blood)

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41
Q

what is the larger twin called in TTTS?

A

recipient twin (overloaded with too much blood)

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42
Q

with TTTS, in attempt to reduce its blood volume, what does the recipient twin do?

A

increase urine production and this twin has distended bladder and polyhydramnios
(donor twin is opposite)

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43
Q

what will oligohydramnios in the donor twin cause?

A

“stuck twin” wrapped by amniotic membrane

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44
Q

alternate name for TTTS?

A

“Twin Oligohydramnios/polyhydramnios syndrome”

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45
Q

what does TRAP stand for?

A

Twin Reversed Arterial Perfusion sequence (TRAP) Acardiac Twin

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46
Q

what happens if TRAP?

A

Anastomosis of vessels establishes a connection between the 2 circulations (unbalanced AA anastomosis).
Retrograde perfusion interferes with normal cardiac development so the acardiac fetus becomes dependant on the perfusion if the “pump” twin

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47
Q

what are missing in an acardiac twin?

A
  • head
  • cervical spine
  • upper limbs
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48
Q

what is blood that enters the acardaic twins abdomen?

A

deoxygenated blood that left the normal twin

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49
Q

why is the lower half but not the upper half of the acardaic fetus develop?

A

Most of the oxygen available is extracted when the blood enters the acardiac twin, allowing for some development of the lower body and extremities.
Once blood reaches the upper half of the body, oxygen saturation is extremely low, halting development of this area.

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50
Q

what is the acardiac twin known as?

A

parasite

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51
Q

what is the pump fetus?

A

the normal fetus

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52
Q

sonograhic findings of TRAP

A
  • reversed arterial perfusion on doppler

- umbilical cord with doppler shows arteries form placenta to acardiac twin, venous flow is opposite

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53
Q

fetus papyraceus

A

once the twin dies, most of the dead twin tends to be absorbed leaving behind a small flattened remnant

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54
Q

whata re complications for demise of co-twin?

A

twin embolization syndrome-the surviving healthy fetus affected by a monochorionic co-twin demise

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55
Q

what is another name for vanishing twin?

A

fetal resorption

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56
Q

vanishing twin

A

Afetusin a multi-gestation pregnancy which diesin uteroand is then partially or completely reabsorbed

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57
Q

what complications may happpen if a fetus is absorbed in 1st trimester?

A

usually no further complications other than first trimester bleeding

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58
Q

what what complications may happpen if a fetus is absorbed in 2nd trimester?

A
  • Premature labour
  • Infection due to the death of the fetus
  • Hemorrhage
  • At the end of the pregnancy, a low-lying fetus papyraceus may block the cervix and require acesareanto deliver the living twin.
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59
Q

what can the vanished twin die from?

A
  • A poorly implantedplacenta
  • Developmental anomaly that may cause major organs to fail or to be missing completely
  • Achromosomal abnormalityincompatible with life. Frequently the twin is ablighted ovum, one that never developed beyond the very earliest stages ofembryogenesis
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60
Q

Twin Embolization Syndrome

A

rare complication of a monozygotic twin pregnancy following an in uteri demise of the co-twin

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61
Q

what is the pathology of Twin Embolization Syndrome?

A

Acute haemodynamic shift from live to dead fetus resulting in hypoperfusion is more recently thought to play a role.

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62
Q

what is Twin Embolization Syndrome associated with?

A

There is usually an underlyingtwin-twin transfusion syndromeas a causative association.

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63
Q

thoracopagus

A

joined at chest

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64
Q

cephalo-thoracopagus

A

joined at head and chest

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65
Q

dicephalus

A

single trunk and 2 heads

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66
Q

craniopagus

A

joined at abdomen

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67
Q

omphalopagus

A

joined at abdomen

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68
Q

rachipagus

A

dorsal union of head and trunk

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69
Q

thoraco-omphalophagus

A

joined at chest and abdomen

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70
Q

Umbilical cord entanglement

A

one of more loops of cord being encircled around any part of the bodyor two umbilical cords getting entangled with each other

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71
Q

position

A

the part of the fetus that presents in the pelvis to the four quadrents of the maternal pelvis

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72
Q

lie

A

relationship between the longituidinal axis of the fetus and longitudinal axis of mother

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73
Q

when does the blastocyst begin the process of implantation?

A

after it attaches to the endometrial surface

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74
Q

what are the 2 cell layers of the trophoblast in the early stage of implantation?

A
  • outer syncytiotrophoblast

- inner cytotrophoblast

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75
Q

lacunae

A

blood filled spaces

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76
Q

where does the trophoblast network invade?

A

into the intervillous spaces

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77
Q

what is the appearance of the normal placenta?

A
  • relatively homogenous
  • retroplacental clear space is hypoechoic
  • venous laking
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78
Q

what are placental venous lakes?

A

formation of hypoechoic cystic spaces centrally within the placenta

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79
Q

what is the colour flow of placental venous lakes?

A

low-velocity intraplacental laminar flow

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80
Q

what are placental venous lakes associated with?

A
  • increased placental thickness
  • placenta accreta spectrum and abnormal placental vilous adherence
  • placental insufficiency, especially if seen early in pregnancy
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81
Q

where does normal placenta attach?

A

decidua basalis

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82
Q

how does the decidua seperate at delivery?

A

cessation of intra-placental flow as the myometrium contracts

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83
Q

when is low lying placenta or placenta previa seen and is considred normal?

A

1st and 2nd trimester

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84
Q

when is <14cm length of placenta abnormal?

A

20 weeks

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85
Q

when is <15cm length of placenta abnormal?

A

23 weeks

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86
Q

when is >3cm thickness of placenta abnormal?

A

20 weeks

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87
Q

when is >4cm thickness of placenta abnormal?

A

23 weeks

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88
Q

where should the cord insert on the placenta?

A

in the middle of the placenta

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89
Q

succenturiate lobe

A

single or multiple lobes connected to the main body of placenta by velamentous connection of the umbilical vessel (vessels traversing the membrane).

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90
Q

why must the accessory lobe of the placenta be reported?

A

make sure the placental accessory lobe is reatined after delivery

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91
Q

why is vascularity connection between the main placenta and succenturiate lobe important?

A

vessels are in proximity of the cervix this could be Vesa Previa

92
Q

bilobed placenta

A

two similarly sized placental lobes separated by intervening membrane.

93
Q

is there connected between bilobed placenta?

A

some vascular connection between lobes and umbilical cord may insert between lobes in membranes
SAME RISKS AS SUCCENTURIATE LOBE

94
Q

Velamentous cord insertion

A

umbilical cord inserts into the fetal membranes (choriamniotic membranes), then travels within the membranes to the placenta (between the amnion and the chorion).

95
Q

circumvallate placenta

A

fetal membranes (chorion and amnion) “double back” on the fetal side around the edge of the placenta.

96
Q

does the circumvallate placenta cause harm?

A

not to the fetus but is associated with increased chances of placental abruption and hemorrhage

97
Q

what can a free membrane of circumvallate placenta mimic?

A

a fetal membrane such as amniotic bands which have more ominous implications

98
Q

another name for placenta membranacea

A

placenta diffusa

99
Q

what is placenta membranacea?

A

all or most fetal membranes remain covered by chorionic villi, because the chorion has failed to differentiate into chorion leave and chorion frondosum.

100
Q

sonographic examination of Placenta membranacea?

A

placenta that is covering most or the entire uterine wall

101
Q

what condition is Placenta membranacea associated with?

A

placenta accreta, increta, percreta, and vasa previa

102
Q

what are pregnancy complications of Placenta membranacea?

A
  • Recurrent antepartum hemorrhages
  • Second trimester miscarriages
  • Preterm delivery
  • IUGR
  • Fetal demise
103
Q

what are delivery complications associated with Placenta membranacea?

A
  • post pardum hemorrhage

- placental retention

104
Q

Placenta Previa

A

placenta that partially or completely covers the internal os

105
Q

what are the 3 degrees of placenta previa?

A
  • complete previa
  • marginal previa
  • low lying placenta
106
Q

low lying placenta

A

or placental the edge is within 2 cm but not covering any portion of the internal os

107
Q

complete previa

A

IO completely covered

108
Q

marginal previa

A

IO partially covered

109
Q

placenta previa risk factors

A 
Maternal age
Parity
Smoking
Endometrial scar
Symptoms:
Bleeding ++
110
Q

what are the symtoms of placenta previa?

A

asymtomatic until the time of labour and delivery

111
Q

where is low lying placenta easier to diagnose?

A

anterior extending down in lower uterine segment

112
Q

can TVS be used in late pregnancy with bleeding?

A

no, use transperineal

113
Q

what is the first modality to diagnose placenta previa?

114
Q

what are the factors contributing to the relatively high false positive diagnosis of Placenta Previa?

A
  • Distortion of lower segment (by over distended bladder)

- Focal myometrial contractions

115
Q

placenta acreta

A

villi invade decidua

116
Q

placenta increta

A

villi invade myometrium

117
Q

placenta percreta

A

villi invade myometrium and serosa

118
Q

risk factors for placenta creta

A
  • Prior uterine surgery
  • Placenta previa
  • Unexplained elevated maternal serum (MS) Fetal Protein
  • Increased maternal free placental lactogen
  • Advancing maternal age
119
Q

sonographic signs of placenta accreta

A
  • Presence of coexisting placenta previa
  • Loss of the normal hypoechoic retro- placental – myometrial interface
  • Thinning of disruption of the hyperechoic subvesicular uterine serosa
  • Numerous placental lakes
120
Q

colour doppler for placenta creta

A
  • Diffuse lacunar blood flow throughout the placenta
  • Absence of normal sub-placental venous flow
  • Demonstration of vessels crossing the placental-myometrial disruption site
  • Dilated vascular channels between placenta and bladder or cervix
121
Q

management of placenta creta?

A
  • information on it is very important for delivery

- prenatal diagnosis allows uterine conservation and avoidance of massive blood loss at delievery

122
Q

what is placenta abruption?

A

seperation of the palcenta prior to delivery of fetus

123
Q

what is antepartum hemorrhage associated with?

A
  • Abdominal pain
  • Uterine hyper-tonicity (rigid or stiff uterus)
  • Uterine tenderness
  • Variable evidence of maternal hypovolemia (state of decreased blood volume; more specifically, decrease in volume of blood plasma)
  • Shock
124
Q

what does placenta abruption look like?

A

subplacental hematoma between the placenta and uterine wall

125
Q

when in pregnancy does subchorionic hematoma occur?

A

occur anytime during pregnancy, it is more common in the first half of pregnancy, and its appearance will change as the hematoma organizes.

126
Q

what is placental hematoma caused by?

A

bleeding from fetal vessels and located on the fetal surface of the placenta under chorion

127
Q

berus mole

A

very large subchorionic haemorrhage

128
Q

sonographic findings of placental hematoma

A
  • acute is similar to echogencity of placenta
  • organized becomes more hypoechoic and look like myometrium
  • thickening of placenta (worse outcome)
129
Q

how does a retroplacental hematoma appear?

A

mass of variable echogenicity between the uterine wall and the uterine surface of placenta.

130
Q

what is a maternal floor infarction?

A

diffuse entity overtaking the villi with a fibrinoid deposition at the maternal surface and basal plate, reaching in the placental substance.

131
Q

what does fibrin surrounding the villi do?

A

villi destructs nutrient exchange from mother to fetus.

132
Q

when are infarctions associated with increased paerinatal mortality?

A

when they are larger than 3cm or involving more than 5% of placenta

133
Q

what can lead to placental infarctions?

A

both maternal and fetal thrombophilias

134
Q

placental infarction sonographic appearance

A
  • Hyperechoic placental masses or (especially in maternal surface) placental thickening
  • Hyperechoic placental masses may be associated with central hypoechoic spaces as they organize.
135
Q

what commonly present with maternal floor infarction?

A

subchorionic cysts

136
Q

how is maternal floor infarction clinicallt characterized?

A

severe early onset fetal growth restriction with features of uteroplacental insufficiency.

137
Q

what is a risk when you have subchorionic cysts?

A

very high recurrence rate and carries a significant risk of fetal demise

138
Q

what are pathological characteristsics of suchorionic cysts?

A

massive and diffuse fibrin deposition along the decidua basalis and the perivillous space of the basal plate

139
Q

what are subchorionic cysts caused by?

A

maternal vascular disease

140
Q

what does subchoronic cysts result in?

A

uteroplacental ischemia and infarction of the villi

141
Q

what is the most common bengin tumor is the placenta?

A

chorioangioma

142
Q

what can large chorioangioma lead to?

A

Cardiac failure
Anemia
Hydrops
Death

143
Q

how do chorioangiomas appear?

A

as solid placental masses bulging towards the fetal surface of the placenta.

144
Q

what is the sonographic appearance of a chorioangioma?

A
  • Well circumscribed solid tumours in the placenta
  • They can range from hypoechoic to hyperechoic compared to echogenicity of placenta.
  • If > 5cm then Poor Outcome.
145
Q

how is the umbilical cord developed?

A

enveloped body stalk + ductus omphalo-entericus + umbilical coelom
`

146
Q

where does fusion occur in the umbilical cord?

A

between the 2 extra-embryonic mesoderm layers

147
Q

what is the diameter of the umbilical cord?

148
Q

what is the length of the umbilical cord?

A

30-90 cm (average 55cm)

149
Q

what does the interior umbilical cord contain?

A

whartons jelly (embryonic form of connecting tissue

150
Q

what is the purpose of whartons jelly?

A

protects the umbilcal vessels from possible mechanical pressure and creasing

151
Q

what does the umbilical cord contain? (vessels)

A
  • 2 relatively small umbilical arteries

- one larger umbilical vein

152
Q

is the umbical arteries deoxygenated or oxygenated?

A

Deoxygenated blood is returned from the fetal circulation to the placenta via the paired umbilical arteries.

153
Q

after birth what do the umbilical arteries become?

A

umbilical ligament

154
Q

what is the path of the umbilical vein?

A

It goes superiorly towards the liver to join the proximal portion of the LPV.

155
Q

what does the umbilical vein become after birth?

A

ligementem teres

156
Q

what is a very long cord associated with?

A

Asphyxia
Death due to knots
Multiple loops of nuchal cord
Cord prolapse

157
Q

what is a short umbilical cord associated with?

A

aneuploidy, and extreme IUGR.

158
Q

what is umbilical coiling?

A

distance between the same umbilical artery making one turn around the umbilical vein

159
Q

what is lower degrees of coiling associated with?

A

lesser degrees of fetal growth

160
Q

in the 2nd and 3rd trimester what is the largest contributer to the size of umbiliccal cord?

A

whartons jelly

161
Q

what is a small diamter in the umbilical cord a marker for in the 1st trimester?

A

pregnancy failure

162
Q

what is a small diamter (thin) in the umbilical cord a marker for in the 2nd or erd trimester?

163
Q

what is a thick cord in the umbilical cord a marker for in the 2nd or erd trimester?

A 
Aneuploidy
Diabetes,
Fetal macrosomia,
Placental abruption, 
Rhesus isoimmunization
164
Q

what is Rhesus Isoimmunization?

A

a small amount of the baby’s blood can enter maternal circulation and if she is Rh-negative and baby os Rh-positive the mother produces antibodies against antigen on baby

165
Q

when can Rhesus disease become worse?

A

with each additional Rh incompatible pregnancy.

166
Q

what are the 2 types of umbilical cord tumors?

A

hemangioma

teratoma

167
Q

are the umbilical cord tumors mailignant or benign?

168
Q

hemangiomas

A
  • occur near placental end

- may arise from one or more umbiical vessels or from remnant of embryonic vessles

169
Q

what are hemangiomas associated with?

A

still birth

170
Q

what is the appearance of an hemangioma?

A

Multicystic appearance and may be impossible to differentiate from a teratoma, hematoma or umbilical cord cyst.

171
Q

what is another name for hemangioma?

A

Angiomyxomas

172
Q

teratoma appearance

A

solid with/without cystic area

173
Q

what does a teratoma contain?

A

Contains tissue from all three germ cell types and occur in places where the components of the tumour are foreign to surrounding tissue.

174
Q

what is absent coiling associated with?

A
  • single umbilical artery
  • both marginal and velamentous umbilical cord insertions
  • multiple gestations
  • aneuploidy
  • preterm delivery
  • fetal demise
175
Q

where are umbilical cysts most frequently seen?

A

portions closest to fetus

176
Q

where do umbilical cysts develop from?

A

allantois and omphalomesenteric duct

177
Q

where may pseudo-cysts develop?

A

through liquefaction of Wharton’s Jelly giving the umbilical cord a hydropic appearance.

178
Q

if unbilical cord cysts perisist in the 2nd and 3rd trimester what could this cause?

A
  • Chromosomal abnormalities: Trisomy 13 and 21

- Structural abnormalities: genitourinary and gastrointestinal anomalies

179
Q

what is nuchal cord?

A

cord around neck

180
Q

what is single unbilical artery (SUA)?

A

congenital absence of either the right or left umbilical artery.

181
Q

in SUA, which artery is more common absent?

A

left umbilical

182
Q

when is SUA increased?

A

twins

maternal diabetes

183
Q

what is SUA due to?

A

secondary atresia or atrophy rather than primary agenesis of the artery

184
Q

what are associations with SUA?

A
  • Intra-uterine growth restriction (IUGR)
  • Aneuploidy
  • Renal abnormalities
  • Cardiac abnormalities
185
Q

what is Velamentous and marginal cord insertions?

A

When the cord inserts into the membranes and not the placental disc.

186
Q

when can Velamentous and marginal cord insertions be identified?

A

early as 10 weeks and routinely 11-14 weeks

187
Q

what is Velamentous and marginal cord insertions associated with?

A
  • IUGR
  • preterm delivery
  • congenital anomalies
  • low apgar scores
  • neonatal death
  • retained placenta after delivery
188
Q

what is vase previa associated with?

A
  • placenta previa
  • multiple gestations
  • in vitro pregnancies
189
Q

with vasa previa what should be offered prior to onset of labour?

A

elective caesarean

190
Q

what is given before an early C-section?

A

Corticosteroids at 28 to 32 weeks to promote fetal lung maturation and hospitalization at about 30 to 32 weeks.

191
Q

why is Umbilical arterial Doppler assessment used?

A

in surveillance of fetal well-being in the 3rd trimester of pregnancy.

192
Q

what is abnormal umbilical artery doppler a marker of?

A

of uteroplacental insufficiency and consequent IUGR or suspected pre-eclampsia

193
Q

what has umbilical artery doppler assessment been shown to improve?

A

perinatal mortality and morbidity in high risk obstetric situations

194
Q

umbilical cord doppler indications

A
  • Assessment of fetal growth and well being in the 3rd trimester: routinely includes umbilical Doppler assessment
  • Indicated in scenarios where there is increased risk of FGR or poor perinatal outcome
195
Q

maternal conditions umbilica cord doppler

A
  • diabetes mellitus
  • chronic renal disease
  • hypertension
  • prothrombotic states
  • pregnancy related conditions
196
Q

suspected IUGR umbilical cord doppler

A
  • previous pregnancy with IUGR or fetal death in utero
  • decreased fetal movement
  • oligohydramnios
  • polyhydramnios
  • multifetal pregnancy
197
Q

what is normal umbilical venous doppler?

A

comprises of a monophasic non-pulsatile flow pattern with a mean velocity of ~10-15 cm/s

198
Q

what does the presence of pulsatility imply?

A

a pathological state

199
Q

when does pulsatility not imply a pathological state?

A
  • Early in pregnancy: up to ~13 weeks gestation

- The presence of pulsatility may be higher in chromosomally abnormal fetuses even in early pregnancy

200
Q

what is a proplapsed cord?

A

Umbilical cord prolapse happens when the umbilical cord precedes the fetus’s exit from the uterus.

201
Q

what does amniochorionic membranes consist of?

A

fused amnion and smooth chorion

202
Q

when does memnranes fuse and finnish fusing?

A

begins at the end of 1st trimester and completes by 20 weeks.

203
Q

what is elevation or bulging of amniochorionic membrane associated with?

A

placental abruption and subchorionic hematoma

204
Q

what is Premature rupture of membranes (PROM)?

A

Rupture of the amniochorionic membrane prior to onset of labour.

205
Q

what is the major concern with PROM?

A

chorioamnionitis if PROM is longer than 24 hours with or without labour

206
Q

what are causes of PROM?

A

Incompetent cervix, multiple gestations, multiple amniocentesis and polyhydramnios

207
Q

what may Chorioamnionitis cause?

A

fetal or maternal dealth

208
Q

is pregnancy is less than 32 wks with PROM

A

Pregnancy is usually continued under very close assessment because the fetus is immature and high risk for neonatal respiratory distress syndrome.

209
Q

is pregnancy is more than 32 wks with PROM

A

Labour may be induced or a C-section can be performed.

210
Q

what does amniotic fluid consist of?

A
  • Desquamated fetal epithelial cell
  • Organic and inorganic salts
  • Proteins, fats, enzymes, hormones, carbohydrates, and pigments
  • Later urine and meconium are added
211
Q

what is the functin of amniotic fluid?

A
  • Amniotic fluid provides a medium in which fetus can move, grow and develop without pressure.
  • It maintains the environment temperature and helps maturation of fetal lungs
212
Q

when is urine production the major source of amniotic fluid?

A

after 16 weeks

213
Q

what do we measure when measuring AFV?

A

longest single pocket free of umbilical cord and fetal small parts

214
Q

AFV measurment oligohydramnois

215
Q

AFV measurment normal

216
Q

AFV measurment polyhydramnios

217
Q

what is oligohydramnois associated with?

A
  • Maternal drug intake
  • IUGR
  • Urinary tract anomalies
218
Q

how is oligohydramnois defined?

A

as more than 2 standard deviation (2 SD) below the mean for the specific GA.

219
Q

when is oligohydramnois reccomended for screening?

A

The 5th percentile value

220
Q

what is the normal cervical length?

A

greater than 30mm

221
Q

Cervical Incompetence

A

A medical condition in which a pregnant woman’s cervix begins to dilate (widen) and efface (thin) before her pregnancy has reached term.

222
Q

what may cervical incompetence cause during the 2nd and 3rd trimesters?

A

miscarriage or preterm birth

223
Q

what is another sign of cervical incompetence?

A

is funnelling at the internal orifice

224
Q

what is cervical funneling?

A

Opening of the internal cervical os with protrusion of the amniotic sac into the cervical canal.

225
Q

when is funneling normal?

A

after 32 weeks

Abnormal OB (7 decks)

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