The Placenta and Umbilical Cord Flashcards
What is the role of the placenta?
growth, development, and maturation of a pregnancy
What is the placenta evaluated for?
size and shape, number, texture, location (relative to internal cervical os)
The placenta comes from?
The trophoblast becomes the chorion then the placenta
The outer trophoblast produces?
hCG
How does hCG contribute to pregnancy?
stops period by telling corpus luteum to thicken endo
The maternal side of the placenta is the?
basal layer
The fetal side of the placenta is the?
chorionic plate
Which part of the decidua does the chorion frondosum contact?
decidua basalis
The smooth chorion contacts?
decidua capsularis
What is a subchorionic hematoma?
bleed below chorionic cavity
What is ABS?
amniotic band syndrome; rupture of amnion causing bands that can wrap around or attach to fetal parts
ABS can lead to?
constrictures, deformations (clefts), amputations,
How do amniotic bands appear sonographicall?
thin and echogenic
What are amniotic sheets?
adhesions or fibrous scar tissue inside the myometrium
Amniotic sheets are also called?
amniotic folds or synechiae
True or False: Amniotic sheets can lead to fetal deformities
False
How can you determine whether or not there is an amniotic sheet?
color doppler (muscle will light up)
What can cause synechiae?
infection (STD), trauma, D&C
How do amniotic folds appear sonographically?
thick, echogenic, color flow
What are the main functions of the placenta?
source of nutrients, exchange of gases and waste products, hCG
The placenta should not exceed what thickness?
4 cm
A large placenta can be caused by?
diabetes
A small placenta can be caused by?
smoking
What is placental trophotropism?
when the uterus grows and the placenta “moves” with it; placenta does not actually move within cavity
What is the reason that placenta previa is not a concern in an early pregnancy scan?
placental trophotropism
What are the locations a placenta can have in a sagittal plane?
anterior, posterior, fundal, previa
What are the locations a placenta can have in a transverse plane?
anterior, posterior, right, left
A grade 2 placenta has?
basal linear echoes
A grade 3 placenta has?
prominent, calcified cotyledons
Most placentas are what grade?
0
Most placental lesions are?
collections/ pools of blood
What is a Breus mole?
a subchroionic hematoma larger than the GS
When do Breus moles occur?
first trimester
What is a circumvallate placenta?
The chorion and amnion fold over on the edge of placenta
What is a bipartite placenta?
placenta is divided into two equal sized lobes connected by vessels
A bipartite placenta is also called?
bilobed or bilobate
What is a succenturiate placenta?
A smaller lobe attached to a larger lobe by vessels
Succenturiate placenta is also called?
succenturiate lobe or accessory lobe
What is placenta membranacea?
placenta is abnormally thin and wraps around large area of decidua
Placenta membranacea is also called?
annular placenta or placenta diffusa
Placenta membranacea is also called?
annular placenta or placenta diffusa
What signals low lying placenta previa?
Edge is more then 2 cm away from internal os
What signals marginal placenta previa?
Edge is less than 2 cm away from internal os
What is partial placenta previa?
part of internal os is covered
What is complete placenta previa?
bulk covers internal os entirely
What is the cardinal symptom for placenta previa?
painless vaginal bleeding
What is placental abruption?
Placenta detaches from uterine wall before delivery
True or False: There is a risk of maternal and fetal death with placental abruption
True
What is the cardinal symptom of placental abruption?
painful vaginal bleeding
What are the three types of placental adherence?
accreta, increta, percreta
What is placenta accreta?
chorionic villi penetrated decidua but not the myometrium
What is placenta increta?
chorionic villi penetrates myometrium but not perimetrium
What is placenta percreta?
chorionic villi penetrates perimetrium
What is the most common placental tumor?
chorioangioma
What is a chorioangioma?
benign vascular tumor of the placenta (think fibroid)
A 3VC consists of?
one umbilical vein and two umbilical arteries
A 3VC consists of?
one umbilical vein and two umbilical arteries
A 2VC consists of?
One umbilical artery and vein
True or False: A 2VC poses a fetal risk
False; normal variant
A short umbilical cord is associated with what anomaly?
limb-body wall complex
A long cord is associated with?
False and True knots; funic presentation
What is a false knot?
folded loops with no complications
What is a true knot?
obstruct blood flow ; fetal demise; cloverleaf sign
What is cord prolapse?
loops of umbilical cord caught between vaginal wall and fetal head
True or False: nuchal cord poses no complications
True
What is umbilical vein thrombosis?
torsion, knotting, or compression of umbilical cord restricting blood flow
What is battledore placenta?
umbilical cord is inserted at edge
What is battledore placenta also called? What does it resemble?
marginal cord insertion; badminton racket
What is a velamentous insertion?
umbilical cord attaches to membranes
Velamentous insertion risks?
vasa previa (vessels near internal os)
True or False: A cord hematoma has a good prognosis
False; poor prognosis (50%)
What is funic presentation?
umbilical cord presents in the cervix
Which vessels provide the maternal blood supply to the placenta?
spiral arteries