week 3- placental and umbilical cord pathology

Question 1

t/f: maternal and fetal circulation are separate

Answer 1

true

Question 2

deoxygenated fetal blood is carried to the placenta by what

Answer 2

umbilical arteries

Question 3

oxygenated blood returns to the fetus through

Answer 3

umbilical vein

Question 4

what plate of the placenta is the mothers

Answer 4

basal

Question 5

what plate of the placenta is the babies

Answer 5

chorionic plate

Question 6

placenta thickness

Answer 6

2-4cm

Question 7

what do we evaluate the placenta for when scanning

Answer 7

• location in relation to cervix (external os)
• texture
• cord insertion
• placental grade

Question 8

placenta thickness is said to be abnormal if > ___ prior to 24 weeks

Answer 8

4cm

Question 9

a pt has complaint of vaginal bleeding and abdominal pain, what are your next steps

Answer 9

evaluate the retroplacental area

Question 10

Succenturiate Lobe

Answer 10

accessory lobe of placenta

Question 11

prevalence of Succenturiate Lobe

Answer 11

6%

Question 12

Succenturiate Lobe attached to placenta via

Answer 12

• vessels within membrane

- bridge of membranes

Question 13

Succenturiate Lobe clinical significance

Answer 13

increased risk of infraction, placenta previa, vasa previa, post partum hemorrhage

Question 14

where does cord insert with Succenturiate Lobe

Answer 14

in the larger, main placenta

Question 15

where does cord insert with Bilobed Placenta

Answer 15

into a thin connecting rim of chorionic tissue between 2 lobes

Question 16

name for 2 lobes of placenta, similar in size

Answer 16

Bilobed Placenta

Question 17

prevalence of Bilobed Placenta

Answer 17

rare

Question 18

attachment of the placental membrane to the fetal surface rather than underlying villous placental margin

Answer 18

Circumvallate Placenta

Question 19

results in villi around the border of the placenta, that are NOT covered by chorionic plate

Answer 19

Circumvallate Placenta

Question 20

is Circumvallate Placenta clinically significant?

Answer 20

mostly no

Question 21

characteristic of Circumvallate Placenta

Answer 21

rolled up placental edge

Question 22

umbilical cord abnormality with a flat transition of the membranes inserting at some distance in from the placental margin

Answer 22

circummarginate placenta

Question 23

Rolled peripheral edge of the membranes as they insert at some distance in from the placental edge

Answer 23

circumvallate placenta

Question 24

umbilical cord inserts at the placental margin, also known as a battledore placenta. through the membranes to the placental disk

Answer 24

Marginal insertion

Question 25

umbilical cord inserts into the membranes at some distance from the placental mass, and the umbilical vessels course through the membranes to the placental disk

Answer 25

Velamentous cord

Question 26

There is the presence of an accessory lobe of the placenta at a distance from the main placental disk and umbilical vessels course through the membranes connecting the two placental masses

Answer 26

Succenturiate placentation

Question 27

Attachment of the placental membranes to the fetal surface of the placenta rather than to the underlying villous placental margin

Answer 27

circumvallate

Question 28

In circumvallate placenta, the villi around the border of the placenta are not covered by the ___ plate

Answer 28

chorionic

Question 29

Can result in limb deformities, spine and facial abnormalities, amputation

Answer 29

amnionic band syndrome

Question 30

sonographic appearance of ___: Collapsed amnion images –multiple linear wavy echoes

Answer 30

amniotic band syndrome

Question 31

implantation of the placenta completely crosses the internal OS

Answer 31

placenta previa

Question 32

edge of the placenta is abut or covering the OS

Answer 32

placenta marginal (partial previa)

Question 33

edge of the placenta is near but not abutting the internal OS

Answer 33

low laying placenta

Question 34

low laying placenta is

Answer 34

2c

Question 35

4 factors associated with placenta previa

Answer 35

- smoking - advanced maternal age - multiparity - prior c section

Question 36

the following are complications of___: - preterm delivery - maternal hemorrhage - increased risk of placental invasion - increased risk of postpartum hemorrhage - IUGR

Answer 36

placenta previa

Question 37

if the maternal bladder is full, the cervix is falsely ___ and may give false impression of ____

Answer 37

- elongated | - previa

Question 38

how to better demonstrate the internal cervical OS in TA scanning

Answer 38

- trendelenburg position (head lower than body) | - empty bladder

Question 39

best imaging tool for identifying the lower uterine segment

Answer 39

transvaginal

Question 40

3 types of placental invasion (penetration of placental tissue beyond endometrial lining of uterus)

Answer 40

1. placenta accreta 2. placenta increta 3. placenta percreta

Question 41

Chorionic villi attach to myometrium without muscular invasion

Answer 41

placenta accreta

Question 42

chorionic villi extension into the myometrium.

Answer 42

placenta increta

Question 43

penetration of the chorionic villi through the uterus.

Answer 43

placenta percreta

Question 44

Placenta ___ results from underdeveloped decidualization of endometrium.

Answer 44

increta

Question 45

Previous____permits trophoblastic invasion.

Answer 45

cesarian section

Question 46

High maternal mortality and morbidity associated with placenta ___& ___

Answer 46

increta & percreta

Question 47

``` differentials for ____: placental lakes fibrin deposits intervillous thrombosis placental infraction septal cysts ```

Answer 47

intraplacental sonolucent lesions

Question 48

irregular anechoic structures within the placental parenchyma that are found beneath the chorionic plate

Answer 48

placental lake

Question 49

t/f: findings of placental lakes in the second trimester is associated with uteroplacental complications and adverse pregnancy outcomes

Answer 49

false

Question 50

swirling blood flow is consistent with ___

Answer 50

venous lakes

Question 51

multiple cysts at the fetal surface of the placenta - resolve spontaneously

Answer 51

subchorionic cysts of placenta

Question 52

what is IUGR

Answer 52

intrauterine growth restriction

Question 53

occurs as a result of obstruction of the spiral arteries and usually found at the periphery of the placenta

Answer 53

placental infraction

Question 54

what is associated with placental infraction in upto 25% of term placentas

Answer 54

retroplacental hemorrhage

Question 55

diagnosis is often pathologic and there is no specific sonographic appearance

Answer 55

placental infraction

Question 56

necrotic infraction may appear ____ (hyper/hypoechoic) or show placental ___ (thinning/ thickening)

Answer 56

- hypoechoic | - thinning