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IMG1036 (OB-GYN 2) > week 3- placental and umbilical cord pathology > Flashcards

week 3- placental and umbilical cord pathology Flashcards

1
Q

t/f: maternal and fetal circulation are separate

A

true

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2
Q

deoxygenated fetal blood is carried to the placenta by what

A

umbilical arteries

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3
Q

oxygenated blood returns to the fetus through

A

umbilical vein

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4
Q

what plate of the placenta is the mothers

A

basal

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5
Q

what plate of the placenta is the babies

A

chorionic plate

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6
Q

placenta thickness

A

2-4cm

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7
Q

what do we evaluate the placenta for when scanning

A
  • location in relation to cervix (external os)
  • texture
  • cord insertion
  • placental grade
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8
Q

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

A

4cm

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9
Q

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

A

evaluate the retroplacental area

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10
Q

Succenturiate Lobe

A

accessory lobe of placenta

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11
Q

prevalence of Succenturiate Lobe

A

6%

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12
Q

Succenturiate Lobe attached to placenta via

A
  • vessels within membrane

- bridge of membranes

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13
Q

Succenturiate Lobe clinical significance

A

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

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14
Q

where does cord insert with Succenturiate Lobe

A

in the larger, main placenta

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15
Q

where does cord insert with Bilobed Placenta

A

into a thin connecting rim of chorionic tissue between 2 lobes

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16
Q

name for 2 lobes of placenta, similar in size

A

Bilobed Placenta

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17
Q

prevalence of Bilobed Placenta

A

rare

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18
Q

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

A

Circumvallate Placenta

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19
Q

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

A

Circumvallate Placenta

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20
Q

is Circumvallate Placenta clinically significant?

A

mostly no

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21
Q

characteristic of Circumvallate Placenta

A

rolled up placental edge

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22
Q

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

A

circummarginate placenta

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23
Q

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

A

circumvallate placenta

24
Q

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

A

Marginal insertion

25
Q

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

A

Velamentous cord

26
Q

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

A

Succenturiate placentation

27
Q

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

A

circumvallate

28
Q

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

A

chorionic

29
Q

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

A

amnionic band syndrome

30
Q

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

A

amniotic band syndrome

31
Q

implantation of the placenta completely crosses the internal OS

A

placenta previa

32
Q

edge of the placenta is abut or covering the OS

A

placenta marginal (partial previa)

33
Q

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

A

low laying placenta

34
Q

low laying placenta is

A

2c

35
Q

4 factors associated with placenta previa

A
  • smoking
  • advanced maternal age
  • multiparity
  • prior c section
36
Q

the following are complications of___:

  • preterm delivery
  • maternal hemorrhage
  • increased risk of placental invasion
  • increased risk of postpartum hemorrhage
  • IUGR
A

placenta previa

37
Q

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

A
  • elongated

- previa

38
Q

how to better demonstrate the internal cervical OS in TA scanning

A
  • trendelenburg position (head lower than body)

- empty bladder

39
Q

best imaging tool for identifying the lower uterine segment

A

transvaginal

40
Q

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

A
  1. placenta accreta
  2. placenta increta
  3. placenta percreta
41
Q

Chorionic villi attach to myometrium without muscular invasion

A

placenta accreta

42
Q

chorionic villi extension into the myometrium.

A

placenta increta

43
Q

penetration of the chorionic villi through the uterus.

A

placenta percreta

44
Q

Placenta ___ results from underdeveloped decidualization of endometrium.

A

increta

45
Q

Previous____permits trophoblastic invasion.

A

cesarian section

46
Q

High maternal mortality and morbidity associated with placenta ___& ___

A

increta & percreta

47
Q 
differentials for \_\_\_\_: 
placental lakes
fibrin deposits
intervillous thrombosis
placental infraction
septal cysts
A

intraplacental sonolucent lesions

48
Q

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

A

placental lake

49
Q

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

A

false

50
Q

swirling blood flow is consistent with ___

A

venous lakes

51
Q

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

A

subchorionic cysts of placenta

52
Q

what is IUGR

A

intrauterine growth restriction

53
Q

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

A

placental infraction

54
Q

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

A

retroplacental hemorrhage

55
Q

diagnosis is often pathologic and there is no specific sonographic appearance

A

placental infraction

56
Q

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

A
  • hypoechoic

- thinning

IMG1036 (OB-GYN 2) (3 decks)

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