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56 Cards in this Set
- Front
- Back
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In placenta, fetal blood and maternal blood exchange ______, ______, _______, and __________, but ___________. |
- Oxygen - Carbon dioxide - Nutrients - Waste materials
- do NOT mix |
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Functions of Placenta (4) |
1- Sends oxygen
2- Nutrition
3- Excretion
4- Produces HCG |
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Placenta send oxygen...... |
- Acts as fetal lungs - Oxygen in maternal blood diffuses across the placental membrane into fetal blood by diffusion - Carbon dioxide passes in the opposite direction
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Placenta- Nutrition
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- Water, inorganic salts, carbs, fats, proteins, and vitamins pass from maternal blood through the placental membrane into fetal blood |
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Placenta- Excretion |
- Waste products cross membrane from fetal blood and enter maternal blood - Excreted by mothers kidneys |
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Fetal blood reaches the placenta through the _________, which are a branch of the __________. |
- Umbilical arteries
- Iliac arteries |
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While blood is circulating through the __________ of the placenta, the _________ takes place. |
- Chorionic villi
- Exchange process |
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Blood rich in ________ and _______ then leaves the placenta to return to the fetus through the __________________. |
- Oxygen - Nutrients
- Single umbilical vein |
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Cotyledons |
- About 20 tree-like structures in the placenta
- Baby's blood from umbilical cord spreads out in placenta sending out large branches
- Mother's blood intimately surrounds Cotyledons |
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Baby's blood and Mother's blood are separated by |
- Syncytial trophoblast- a seamless layer comprising a single cell |
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2 parts o the placenta |
1- Fetal portion- from the chorion
2- Maternal portion- from the decidus basalis |
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The major functioning unit of the placenta |
- Chorionic vilus- house the intervilous space |
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Placenta- Weight
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- 450-550 grams |
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Placenta- Size - length - thickness |
- 16-20 cm - 5 cm (AP) |
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5% of placentas may have an _________. |
- Accessory lobe- Separate piece of placenta (Like spleen) |
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Placenta- Implantation sites |
- Anterior - Fundal - Posterior ........ wall of uterus |
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Placenta- Chorionic plate |
- Fetal surface - Smooth surface - Pretty reflective |
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Placenta- Basal plate |
- Maternal surface - Irregular surface |
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Placenta- Sono |
- Relatively homogeneous |
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Umbilical Cord |
- 2 Arteries - 1 Vein - Wharton's jelly |
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% of 1 Artery - Singletons - Twins |
- 1%
- 7% |
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Congenital abnormalities seen in ___-___% of infants with 1 artery.
1 Artey used as a ________. |
- 25-50%
- Soft marker |
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Arteries connect to the ___________ in the fetus, carries blood ______ the fetus. |
- Internal iliac arteries
- Away from |
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Vein connects to the _________, carries blood _____ the fetus. |
- Left portal vein
- To |
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Normal cord length ....
Short cord can indicate ....
Long cord ...... |
- 40-60 cm
- Abnormalities
- Worry about knots or wrapping around neck
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Umbilical cord-
Doppler is used to asses ..... |
- Fetal well being in the 3rd trimester |
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Umbilical cord-
Normal S/D ratio ________ as gestational age ________. |
- Decreases
- Increases |
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Umbilical cord-
Absent diastole is ________ before _______. |
- Normal
- 20 weeks |
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Umbilical cord-
_________ of is never normal. |
- Reversal flow |
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Umbilical cord-
Doppler of umbilical vein can indicate ________. __________ is needed in umbilical vein. |
- Fetal distress
- Low resistance |
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Amniotic Fluid- Functions (4) |
1- Cushion to fetus
2- Allows movement
3- Promotes lung growth
4- Regulates temp |
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Structures responsible for amniotic fluid production (5) |
1- Amniotic membrane 2- Umbilical cord 3- Lungs 4- Skin 5- Kidney |
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Structures responsible for amniotic fluid removal (4) |
1- GI tract 2- Lungs 3- Membranes 4- Cord |
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Fluid regulation- 1st Trimester |
- Chorion - Amnion |
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Fluid regulation- Mid-late 1st Trimester |
- Diffusion occurs across fetal skin- only 4 layers thick at this time (thin skin = no fat) |
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Fluid regulation- 2nd & 3rd Trimester |
- Kidneys are primary souce of fluid production - Primary source of removal is GI tract - Fluid absorpion occurs in the intestines |
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Amniotic Fluid Volume coorelates to ______ & ______. As gestational age increases, fluid _______.
Peak volume ..... |
- Age - Fetal weight - Decreases
- At 33 wks |
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Amniotic Fluid Volume - Poly - Oligo
We can't measure ...... |
- 1500 - 2000 mL at term (1000 mL normal)
- Less tham 300- 500 mL
- Volume |
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Quantitative measurement is ... |
- Subjective |
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AFI
- Poly - Oligo |
- 4 quads - Parallel to floor
- Greater than 24 cm - Less than 5 cm |
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Single pocket fluid measurment
- Poly - Oligo |
- Greater than 8 cm
- Less than2 cm |
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Poly could indicate |
- Facial/ brain abnormalities becasue baby can't swallow |
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Oligo could indicate |
- Kidney problems or GI |
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In relation to singleton pregnancy. multiple- gestation pregnancy is |
- High-risk - Signifigant increases in morbidity and mortality rates
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Twin gestations have a _______ time greater mortality rate than singletons. |
- 7-10
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Clinical associations of Multiples- (4) |
1- Larger than dates 2- Elevated maternal serum alpha-fetoprotein 3- Hyperemesis- Increased hCG levels- related to more morning sickness 4- History of ART- Assisted Reproductive Technique |
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Dizygotic - % of all twins |
- 2 ova - 70% of ALL twins - Dichorionic/diamniotic - Phaternal twins
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Dichorionic-diamniotic- Sono
Each sac contains...... |
- 2 separate gestational sacs with individual trophoblastic tissue, appears as a thick dividin membrane - Membrane becomes thinner- later in gestation more dificult to diagnose
- Individual yolk sac, amniotic membrave and embyo
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Monochorionic-Diamniotic- Sono |
- Appear to be in 1 chorionic sac with 2 amnions and 2 embryos - Thinner dividing membrane especially in 1st trimester |
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Monozygotic Monochorionic-Monoamniotic - Mortality rate - Sono |
- Crutial diagnosis - 50% mortality rate - Identical twins - 1 gestational sac, 1 amniotic membrane, 1 or 2 yolk sacs and 2 embyos in the single amniotic membrane - 1 egg, 1 sperm, divided early |
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Dizygotic Twins - How many zygotes
- Criteria (3) |
- 2 zygotes
- Thick separating membrane - Separate placenta - May be diferent sex |
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Monozygotic Twins Di/Di |
- 1 zygote - 30% of monozygotic
- Thick separating membrane (Lmbda sign/twin peak sign) - May be separate placenta - Single sex |
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Monochorionic-Diamniotic |
- 70% of monozygotic - Thin separating membrane (T-sign) - Single placenta - Single sex |
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Monochorionic-Monoamniotic |
- 1% of monozygotic - No separating membrane - Single placenta - Single sex - Single yolk sac |
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Dichorionic- Thick membane becasue
Mono- Di- Thin membrane
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- 2 double layers come together to make 4
- 2 amnions layers together |
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Sonographic assesment of multiple gestation- (6) |
1- Fetus A closest to internal OS 2- Placenta # and location 3- Dividing membrane 4- Fetal gender 5- Assesment of AFV 6- Anatomy evaluation |
