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79 Cards in this Set
- Front
- Back
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The word Trophoblast means: |
To feed |
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Name & describe the 2 types of cells that make up the Trophoblast: |
1. Syncytiotrophoblast- outer layer 2. Cytotrophoblast- Inner layer |
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Maternal portion of Placenta: |
Decidua Basalis |
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Fetal Portion of Placenta: |
Decidua Capsularis |
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Name the AKA for Decidua Vera |
Parietalis |
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Name the functional unit of the placenta that contain fetal capillaries and placental tissue: |
Chorionic Villi |
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Name the part of placenta that is composed of main stem villi and branches and covered by a layer of the decidua basalis: |
Cotyledon |
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The Intervillous space fills with: |
Maternal blood |
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The placenta is responsible for all of the following EXCEPT: a) exchange of nutrients b) barrier to some medications c) fetal blood cell formation (hemopoiesis) d) oxygen exchange |
c) Placenta is NOT responsible for hemopoiesis |
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Describe Grade 0 placenta |
Homogenous- no calcs |
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Describe Grade 1 Placenta: |
Few flecks of calc scattered randomly thro placenta |
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Describe Grade 2 placenta |
Basal calcs and indentations of the chorionic plate |
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Describe Grade 3 placenta |
Circular indentations of chorionic plate with anechoic "centers" to indentations. Echogenic. |
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Normal A-P thickness of placenta |
< 5cm, but more than 1.5cm |
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Describe Placentomegaly |
Enlarged placenta > 600 grams > 5cm A-P thickness |
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What is placentomegaly associated with? |
Maternal diabetes and Rh incompatibility |
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What is the AKA for a Marginal Cord Insertion? |
Battledore Placenta |
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Describe a Marginal Cord Insertion |
Cord insertion near edges of placenta, eccentric insertion |
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An umbilical cord that inserts into the chorio-amniotic membranes before entering the placenta is known as: |
Velamentous insertion |
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Describe Placenta previa |
Implantation of the placenta over the LUS |
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Describe Complete/ Total previa |
Internal os is completely covered by placenta (90% resolve by term) |
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Describe partial previa |
Partially covers internal os |
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Describe marginal previa |
Doesn't cover the os edge, comes to the margin of the os
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Describe a low lying placenta |
Implanted in the LUS, but edge does not reach os. <2cm from os |
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List some RISK FACTORS for previas |
AMA Smoking Cocaine use Previous previa Multiparity Prior c-section/ uterine SX |
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MC clinical finding of placenta previa |
Painless bright red bleeding in 3rd trimester |
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Describe placenta Accreta |
Abnormal adherence of all or part of placenta with partial or complete absence of the decidua basalis. |
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Which patients are at an increased risk for developing placenta accreta? |
Pts with previous placenta previa and uterine scars (ex c-section) |
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Describe Placenta Increta? |
Placenta grows thru the myometrium. |
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Describe Placenta Percreta? |
Penetration of uterine serosa |
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Describe a Succenturiate placenta |
Presence of one or more accessory lobes to body of the placenta --- connected by blood vessels! |
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AKA of Circumvallate placenta |
Circummarginate |
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Describe a circumvallate placenta |
Placental margin may be thickened, folded, or elevated with underlying fibrin and hemorrhage. |
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Separation of a normally implanted placenta prior to term: |
Placental abruption |
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Describe a Grade 1 placental abruption: |
Small amount of vag bleeding & some uterine contractions |
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Describe Grade 2 placental abruption: |
Mild - Mod amount of vag bleeding, uterine contractions, FHR may show signs of distress |
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Describe Grade 3 placental abruption: |
Mod - Sev bleeding or concealed bleeding, uterine contractions that DO NOT RELAX (tetany), abdominal pain, low maternal BP, fetal death |
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Describe Retroplacental Abruption |
Rupture of spiral arteries = high pressure bleed |
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Retroplacental Abruption is assoc with:
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*Assoc with maternal HTN & vasc dis
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Retroplacental Abruption on U/S
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Thick placenta with occasional retroplacental clot |
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Describe a Marginal abruption |
Tears in the marginal veins = low pressure bleed |
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Marginal abruption is assoc with
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Maternal smoking
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Marginal abruption on U/S
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Dissects beneath placental membranes with little placental detachment |
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Intervillous Thrombus is assoc with |
Rh sensitivity, can lead to to incr AFP levels |
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Name MC benign tumor of the placenta (secondary to trophoblast) |
Chorioangioma |
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This portion of the placenta lies along the uterine cavity and is separate from the basalis: a) capsularis b) amnion c) parietalis d) cotyledon |
c) parietalis
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Rare GTD that results from hydatidform degeneration of twins |
Coexistent molar and fetus |
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MC neoplasm that arises from the trophoblast |
Complete Hydatiform Mole |
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GTD that results from triploid karyotype (69 chromosomes) |
Partial Hydatiform Mole |
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What pathology is highly assoc with Molar pregnancies? |
Ovarian Theca Lutein cysts |
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Describe Theca Lutein cysts |
Bilateral Multi cysts & septa |
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Labs with Molar preg |
Elevated hCG levels (beyound 100 days after LMP) |
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Malignant, non-metastatic trophoblastic disease |
Chorioadenoma Destruens (Invasive Mole) |
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Most Malignant form of GTD |
Choriocarcinoma |
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MC locations for METS from choriocarcinoma: |
Lungs & Vag |
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Tx for GTD |
BCP for 1 yr hCG performed 1-2 weeks until 3 normal consecutive tests, then monthly for 6 mos, and then every other for 6 mos |
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Describe Whatron's Jelly |
myxomatous connective tissue |
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Normal Cord contains: |
2 arteries & 1 vein |
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Norm diameter of umbilical cord |
1-2cm |
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Norm length of umbilical cord |
40-60cm |
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Name the intra-abdominal portion of the umbilical cord that degenerates after birth |
Round Ligament (Ligamentum teres) |
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Describe abnorm coiling of cord |
Helix to right assoc with incr risk anomalies Absent coiling = decr fetal activity |
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Describe a short cord |
<35cm long |
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A short cord is assoc w/ |
Oligohydraminos Restricted uterus Intrinsic fetal anomalies tethering of fetus by amniotic band inadequate fetal decent cord compression fetal distress |
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Descrive an atretic cord |
Fetus directly connected to placenta always has OMPHALOCELE |
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Describe a long cord |
>80cm |
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Complications of Long Cord |
Polyhydraminos Nuchal Cord True Knots Cord compression Cord presentation Prolapse Stricture or torsion d/t excess fetal movement |
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Describe an angioma of the cord |
Well circumscribed echogenic mass |
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Describe a Hemangioma of the cord & where found? |
Surrounded by edema and myxomatous degeneration of Wharton's Jelly
**Found near placental cord insertion |
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Describe Hematoma of Cord |
Trauma to umbilical vessels causing invasion of blood into Wharton's Jelly |
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Describe Thrombosis of Cord & which pts have higher incidence? |
Occlusion of 1 or more vessels
*** Incr incidence in diabetic mothers |
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True knot of cord assoc w/ |
Long cords, poly, IUGR, Monoamniotic twins **congenital twins |
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Describe false knot of cord |
Vessels longer than cord Fold on themselves |
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Describe Vasa Previa |
Presence of cord vessels crossing internal os of cervix |
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Describe an occult prolapse |
cord lies alongside presenting part |
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Which UA is MC absent? |
LEFT UA |
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Single UA is assoc w/ |
Congenital Anomalies Incr risk of IUGR, perinatal mortality, incr incidence of aneuploidy |
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4 vessel cord may be d/t what 2 things? |
Extra vessel - small vitelline artery Persistence of the allantois |
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Describe a Varix of the umbilical V |
Dilated intraabdominal extrahepatic portion of the umbilical V |
