Placenta

Question 0

Placenta

Answer 0

Vascular organ
Discoid shape
Weighs 500-600 g

Chorionic plate on fetal side
20 lobes
Basilar plate on maternal side adj to retroplacental complex

Question 1

What is the earliest the placenta is seen on US

Answer 1

Week 12

Question 2

Major functioning unit of placenta

Answer 2

Chorionic Villi

Question 3

Functions

Answer 3

Protection, nutrition, respiration, excretion

Question 4

Cord should insert

Answer 4

Centrally

Question 5

May ID by 8-10 wks as

Answer 5

Focal thickening

Question 6

Size

Answer 6

< or = 5 cm

Question 7

Visualize retroplacental complex by

Answer 7

18 wks

Question 8

Grading

Answer 8

0: smooth no Ca+, homo
1: sm Ca+ randomly dispersed
2: Ca+ of basilar plate
3: Ca+ intentions of pl extending from chorionic plate to basilar plate. See lobes.

Question 9

Grade 3 < 34 wks inc risk for

Answer 9

IUGR, preeclampsia

Question 10

Grade/calcification delay with, accelerated with

Answer 10

Maternal diabetes, Rh blood

HTN, IUGR, smoking, AMA

Question 11

Bilobate placenta

Answer 11

2 lobes both equal in size. Cord inserts between both lobes.

Question 12

Succentureate Lobe/Accessory Lobe

Answer 12

1 or more small lobes connect to main placenta. If retained after delivery, may hemorrhage. Connecting vessels may overly internal os.

Question 13

Annular placenta

Answer 13

Doughnut, ring shape

Question 14

Placenta membranacea

Answer 14

Covers surface of sac, very thin.

Placenta Diffusa: rare, covers most of uterine wall.

Question 15

Circumvallate placenta

Answer 15

Placenta extends beyond chorionic plate. Curled up margins.

Assoc with bleeding and preterm.

Question 16

Synechiae

Answer 16

Amniotic sheets/folds, thick band with color flow

Question 17

Amniotic band syndrome/ ADAM complex

Answer 17

Rare, thin membrane of amnion freely cross sac. May entangle fetus. Risk of ABS with early amniocentesis

Question 18

Placenta size increase with

Answer 18

Diabetes, Rh, CMV, chorioangioma, abruption, twins, hydrops, fetal anemia, triploidy, maternal anemia

Question 19

Placental size decrease

Answer 19

IUGR, preeclampsia, infarction, toxemia, maternal cardio renal disease, trisomies, severe diabetes, chronic infection, htn

Question 20

Placenta Previa

Answer 20

Placental covers internal os

Complete/Total: covers both sides of cx canal
Partial/Marginal
Low lying: within 2 cm of io

Do c section

Painless vag bleeding

Inc with AMA, smoking, multiparity, c sections, low ut scars, trauma, hx D&C, twins, abnl fetal lie

Premature delivery, maternal hemorrhage, placenta accreta, post partum hemorrhage, IUGR,

Over distended bladder cause false positive

Question 21

Trophotropism

Answer 21

Hypertrophy of upper part & atrophy of lower part bc LUS isn’t as vascular

Question 22

Vasa Previa

Answer 22

Vessels overly internal os. High fetal mortality. C section.

Question 23

Abruption

Answer 23

Premature placenta detachment
Dangerous.

Knife like pain. Bleeding, shock, preterm labor, fetal distress/demise

Assoc with HTN, cocaine, vasc disease, trauma, preeclampsia, short umb cord, fibroids, previa

Hematoma. Retroplacental hemorrhage

Question 24

Placenta Accreta

Answer 24

Abnl placental attachment Accreta: on myometrium, mildest, most common Percreta: into myometrium Increta: through serosa, rarest Hx of c section + previa = 25% chance

Question 25

Chorioangioma

Answer 25

MC placental tumor 1%, benign vasc tumor, inc MSAFP, through fetal surface of placenta, solid, complex, usually near cord insert. Large leads to hydrops, polyhydramnios, hemorrhage, premie, IUGR, demise, cardiomegaly

Question 26

Teratoma

Answer 26

Rare, usually benign, malignant very bad, complex mass with shadow.

Question 27

Mets to placenta

Answer 27

From mom: Melanoma, Breast cancer, lung cancer. Lung most common. Fetal: neuroblastoma, leukemia

Question 28

Umbilical cord

Answer 28

2 arteries, 1 vein. Mickey Mouse, surrounded by Wharton's Jelly for protection. Length: 55cm at term. Should insert centrally

Question 29

Marginal cord insertion / battledore placenta

Answer 29

Inserts within 2 cm of edge of placenta. (Inside placenta)

Question 30

Velamentous insertion

Answer 30

Cord inserts a distance away from placenta (cord inserts on membrane)

Question 31

Knotted cord

Answer 31

Difficult to ID, hazardous if construction occurs.

Question 32

Nuchal Cord

Answer 32

Cord around fetal neck, 20% of deliveries. Nurse unwraps cord when delivering.

Question 33

Cord prolapse

Answer 33

Part of cord presents before fetus. May compromise circulation. Dangerous at birth.

Question 34

Single Umbilical Artery / 2 Vessel Cord

Answer 34

1 artery at bladder. Mickey Mouse missing ear trvs. | Inc risk IUGR, tri 18, 13, 21

Question 35

Hemangioma

Answer 35

Benign vascular hyperechoic umbilical cord mass

Question 36

Teratoma

Answer 36

Ca+. Umbilical cord teratoma.