Martin's Notes
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| Trophoblast | What surrounds the embryo in the 1st trimester?
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| Cytotrophoblast | What is the inner layer of the trophoblast?
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| Syncytiotrophoblast | What is the outer layer of the trophoblast?
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| Decidua | Another term for gravid endometrium?
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| Decidua Basalis | This decidual layer occurs between the blastocyst and myometrium.
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| Decidua Basalis | This thick decidual layer is found at the implantation site.
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| Decidua Capsularis | This thin decidual layer overlies the gestational sac facing the UT cavity.
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| Decidua Parietalis | This decidual layer is also known as Decidua Vera.
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| Decidua Parietalis | This decidual layer surrounds the remaining endometrium, and lies opposite of the implanted ovum.
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| Smooth Chorion | This is also known as Chorion laeve.
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| Smooth Chorion | This consists of degenerating villi and lies opposite of implantation site.
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| Chorion Frondosum | This is also known as the definitive placenta.
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| Chorion Frondosum | This is the portion of the chorion at the implantation site and invades the decidua basalis for embryo nutrition. Seen sonographically as a hyperechoic focal thickening.
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| Chorion Frondosum | This structure of 1st trimester/placental development is seen by 12 weeks sonographically.
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| Chorionic Villi | These are the functioning units of the placenta; vascular projections from the chorion.
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| centrally | Where does the cord insert on the placents?
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| Maternal, Fetal | What are two portions of the placenta?
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| Basal plate | The maternal aspect of the placenta is called what?
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| Chorionic plate | The fetal aspect of the placenta is called what?
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| Basal plate | This is divided into cotyledons.
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| Chorionic plate | This aspect of the placenta is covered by amniotic membrane.
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| Intervillous space | What space lies between the chorionic villi and acts as reservoirs for transfer of gases and nutrients?
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| Spiral arteries | Oxygenated maternal blood enters the placenta through what arteries?
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| Hemoglobin | Which is NOT associated with the placenta and 1st trimester bleeding? Subchorionic bleed, hemoglobin, hemorrhage, hematoma
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| Subchorionic bleed | Defined as the chorionic membrane stripped from the endometrium with elevation of the chorionic membrane.
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| 2-4 | Normal placenta is usually _____ cm thick.
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| 4 cm, 24 | Placenta thickness > _____ before _____ weeks is abnormal.
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| Retroplacental damage (correct answer would be Intraplacental) | All of the following are causes of placenta thickening EXCEPT: Retroplacental damage/hemorrhage, chorioangioma, fetal hydrops?
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| 5 | Placenta thickness @ _____ in the 3rd trimester is considered abnormal.
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| 1.5 | Thin placenta is </= _____ cm
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| Diabetes Inspidus (correct answer would be Diabetes Mellitus) | All are causes of thin placenta EXCEPT: IUGR, Diabetes Insipidus, Intrauterine infection
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| Placental substance | Placental tissue aka?
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| 12-13 | Placenta is homogenous & hyperechoic by _______ week.
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| 12-13 | Placenta intervillous blood flow can be demonstrated by _______ week.
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| 2-3 trimesters | Placenta is homogenous-heterogenous in _________.
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| Venous lakes | Another name for placenta lakes?
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| 5 | Venous lakes are seen in ____% of pregnancies.
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| base | The placenta demonstrates a clear separation from myometrium at the ______.
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| Retroplacental complex | This structure of placenta is seen by 14-15 week.
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| Retroplacental complex | This structure at the base of the placenta is composed of decidua, myometrium, and UT vessels.
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| edges | The marginal sinus of the placenta can be found at the ______.
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| Marginal sinus | This is defined as the area where intervillous blood drains into the maternal venous circulation.
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| Marginal sinus | Do not mistake this portion of the placenta for separation/abruption.
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| 3 | Which trimester does the placenta exhibit high vascularity?
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| Placental migration | This is defined as the uterus expanding and displacing placenta away from the cervix.
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| Metabolism | All are FUNCTIONS of the placenta except? Respiration, Nutrition, Excretion, Metabolism, Protection, Storage, Hormone production
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| Respiration | This function of placenta diffuses maternal blood across placental membrane into fetal blood.
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| Nutrition | This function of placenta supplies carbs, fat, protein from maternal blood.
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| Excretion | This function of placenta carries fetal waste away.
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| Protection | This function of placenta guards against microorganisms.
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| Storage | This function of placenta holds carbs, proteins, calcium, and iron for release into fetal circulation.
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| Hormone production | This function of placenta creates hCG, estrogen, progesterone.
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| Vitamin A | All are stored by the placenta for later fetal circulation use EXCEPT: Carbs, Protein, Vitamin A, Calcium, Iron
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| Grade 0 | This placenta grade is defined as a smooth chorionic plate.
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| Grade 1 | This placenta grade contains small, randomly dispersed intraplacental calcs.
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| Grade 2 | This placenta grade displays calcification of the basilar plate. The chorionic plate displays comma-like densities.
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| Grade 3 | This placenta grade divides the placenta into segments.
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| Diabetes Mellitus | Advanced maturation of the placenta before expected is associated with all of the following EXCEPT: Htn, Diabetes Mellitus, IUGR, Smokin, Multiples
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| Circumvallate placenta | Which placental variant is associated with PROM, PTL, hemorrhage, and abruption?
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| Circumvallate placenta | Which placental variant can appear as linear and confused with uterine synechiae or amniotic bands?
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| Succenturiate placenta | Which placental variant is seen as two unequally sized lobes connected by vascular bands?
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| Chorioangioma | Most common benign tumor of the placenta (1%)
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| Complete hydatidiform mole | Which molar pregnancy has a "snowstorm" appearance?
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| Partial mole | Which molar pregnancy has placenta with a triploid karyotype fetus?
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| Placental Infarction | This is a focal lesion caused by ischemic necrosis due to interruption of maternal blood supply.
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| Placental Infarction | The sono appearance of this is small or large, anechoic/hypo, and absent blood flow.
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| Abnormal Adherence | This is a deficiency of decidua during implantation and may cause the placental villi to adhere to myometrium.
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| Previous trisomic pregnancy | Predisposing factors for Abnormal adherence are all EXCEPT: Previous trisomic pregnancy, previous c-section, previous placenta previa, previous myomectomy surgery/ut scarring, AMA
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| Placenta Accreta | This type of abnormal adherence has a growth of chorionic villi to surface of, but not into the myometrium.
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| Placenta Increta | This type of abnormal adherence has a growth of chorionic villi into the myometrium.
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| Placenta Percreta | This type of abnormal adherence has a growth of chorionic villi through the myometrium and can perforate the uterine serosa as well as invade other organs.
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| MRI | Which imaging modality is best for diagnosis of Placenta accreta, increta, or percreta?
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| Placenta Previa | Clinical signs of this: painless, bright red vaginal bleeding in 3rd trimester
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| Nulliparity (correct would be multiparity) | All are predisposing factors of Placenta Previa EXCEPT: AMA, smoking, nulliparity, prior c-sec/UT surgery, abortion
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| Vasa Previa | The risks of this condition are: hemorrhage or hypoxia
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| Abruptio Placentae | Placental abruption is also called:
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| Placental Abruption | Clinical signs of this are PTL, vaginal bleedings, UT pain, fetal distress, and shock.
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| Placental Abruption | Risk factors of this are htn, trauma, fibroids, previa
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| Retroplacental Abruption | This type of abruption is associated with a high pressure bleed.
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| Marginal Abruption | This type of abruption is associated with a low pressure bleed.
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| Retroplacental Abruption | This type of abruption is due to a rupture of spiral arteries.
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| Marginal Abruption | This type of abruption is due to tears in marginal veins.
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| 5 | Umbilical cord forms during the first ___ weeks of gestation.
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| 2 | Normal diameter of umbilical cord is < ___ cm.
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| 40 | Umbilical cord develops appx ____ spiral turns as it elongates.
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| Short cord | This condition is associated with CNS abnormalities, aneuploidy, and extreme IUGR.
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| Long cord | This condition is associated with conditions that compromise cord flow.
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| False knots (correct would be True knots) | Long umbilical cord is associated with all of the following EXCEPT: Excessive coiling, false knots, multiple loops of nuchal cord, cord prolapse
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| 25 | Nuchal cord entanglement around neck occurs in about ____% of deliveries.
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| 1 | True knots occur in ___% of singletons.
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| False knot | This type of knot is a folded knot; not knotted (haha).
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| Umbilical Vein Thrombosis | This is caused by FBS or intrauterine transfusion.
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| SUA/Bivascular cord | This is associated with autosomal trisomy, renal abnormalities, cardiac abnormalities.
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| Umbilical Cord Cyst | This type of cyst may be associated with aneuploidy or GI or GU anomalies.
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| Omphalomesenteric & allantoic duct cysts | These cysts are located toward the fetal end of the umbilical cord.
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| Body Stalk Anomaly | This condition is lethal and the umbilical cord is absent or rudimentary. The fetus is "tethered" to placenta.
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| Battledore Placenta | This cord condition has a cord insert @ margin of the placental.
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| Velamentous CI | This cord condition has a cord attachment to membranes instead of placenta.
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| 3.0, 30 | UA Doppler: S/D ratio > _____ after _____ weeks is abnormal.
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