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