Lecture 5- Fetal period Flashcards

1
Q

Placenta- What does the endometrium consist of that comes from mom

A

Epithelium & vascularized stroma

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2
Q

Placenta- what does from maternal stroma differentiate into

A

Decidua

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3
Q

Placenta- What is the maternal part of the placenta

A

Decidual basalis

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4
Q

Placenta- What is the fetal part of the placenta

A

The chorionic plate

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5
Q

Placenta- what does the chorionic plate derive from

A

Cytotrophoblast, syncytiotrophoblast, and parietal extraembryonic mesoderm

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6
Q

What is the bilaminar disc composed of

A

Hypoblast, Epiblast

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7
Q

Where is the decidua basalis

A

Between the embryo and myometrium

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8
Q

What are the 2 parts of the placenta

A

Decidua basalis (maternal), villus chorion (fetal)

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9
Q

When does the placenta separate from the uterine wall

A

After delivery of the baby

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10
Q

Identify red box on top only

A
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11
Q

When is the endometrium called the decidua

A

When fibroblastic stromal cells of endometrium swell into decidual cells

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12
Q

What is the area of the decidua basalis that is most intimately connected with the fetal parts

A

Decidual plate

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13
Q

Identify bottom arrows

A
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14
Q

What does the chorionic plate consist of

A

Parietal EEM, cytotrophoblast, syncytiotrophoblast

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15
Q

What projections from the chorionic plate increase surface area for exchange

A

Chorionic villi

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16
Q

What is the most mature developmental stage of a chorionic villus containing fetal capillaries derived from parietal EEM?

A

Tertiary villus

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17
Q

What do chorionic villi anchor to

A

Chorionic plate and cytotrophoblast shell

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18
Q

What covers the top part of the placenta

A

Cytotrophoblastic shell

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19
Q

What is the most efficient at gas transport

A

Fetal endothelium and syncytiotrophoblast

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20
Q

What does the placental barrier block

A

Large complex molecules, peptide hormones, bacteria

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21
Q

What does the placental barrier allow to cross

A

Gas/nutrients/waste, steroid hormones, some antibodies, medications/ drugs (alcohol), viruses

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22
Q

What can the passage of an Rh antigen cause

A

Hemolytic disease of newborn (erythroblastosis)

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23
Q

What is it called when the placenta covers the cervix

A

Placenta previa

24
Q

How do you diagnose placenta previa

A

Ultrasound

25
Q

What is placenta accreta?

A

Attachment to the myometrium

26
Q

What is placenta increta

A

Invasion of the myometrium

27
Q

What is placenta percreta

A

Growth through the uterus to adjacent organs of the body

28
Q

Rate the placenta accretas in order from least to worst

A

Accreta, increta, percreta

29
Q

What does the umbilical cord contain

A

1 vein (blood to fetus), 2 arteries (blood to placenta), stalk of yolk sac, allantois

30
Q

By week 12 amnion and chorion contact and fuse into _____

A

Amniochorionic membrane (ACM)

31
Q

Rate the placenta accretas in order from least to worst

A

Accreta, increta, percreta

32
Q

Define PROM (premature rupture of the membranes)

A

Rupture of the ACM before uterine contractions begin

33
Q

Define preterm PROM (PPROM)

A

ACM ruptures prior to 37 weeks of pregnancy. PPROM is a common cause of preterm labor

34
Q

Define Polyhydramnios

A

Excessive amniotic fluid volume caused by GI malformations preventing fetus from swallowing

35
Q

Define oligohydramnios

A

Low amniotic fluid volume linked to PROM or renal issues preventing urination

36
Q

What causes increased occurrences of twinning

A

Increased maternal age, ARTs (assisted reproductive technologies)

37
Q

Dizygotic twins are called what

A

Fraternal twins

38
Q

Why do dizygotic twins have unique DNA

A

Because of the simultaneous shedding of 2 oocytes each fertilized by a different sperm

39
Q

What are 2 characteristics of a dichorionic/ diamniotic (DCDA) twins

A

Each twin has their own chorion/ placenta and amnion

40
Q

What kind of twins is this

A

Dizygotic

41
Q

What is another term for monozygotic twins

A

Identical twins

42
Q

Monozygotic twins originate from what

A

From single zygote that can split at various stages of development

43
Q

What are characteristics of Dichorionic / diamnionic (DCDA)

A

▪ Split at two-cell stage, leading to two blastocysts
▪ Each twin has own chorion/placenta and amnion

44
Q

What are characteristics of Monochorionic / diamnionic (MCDA)

A

Embryoblast (inner cell mass) splits into two
▪ Shared chorion/placenta but separate amnions
▪ Most common

45
Q

What are characteristics of Monochorionic / monoamnionic (MCMA)

A

▪Early bilaminar disc splits
▪Shared chorion/placenta and amnion

46
Q

Identify each set of twins

A
47
Q

How many weeks is a full-term pregnancy

A

38 weeks fertilization age, (40 weeks gestational age, as determined by LNMP)

48
Q

When does the rupture of fetal membranes occur

A

At full-term or during labor

49
Q

What can a transabdominal ultrasound assess

A

Measures fetus, assess placenta, estimate fetal mass to test for intrauterine growth restriction (poor outcomes for fetus with very low weight)

50
Q

What can a maternal serum screening assess

A

Triple screen test (must also confirm with amniocentesis)
▪ Organ defects
▪ Molar pregnancy
▪ Ectopic implantation
▪ Hormone deficiencies
▪ Down’s syndrome (trisomy 21)

51
Q

Ultrasound- guided needle sampling is called what

A

Amniocentesis (amniotic fluid test)

52
Q

What does US guided needle sampling (amniocentesis) test for

A

▪ Low risk to fetus
▪ Fluid contains fetal cells,
proteins, hormones,
metabolites that can be
analyzed

53
Q

What does maternal serum screening test-(Cell-free fetal DNA)

A

Sex of baby, downs syndrome

54
Q

What does maternal serum screening test for

A

Sex of fetus, downs syndrome

55
Q

What does an endoscopic (fetoscopy) exam test for

A

▪ Very invasive
▪ Reserved for
extreme cases

56
Q

What is one downside of a maternal serum screening (triple screen test)

A

Lots of false positives