Placenta

Question 1

What is placentomegaly and what are it’s two main associations?

Answer 1

>600 g (Fetal:Placental weight ration less than 3:1)–THINK MATERNAL DIABETES AND BECKWITH-WEIDEMANN SYNDROME Most often due to villous edema; also severe maternal anemia, fetal anemia, fetal hydrops, congenital syphilis/TORCH

Question 2

What is the characteristic placental lesion associated with oligohydramnios?

Answer 2

Amnion nodosum – granular, pick off, associated with chronically decreased amnionic fluid (renal agenesis, premature or prolonged amniorrhea, donor of twintwin transfusion or other congenital anomaly)

Question 3

What organisms cause placental intervillous abscesses and septic infarcts?

Answer 3

Listeria monocytogenes and Campylobacter fetus

Question 4

What organism causes yellow, punctate microabscesses on surface of umbilical cord;?

Answer 4

Candida (“peripheral funisitis”)

Question 5

What organism causes a characteristic light green color to the placenta?

Answer 5

Fusobacterium

Question 6

What two organisms are known to cause necrotizing funisitis?

Answer 6

Syphilis and HSV

Question 7

If you see placental diffuse lymphohistiocytic inflammation, “diffuse sclerosing villitis”, what organisms should you think of?

Answer 7

TORCH (lymphoplasmacytic inflammation associated with syphilis, CMV, HSV, Rubella; plasma cells associated with CMV)

Question 8

What organism causes chronic (histiocytic) intervillositis?

Answer 8

Malaria (has malarial pigment!–blue black granular pigment)

Question 9

What placental lesion is can be associated with HELLP syndrome and is characterized by recurrent reproductive failure, severe normotensive intrauterine growth retardation; anomalous procoagulant expression on trophoblast, inappropriate secretion of fibrinoid?

Answer 9

Massive Perivillous Fibrinoid (Maternal Floor Infarction)

Question 10

What is the definition of chorangiosis?

Answer 10

>10 capillary vessels in 10 tertiary villi under 10x in multiple fields Associated with associated with maternal diabetes, placentomegaly, delayed villous maturation, and chronic villitis

Question 11

What are the placental associations with fetal neurological impairment?

Answer 11

Severe chorioamnionitis, Extensive avascular villi, Diffuse chorioamnionic hemosiderosis

Question 12

What are the fetal anomalies associated with a single umbilical artery?

Answer 12

~20% have associated fetal anomalies: cardiovascular, GI, esophageal atresia, renal defects, multiple anomaly syndromes, TRISOMY 18