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OB 2 > Abnormalities of the Placenta and Cord > Flashcards

Abnormalities of the Placenta and Cord Flashcards

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1
Q

Low-lying placenta is considered when the inferior margin is how far away from the os?

A

Within 2cm

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2
Q

Increased placental thickness can be caused by?

A
  1. Maternal diabetes
  2. Immune hydrops
  3. Placental abruption
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3
Q

Decreased thickness of the placenta can be caused by?

A
  1. Maternal hypertension
  2. Preeclampsia
  3. IUGR
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4
Q

What can simulate placental thickening?

A
  1. Myometrial contractions
  2. Fibroids
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5
Q

What is the term for selective loss of parts of the placenta and growth of other parts?

A

Trophoblastic trophotropism

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6
Q

What is the term for a bilobed placenta?

A

Succenturiate

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7
Q

What is the term for a placenta where the fetal membrane insertion is flat?

A

Circummarginate

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8
Q

What kind of placenta has a rolled edge?

A

Circumvallate

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9
Q

Are succenturiate lobes clinically significant? Why or why not?

A

Yes, because they can cause postpartum hemorrhage and infection

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10
Q

When can placental shelves be detected on ultrasound?

A

Early second trimester

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11
Q

Risk factors for placenta previa?(4)

A
  1. Advanced maternal age
  2. Previous c-section
  3. Multiple gestations
  4. Cocaine or smoking
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12
Q

Why is it important that the bladder isn’t too full when evaluating the placenta?

A

If the bladder is too distended, it can squish the placenta and make it look as if it is closer to the os than it really is

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13
Q

What does MAP stand for?

A

Morbidly adherent placenta

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14
Q

MAP encompasses what three types?

A
  1. Accreta
  2. Increta
  3. Percreta - the most severe
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15
Q

Why has placenta accreta risen 10 fold in the past 50 years?

A

Due to increased rates of c-sections

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16
Q

What is the most common reason for an emergency postpartum hysterectomy?

A

Placenta accreta

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17
Q

When is delivery planned in cases of MAP?

A

34-35 weeks

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18
Q

What are the two most common risk factors for placenta accreta?

A
  1. Placenta previa
  2. Previous c-section
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19
Q

The loss of visualization of what structure indicates a MAP?

A

Retroplacental complex

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20
Q

When there is multiple vascular lacune present within the placenta, what may this be caused by and in what trimester?

A

Placenta accreta and in the third trimester

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21
Q

Do venous lakes within the placenta increase or decrease with GA?

A

Increase

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22
Q

Irregular anechoic structures within the placenta and found beneath the chorionic plate signify what?

A

Venous lakes

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23
Q

What causes subamniotic cysts?

A

Rupture of fetal vessels near umbilical cord insertion into the placenta

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24
Q

What are the two primary nontrophoblastic tumors of the placenta?

A
  1. Chorioangioma
  2. Teratoma
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25
T or F? Small solitary chorioangiomas are of little clinical significance
True
26
If there is a chorioangioma seen with vascular flow and measures 4cm, is it clinically significant?
No, it is reported that it may cause complications when >5 cm
27
What is the term for the premature separation of all or part of the placenta from the myometrium?
Placental abruption
28
What are the three types of placental abruption?
1. Marginal 2. Partial 3. Complete
29
Risk factors of placental abruption?(3)
1. Maternal cocaine use and smoking 2. Hypertension 3. PROM
30
What abnormality is thought to be cause by the rupture of the chorion without rupture of the amnion?
ABS
31
What does PMD stand for?
Placental Mesenchymal Dysplasia
32
What abnormality may be mistaken for a molar pregnancy and appears as "grape-like" vesicles in the placenta?
PMD
33
What side is most common to see SUA?
Left
34
What trisomies can be seen with SUA?
13 and 18
35
In a persistent RUV, the umbilical vein curves toward what rather than toward what?
L-sided stomach rather than the liver
36
In what abnormality does the umbilical vein curve toward the left sided stomach rather than the liver?
Persistent RUV
37
Body stalk anomaly vs. limb-body wall complex
Body stalk = NO umbilical cord Limb-body wall = short umbilical cord
38
What is body stalk anomaly associated with? (hint: cause)
Maternal cocaine use
39
What length is a short umbilical cord defined as?
35cm or less
40
In cases of vasa previa, when is hospitalization recommended?
32 weeks onward
41
T or F? Bleeding from vasa previa is from maternal origin
False: it is from fetal origin
42
In cases of umbilical cord cysts, the fetus is more likely to be abnormal when?
The cyst is located near the placenta of fetal extremity or if the cyst persists over 12 weeks GA
43
Where are TRUE umbilical cord cysts located?
Near the cord insertion into the fetal abdomen
44
T or F? True umbilical cysts have no increased risk of chromosomal anomalies
True
45
What can Edematous whartons jelly be confused with?
Teratoma
46
Imaging an umbilical cord that appears to contain a large mass with cystic areas, solid components, and calcifications indicates what pathology?
Edematous Whartons Jelly
47
A nuchal cord is describes as what?
The umbilical cord wrapped around the fetal neck one or more times
48
When does a true umbilical cord knot occur?
When the fetus passes through a loop of cord
49
Fetuses with true knots are at fourfold risk of what?
Stillbirth
50
Cord entanglement is a complication in what kind of pregnancies?
Monoamniotic
51
What abnormality typically occurs in long umbilical cords, hypercoiled cords, and highly active fetuses?
Cord stricture
52
T or F? Umbilical artery doppler is always assessed
False: It is only assessed when clinically indicated
53
When should umbilical artery doppler NOT be done?
In low risk pregnancies
54
In umbilical artery doppler, how many measurements should be taken and what is reported?
At least 3 S/D ratios should be taken and the LOWEST one should be reported
55
T or F? When performing cord doppler, the waveform should always be monophasic in a healthy fetus
TRUE - waveform doesn't dip below the baseline
56
A placenta is considered abnormal when it measures what?
>4cm before 24 weeks
57
If the placenta measures 5cm at 30 weeks, is this normal or abnormal?
Normal. It is abnormal if pregnancy is less than 24 weeks
58
If the placenta measures 5cm at 30 weeks, it this normal or abnormal?
Normal. It is abnormal if pregnancy is less than 24 weeks
59
With a morbidly adherent placenta, what does the placental tissue invade?
The decidua basalis and myometrium (accreta) and uterine wall (percreta)
60
Patient presents with acute abdominal and pelvic pain and vaginal bleeding. On ultrasound you visualize a non-vascular subchorionic hematoma. What is the likely diagnosis?
Placental abruption - will NOT be vascular
61
What 2 trisomies are most commonly associated with a SUA?
Trisomy 13 (P) and trisomy 18 (E)

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