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OBGYN Ultrasound > placental pathology > Flashcards

placental pathology Flashcards

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1
Q

Fibroid versus contraction

A

Equivalent sonographic appearance

Braxton-Hicks relaxes with time

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2
Q

what is cervical incompetence

A

Painless spnataonous dilation of the cervix

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3
Q

cervical incompetence can cause what

A

second trimester preganncy failre

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4
Q

nomral cervix

A

at least 30mm

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5
Q

cervical incompetnce meaurement

A

less than 25mm at 24 weeks

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6
Q

what are risk factors for cervical incompetence

A

history of preterm labour or borth
PROM
uterine abnormalities
multiple gestations

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7
Q

what is cord prolapse

A

presentation of the umbilical cord in advance of presenting fetus during labour and deverlivery

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8
Q

cord proplase may lead to what

A

Sono detection is clinically important b/c it may lead to cord compression and fetal vascular compromise

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9
Q

1st trimester umbilcal cord cysts

A

defined as echolucent area within the umbilical cord with YS separate

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10
Q

if cystic cord masses are seen between 7 and 13 weeks

A

20% are associated with chromosal strctural defects

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11
Q

when is fetal abnormality more likley (cystic cord masses)

A

more likley if a cyst is close to the placenta or close to the fetus or if it persists beyond 12 weeks GA

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12
Q

what does vasa previa result in

A

fetal hypoxia or fetal blood loss

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13
Q

what can occur in vasa previa during labour

A

Can be easily compressed or rupture when uterine contractions or membrane rupture occurs

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14
Q

vasa previa is associated with what

A

bleeding

fetal morbidity

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15
Q

what is vasa previa

A

Condition where umbilical vessels run within membranes near or across the internal cervical os

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16
Q

what is velamentous insertion

A

umbilical vessels separate and course b/t the amnion and chorion at a distance from the placental margin surrounded only by a fold of amnion

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17
Q

velamentous insertion is asscoiated with what

A 
Devoid of Wharton’s jelly 
Associated with cord compression 
Poor fetal growth 
Thrombosis 
Miscarriage 
Prematurity
Lowe birth weight 
Fetal malformation 
Perinatal death 
Low apgar scores 
Placenta previa 
Vasa previa 
Retained placenta
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18
Q

what is marginal insertion known as

A

Battledore placenta

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19
Q

in marginal/battledore placenta

A

CI is within a cenitmere of the placental margin

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20
Q

what is umbilical vein vanix

A

focal dilation of the umbilical vein

usually seen intraabdominal

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21
Q

umbilcal vein varnix diameter

A

greater than 9mm

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22
Q

umbilcal vein varnix outcome

A

usually normal

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23
Q

what anomalies can be associated with umbilcal vein varnix

A

Aneuploidy
Perinatal death
Hydrops

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24
Q

fetusues with SUA have a high rate of structural anomaies

A 
Cardiovascular Malformations 
CNS 
Gastrointestinal
Genitourinary defects 
MSK Malformations
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25
what chromosomal abnormalities can be associated
trisomy 13 and trisomy 18
26
SUA is asscoiated with
Growth restriction prematurely increased perinatal mortality rate
27
what is PMD
relatively recently recognized, rare placental vascular anomaly characterized by mesenchymal stem villous hyperplasia. placentomegaly often clinically mistakenly as partial hydatidiform mole Fetus may be completely normal or have intrauterine growth restriction (IUGR)
28
Sono appearance of choriocarcnoma
Focal, hemorrhagic nodule within endometrium Secondary masses to cervix or vagina Metastasis to liver
29
symptoms of choriocarcinoma
cough hemoptysis neurologic disturbances or hemorrhage
30
what is choriocarcinoma
Abnormal tissue beyond the myometrium that is capable of mets
31
when does choriocarcinoma occur
50 % arise after a molar pregnancy 25 % arise after abortion 25 % after a normal pregnancy
32
invasive mole sonographic appearacne
focal areas of increase echogenicity
33
what is invasive mole
characterized by proliferation of trophoblats and presence of chorionc vill within the endometrium and myoetrium
34
what can invasive mole sometimes cause
This focal invasion can, on rare occasions, penetrate through the myometrium and blood vessels, causing uterine rupture and potential death from severe intraperitoneal hemorrhage.
35
Complete hydatifiform mole
molar pregnancy
36
what is the sono appearance of a moLar poregancy
Distention of the uterine cavity with a heterogenous echogenic mass “snow storm appearance”
37
complete mole
Absence of amniotic fluid and a fetus
38
partial mole
presence of co-excistng fetus along wuth an enlarged thickened placenta with mutlple cystic spaces
39
what abnormaloty is noted in most molar pregnancies
triploidy | Severe IUGR and fetal anomalies
40
Complete hydatidiform mole characterization
Characterized by chorionic villi that are markedly hydropic, swollen and proliferation of the trophoblast cell Results in excessive production of b HCG
41
signs of molar pregnany
Uterine enlargement Hyperemesis gravidarum Vaginal bleeding
42
gestational trophoblastic disease
encompassses disease processes that originate within the placenta can be benign or malignant
43
what is gestational trophoblastic neoplasia
complciation of pregnancy results from an abnormal proliferation of trophoblastic tissue
44
benign trophoblastic disease
hydatiform mole (complete or partial mole)
45
malignant trophoblastic disease
invasive mole choriocarcinoma PSTT ETT
46
chorioangioma sonographic appearance
Well circumscribed hyperechoic or hypoechoic ovoid mass protruding form the fetal surface of the placenta Near cord insertion May see necrosis or calcifications Increased vascularity
47
what is chorioangioma
benign vascular malformation
48
what is chorangioma assciated with
Elevated maternal AFP or bHCG
49
what fetal complications can chorioangioma lead to
``` Anemia Heart failure Nonimmune hydrops Thrombocytopenia Polyhydramnios IUGR Prematurity Placenta abruption ```
50
Placenta abruption prognosis
``` Depends on degree of placenta detachment and gestational age Fetal growth restriction Oligohydramnios PTD (preterm delivery) Fetal Demise ```
51
Placenta abruption symtptoms
Acute abdominal and pelvic pain Vaginal bleeding Uterine tenderness Fetal distress
52
placenta abruption risk factors
``` Maternal HTN (hypertension) Drug use Smoking Trauma Uterine anomalies PROM (Premature rupture of mebranes) ```
53
what is placental abruption
Premature separation of all or part of the placenta from the underlying myometrium Occurs in 1 in 120 pregnancies Bleeding in decidua basalis occurs with separation
54
how is placenta abruption classified
Classified according to the location of separation Occurring hemorrhage: Retroplacental Intraplacental Marginal Subchorionic blood clot (may be at a distance from the placenta with or without vaginal bleeding).
55
placenta infarcts sono appearance
Evolve through acute, subacute, and chronic stages Majority hypoechoic in acute stage; ultrasound may be unable to distinguish them from intraplacental hemorrhages Calcification may occur over time.
56
what is placental infarction
Placental infarction occurs as a result of obstruction of the spiral arteries and is usually found at the periphery of the placenta.
57
what is a placental lake
Placental infarction occurs as a result of obstruction of the spiral arteries and is usually found at the periphery of the placenta.
58
what is a finding of placental lakes during second semester indicative of
A finding of placental lakes during the second-trimester ultrasound scan does not appear to be associated with uteroplacental complications or an adverse pregnancy outcome. q
59
placental invasion
Abnormal penetration of placental tissue beyond endometrial lining of uterus
60
placenta accreta
Chorionic villi attach to myometrium without muscular invasion.
61
placenta increta
is further extension of the chorionic villi into the myometrium.
62
placenta percreta
penetration of the chorionic villi through the uterus.
63
what is placenta increta the result of
Placenta increta results from underdeveloped decidualization of endometrium.
64
what is the best way to idnetify lower uterine segment
transvag
65
complications of placental previa
``` Preterm delivery Maternal hemorrhage Increased risk of placental invasion Increased risk of postpartum hemorrhage IUGR ```
66
factors associated with placenta previa
``` Advanced maternal age Smoking Cocaine abuse Prior placental previa Multiparity Prior cesarean section Uterine surgery ```
67
Placenta previa
implantation of the placenta completely crosses the internal os
68
marginal (partil previa)
edge of the placenta is abut or covering the os
69
low lying placenta
edge of the placenta is near but not abutting the os | < 2.0 cm from Internal os
70
amniotic bands sonographically
collapsed amnion images, multiple linear wavy echoes | amniotic bands are linear echoes transversing the amniotic cavity
71
in most cases amniotic bands
Do not disturb the fetus
72
amniotic band syndrome can result in what
feral entanglement | Can result in limb deformities, spine and facial abnormalities, amputation
73
what may abnormal membranes present as
without complications or with vaginal bleeding
74
Circumvallate placenta
Attachment of the placental membranes to the fetal surface of the placenta rather than to the underlying villous placental margin
75
what does circumvallate placenta result in
``` Results in placental villi around the border of the placenta that are not covered by the chorionic plate.  Rim forms (Fibrinoid tissue) Most cases have no clinical significance ```
76
what ay circumvallate placenta be associated with
``` Maternal bleeding Placenta Abruption Preterm loss Oligohydramnios Involved in amniotic band syndrome ```
77
Bilobed placenta
Two lobes that are similar size Separated by membranes with some vascular connation between the lobes Communication of placental tissue between the lobes (chorionic bridge). The cord commonly attaches to a thin connecting rim of chorionic tissue which bridges the two lobes.
78
Succenturiate lobe
Visu: 6 % of cases Connected to main placenta by – vessels with in a membrane or by a bridge of membranes Main Placenta- larger & is where Umb. Cord inserts Visu. of Accessory Lobe –clinical relevant b/c of increased risk of infarction, placenta previa, vasa previa, postpartum and hemorrhage assoc. with retained accessory lobe

OBGYN Ultrasound (5 decks)

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