Placenta Study Guide

Maternal conditions that affect placenta include:

*hypertension renal disease diabetes anemia blood clotting dugs/toxins infarction

Placental abruption is associated with ___ and vascular disease.

Hypertension

Circumvallate placenta is important to diagnose because it can lead to ___, preterm labor, IUGR, and placental ___.

PROM abruption

3 types of abnormal placental invasion are:

1. accretta = attach 2. increta = into myometrium 3. percreta = penetration (through) myometrium

List the 4 types of previa and describe them.

1. complete 2. partial - touching cervix but not covering 3. marginal 4. Low lying

Placenta can be seen towards the end of the ___ trimester. Usually should measure ___.

1st less than 4cm

Dizygotic twins come from ___ separate fertilized eggs and result in ___ separate placentas. These are termed dichorionic.

2 2

Mothers contribution to the placenta is the decidua ___. This is referred to as the ___ plate and is found ____.

basalis basal retroplacental

Depending on location patient may present with pain and/or ___.

bleeding

The decidua ___ surrounds the blastocyst which is covered by ___ initially. The ___ is found opposite side of the implantation site. Together they make up the ___ sign.

capularis villi parietalis decidua

Most common placental tumor is the ___. It is a benign tumor that may increase ___.

chorioangioma maternal serum AFP (MSAFP)

Circumvallate is when the borders of the placenta are not covered by the ___ plate (baby side). Placental margins will be ___, thickened and ___.

chorionic folded elevated

What is migration?

describes how the placenta changes position within uterine cavity.

Causes of placentomegaly include maternal ___ and ___, Rh sensitivity, uterine ___, twin-to-twin transfusion, and fetal ___ and neoplasms.

diabetes anemia infections malformations

Marginal bleeds will be located on the placental ___ and bleeding if present will be ___ due to low pressure.

edge/margin old/brown

The chorion ___ forms the fetal contribution to the placenta. The chorionic ___ are found here after implantation. The part of the blastocyst that does not contain villi is referred to as the chorionic ___.

frondosum villi laeva

Locations a placenta may attach:

fundus anterior posterior lateral - lt/rt

Causes of small placenta include aneuploidy (anomaly), intrauterine ___, and IUGR.

infection

Vasa previa is when fetal vessels cross the ___ os of cervix. These vessels can cause rupture and life-threatening ___.

internal hemorrhage

You should document the echogenicity and ___ of the placenta. Document the inferior edge of placenta in relation to the ___ cervical os. You need to also document the ___ to the umbilical cord. This should attach ___ placenta.

location internal insertion mid

In accreta the villi attach to the ___, increta is a further extension into the myometrium and percreta the villi ___ the myometrium and into adjacent ___. Accreta = ___. Increta = ___. Percreta = ___.

myometrium penetrate bladder attach into penetrate

Clinical presentation of placenta previa include ___, bright red ___ in the ___ and ___ trimesters.

painless bleeding 2nd 3rd

Identical twins may or may not share a ___. If they have their own placenta they are dichorionic and if they share a placenta it is termed ___. These babies are more at risk.

placenta monoamniotic

Implantation of placenta over the internal os is termed?

placenta previa

Premature separation of placenta is termed:

placental abruption or abrupto placenta

Describe succenturiate lobe.

presence of one of many accessory lobes connected to body of placenta by placental/blood vessels

Functions of the placenta are: ___, ___, excretion, protection, give ___, and storage.

respiration hormones nutrients

With succenturiate lobe there is a risk that the connecting vessels may ___ or be left behind as retained POC.

rupture

Typically these are ___ masses but can be large causing ___, anemia, ___, hydrops and even ___.

small polyhydramnios demise IUGR

Most common causes of vasa previa are ___ insertion of the umbilical cord or ___ lobe that vessels traverse the ___.

velamentous succenturiate cervix

Placental or ___ lakes are a normal finding and can be seen within the placenta and show no ___ on color doppler.

venous flow

Factors associated with placenta previa include:

-advanced maternal age -smoking -cocaine abuse -prior placenta previa -multiparity -prior cesarean section -uterine surgery scar

How can you prove abruption?

-echogenicity (depends on age of hemorrhage), acute is similar to placenta. chronic is hypoechoic *color to look for void on myometrium