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