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100
Takes wastes and carbon dioxide away from baby
Umbilical arteries
100
Delivers oxygen, nutrients, and hormones to the baby from the placenta
Umbilical Vein
100
What does the ductus arteriosis become after birth?
Ligamentum arteriosum
100
90% of cord insertions are either ____________ or ____________
Central or eccentric
100
Usually defined as < 2 cm between the cord and placental edge
Marginal insertion
100
Increase of the size of the placenta
Placentomegaly
100
The Ductus Venosus becomes what after birth?
Ligamentum venosum
100
Occurs when the placenta partially or totally covers the cervix
Placenta previa
100
Placental Accreta, Increta, and Percreta can be detected as early as ______ to ________ weeks in most at-risk patients by visualization of irregular ___________ spaces within the placenta
15 - 20; vascular
100
This type of placenta anomaly is rarely associated with fetal malformation and ususally has no clinical significance
Circummarginate placenta
100
This type of placental abruption is between the amnion and chorion
pre-placental abruption
200
A ___________ insertion may evolve into a ________________ insertion during pregnancy
marginal; velamentous
200
Placental grading has been found to correlate to
fetal lung maturity
200
Shunts most of the umbilical vein blood flow directly to the IVC
Ductus Venosus
200
Where do the umbilical arteries branch from?
Internal Iliac Arteries
200
Allows blood to enter the left atrium from the right atrium
Foramen Ovale
200
A normal placenta will appear:
smooth with a granular echo pattern
200
When does placental calcification often occur with increasing gestational age?
~ 29 weeks
200
An early progression to a grade 3 placenta is concerning and sometimes associated with this
Placental Insufficiency
200
Placental accreta, increta, and percreta happen when the placenta attaches itself too far into what?
Myometrium
200
Succenturiate placenta is caused by abnormal
Distributions of the chorionic villi
200
This type of placental abruption is also known as subchorionic
marginal placental abruption
300
The umbilical cord is normally made up of how many vessels? What are they?
3; AVA (2 umbilical arteries and 1 umbilical vein)
300
Premature aging of the placenta can indicate
placental insufficiency
300
The umbilical cord inserts into the fetal membranes outside the placental margin and travels between the amnion and chorion to the placenta
velamentous insertion
300
When is the placenta apparent on ultrasound
9-10 weeks
300
Maximum thickness of the placenta at any stage of pregnancy should not exceed
4 cm
300
Connects the pulmonary artery to the proximal aorta and allows most of the blood from the right ventricle to bypass the fetus's fluid-filled non-functioning lungs
Ductus arteriosis
300
One of the biggest concerns of placenta previa
Risk of hemorrhage during labor, deliver, or the first few hours after delivery
300
What is this structure in the fetal heart?
Ductus Arteriosis
300
What type of placenta is shown here
Succenturiate Placenta
300
What type of placenta is shown here
Circummarginate placenta
300
2 primary neoplasms of the placenta (nontrophoblastic)
1. chorioangioma
2. teratomas
400
Succenturiate placenta may be confused with
myometrial contraction
400
The umbilical cord does not insert centrally; common and not considered an abnormality; still in the meaty part of the placenta
eccentric insertion
400
Can occur as a result of velamentous insertion; the vessels traverse the internal os trapping them between the fetus and opening of the birth canal
Vasa Previa
400
In this situation the cord insertion is too close to the edge of the placenta
Marginal insertion
400
Painless, bright red vaginal bleeding during the second half of pregnancy; may have contractions
Placenta previa
400
This is an image of
Placentomegaly
400
Occurs when the placenta goes into the myometrium but does not penetrate uterine muscle
Accreta
400
Placental Accreta, Increta, and Percreta have an increased incidence with: (4)
1. placental previa
2. previous C-section deliveries
3. Women over 35 (AMA)
4. Multiple pregnancies
400
Occurs when the placenta penetrates through the entire uterine wall and invades other organs such as bladder and rectum
percreta
400
What type of placenta is shown here
Circumvallate Placenta
400
This type of placental abruption is the most common
marginal placental abruption
500
Types of cord insertion (4)
1. Eccentric
2. Marginal
3. Velamentous
4. Normal/central
500
Types of Placenta Previa:
1. low lying
2. marginal
3. complete
500
What is the fetal circulation adaptation that allows blood to flow from the right atrium to the left atrium of the heart?
Foramen Ovale
500
At about _____ weeks the ________________________ opposite the implantation site will begin to produce a smooth membrane
5; chorionic villi
500
What is the fetal circulation adaptation that allows blood to bypass the liver and go straight to the IVC?
Ductus Venosus
500
With ________ previa the placenta will usually move away from the cervix as the uterus grows and stretches
marginal
500
Occurs when the placenta does penetrate into the uterine muscle
Increta
500
What is the fetal circulation adaptation that allows blood to bypass the lungs and go straight to the aortic arch?
Ductus Arteriosis
500
What kind of placenta is this
Circumvallate placenta
500
3 secondary neoplasms of the placenta
1. melanoma
2. carcinoma of breast
3. carcinoma of lung
500
This type of placental abruption is where the placenta is detaching from the wall of the uterus
retro-placental abruption
600
One or more accessory lobes connected to the placenta by blood vessels
Succenturiate placenta
600
Most common form of placenta attaching into myometrium
Accreta
600
Premature aging of the placenta can cause _______ and is associated with: (4)
IUGR:
1. smoking
2. chronic HTN
3. Lupus
4. Diabetes
600
What are 1 and 2 in this image? And what are they going around?
umbilical arteries; bladder
600
Risk factors of Placenta previa: (3)
1. C-section
2. surgery to remove fibroids
3. D & C
600
Placenta Grade _____
II
600
Placenta grade ____
I
600
Placental Grade ____
III
600
Label 1, 2, and 3
1. Accreta
2. Increta
3. Percreta
600
What type of placental abruption is this?
Marginal
600
This is the most common maternal malignant tumor to metastasize to the placenta
Melanoma
700
2 complications of vasa previa
1. vessels may rupture causing significant blood loss
2. vessels easily become compressed which causes heart rate to drop
700
PLACENTAL GRADE:
< 18 weeks:
uniform echogenicity
smooth chorionic plate
Grade 0
700
PLACENTA GRADE: > 39 weeks
significant calcification
chorionic plate interrupted by indentations
Grade III
700
PLACENTAL GRADE:
18-29 weeks:
occasional hyper-echoic area/calcification
chorionic plate well defined
Grade 1
700
3 classifications of placental abruption
1. pre-placental
2. marginal placental
3. retro-placental
700
Placental grade ____
0
700
Least common and most dangerous form of placenta attaching into myometrium
Percreta
700
PLACENTAL GRADE:
> 30 weeks:
basal echoed in the placenta are a hallmark
grade II
700
Relatively common; benign vascular tumor; usually asymptomatic and small
chorioangioma
700
A benign non-trophoblasic tumor composed of mixture of epithelial, adipose, skeletal, and connective tissues
teratoma
700
Similar to cirumvallate placenta, but the membrane ring is thinner
circummarginate placenta
800
5 Fetal adaptations from video:
1. Umbilical vein
2. Umbilical artery
3. Ductus Venosus
4. Foramen Ovale
5. Ductus Arteriosus
800
Types of placental positioning (7)
1. Posterior
2. Anterior
3. RT Lateral
4. LT Lateral
5. Fundal
6. Combination
7. Covering OS
800
Causes of placentomegaly: (7)
1. maternal anemia
2. maternal diabetes
3. chromosomal abnormalities
4. hydrops
5. inutero infection
6. Beckwith-Wiedemann syndrome
7. Hydatidiform mole
800
Placenta previa is more common among women who (6)
1. have already delivered at least one baby
2. had placenta previa in past
3. are carrying multiples
4. AMA
5. Asian
6. Smoke
800
Circumvallate placenta is associated with (4)
1. Placental abruption
2. Oligohydramnios
3. Preterm birth
4. Increased risk of fetal demise
800
Symptoms of placental abruption: (4)
1. vaginal bleeding
2. abdominal tenderness/back pain
3. contractions
4. abnormalities in the baby's heartbeat
800
Cause is unknown but some risk factors for placental abruption (7)
1. polyhydramnios
2. trauma
3. high blood pressure
4. past pregnancies
5. smoking
6. street drugs
7. AMA
800
label 1, 2, and 3
1. pre-placental abruption
2. marginal placental abruption
3. retro-placental abruption
800
Tend to occur on fetal side of placenta near cord insertion; solid, hypo-echoic, rounded mass with anechoic areas
Chorioangioma
800
Very rare and benign; almost never associated with congenital deformities
Teratoma
800
What type of placental abruption
Retro-placental abruption
900
Perfused by the fetal circulation and may impair fetal cardiac activity if large in size
chorioagnioma
900
Doppler evaluation of the placenta is useful in diagnosing (3)
1. chorioangioma
2. placenta accreta
3. vasa previa
900
Succenturiate Lobe
900
What is this image of
Percreta
900
Premature aging of the placenta
900
The placenta should never measure more than
4 cm
900
These will present as very vascular with fetal arterial waveforms
Chorioangiomas
900
Circumvallate
900
Vasa Previa
900
Placental Metastasis (from maternal breast cancer)
900
What is this an image of
Chorioangioma