OBGYNE - form due to slowing down of maternal

blood flow leading to stasis & fibrin

1. cord inserts b/n 2 placental lobes – either
deposition
into a connecting chorionic bridge or
- -layer of fibrin diminishes O2 to villus
intervening membranes? 1:350 deliveries
- ---syncytiotrophoblast necrosis
a. Other names?
11. Types of Hematoma
2. Smaller version of bilobate placenta?
a. b/n placenta & its adjacent decidua?
- 2fold higher incidence in twin
b. b/n chorion & decidua aka
pregnancies
“subchorionic hemorrhage”?
- vascular connections of fetal origin
c. along roof of intervillous space &
- -if retained in the uterus after delivery
beneath chorionic plate? Aka
- --- HEMORRHAGE
“Breus mole”
3. All or large part of fetal membranes are
d. b/n placenta & amnion; of fetal
covered by functioning villi? -may give
vessel origin?
rise to serious hemorrhage because of
- acute events during 3rd stage labor when
associated placenta previa or accreta
cord traction ruptures a vessel near cord
4. Placenta is annular in shape?
insertion
- variant of placenta membranacea
- chronic lesions, asstd. w/ fetomaternal
- tissue atrophy in a portion of the ring, a
hemorrhage or fetal growth restriction
horseshoe shape is more common
- confused with chorioangioma
- antepartum and postpartum bleeding and
12. Calcium salts may be deposited
IUGR
throughout placenta but are most
5. Central portion of a discoidal placenta is
common on maternal surface in basal
missing?
plate
- actual hole in the placenta, more often
- Asstd. w/ nulliparity, higher
defect involves only villous tissue with
socioeconomic status & greater maternal
chorionic plate intact
serum calcium level
6. -when the chorionic plate is smaller than
- Seen in sonography
the basal plate --- placental periphery is
13. Striking enlargement of chorionic
uncovered?
villi commonly seen in severe
7. -fetal surface presents a central
erythroblastosis & fetal hydrops
depression surrounded by
- maternal diabetes, fetal congestive
- a thickened, grayish-white ring
- heart failure & maternal-fetal syphilis
- -ring is composed of a double fold of
14. Resemblance of their components
amnion and chorion, with degenerated
to the blood vessels & stroma of the
decidua and fibrin in between
chorionic villus?
8. -when the ring does not have the central
- Only BENIGN tumors of the placenta
depression with the fold of membranes?
- Well-circumscribed , rounded,
- less well defined adverse clinical
predominantly hypoechoic lesion near
outcomes
chorionic surface & protruding into
9. -deposits dense fibrinoid layer on
amnionic cavity
placental basal plate?
- > 5 cm, asstd w/ significant AV
- Blockade to normal maternal blood flow
shunting w/in placenta leading fetal
10. -small yellow white nodules w/in
anemia & hydrops
placenta are normal part of placental
aging? 15.4 most common metastatic cancers in
the placenta? M,L,L,Bc
16. What type of cancer can metastasize to the
fetus?
17. Inflammation of the fetal membranes?
a. -leukocytes in amnionic fluid?
b. -umbilical cord?
18. a condition in which the umbilical cord is
inserted at or near the placental margin rather
than in the center?
19. insertion is normal but umbilical vessels
lose their protective Wharton jelly shortly
before insertion?
- covered only by amnion & prone to
compression, twisting & thrombosis
20. umbilical vessels spread w/ in membranes
at a distance from the placental margin, which
they reach surrounded only by a fold of amnion
–- vessels vulnerable to compression –- fetal
anoxia?
21. placental vessels overlie the cervix, lie b/n
cervix & presenting fetal part, & supported only
by membranes? 1:5200 pregnancies
22. knobs protruding from cord surface
-focal redundancies of a vessel or Wharton jelly
-w/ no clinical significance
23. active fetal movements, -high in
monoamnionic twins, risk of stillbirth increased
5-10fold, in live fetuses, increased FHR
abnormalities but cord blood acid base values
usually normal?
24. UC may be the presenting part in labor &
asstd w/ fetal malpresentation; cord prolapse or
FHR abnormalities is an asstd labor finding?
25. focal narrowing of cord diameter that
develops in area of fetal umbilical insertion ?
26. -Found along the course of the cord;
a. epithelium –lined remnants of the allantois;
co-exist w/ persistently patent urachus?
b. form fr local degeneration of Wharton jelly;
asstd w/ structural & chromosomal defects
(trisomy 18 & 13 )?
c. found in1st tri tend to resolve completely?
d. may portrend miscarriage & aneuploidy?
27. have lower perinatal morbidity &
mortality than those in the artery?
28. –marked focal dilatation that develop w/in
intra-amnionic part of the umb. vein w/in its
fetal intra-abd’l portion?
29. rare congt’l thinning of vessel wall w/
diminished support fr Wharton jelly?
- most form at or near cord insertion into the
Placenta
asstd w/ single umb. artery, trisomy 18, fetal
growth restriction & stillbirth
30. Good contractions, frequency?
31. After the expulsion of the baby and
placenta and membranes, what stage of labor?
32. How many cotyledons of the placenta?
33. Causes uterine contraction and peripheral
vasodilation? --> hypotension and tachy
34. Not given to women with a history of
bronchial asthma?
35. Cautiously given to women with
hypertension?
36. Keeps the fundus low?
37. A physiologic pain experienced during
postpartum in the uterus (lower abdomen)
when the baby suckles?
38. From expulsion of membranes up to 1 or 2
hours post-partum, what stage?
39. From delivery of the membrane up to 6
weeks post-partum?
40. Rarely exceeds 39celsius and usually lasts
<24 hours?
41. What are the three complications of uterine
and pelvic infections?
42. A common cause of persisitent fever in
women treated for metritis?
a) Begins at what day?
43. A serious complication, bowel evisceration
can be a morbid, surgical emergency, presents
w/in 7-10 post-op days, high mortality risk,
usually caused by infections?
44. Uncommon severe wound infection
a) Risk factors?
b) Symptoms noted until 3-5 days after
delivery
45. Organs outside the uterus such as fallopian
tube and ovary located bilaterally?
46. Intense parametrial cellulitis forming a
phlegmon within the leaves of the broad
ligament, fever persist longer than 72 hours
despite IV antimicrobial therapy, fever resolves
in 5-7 days?
47. Frequent complication in the pre-antibiotic
era, septic embolization was common, ovarian
veins may become involved?
a) Chills, occasional lower quadrant pain,
usually asymptomatic
48. An acute febrile illness w/ severe
multisystem derangement, 10-15% case-
fatality rate?
a) Caused maternal mortality
49. Post-partum incidence of mastitis?
a) Suppurative mastitis seldom appear
before the end of the 1st week
postpartum seen usually at 3rd or 4th
week, unilateral
b) Engorgement first followed by
inflammation
c) Sonography (diagnostics)
50. Immediate source of mastitis-causing
organisms is almost always caused by?
a) Resolves within 48hours
b) Dicloxacillin 500mg 4x a day
c) Erythromycin
d) Vigorous milk expression maybe be a
sufficient treatment alone
e) Continue breastfeeding