The Placenta- Pt 1

The placenta is highly _______________, and is a ____________________ organ, present during pregnancy only.

Fetal well being depends on an ________________ and ________________ utero-placental vascular supply.

The placenta is divided into two portions, the ________________ surface and ________________ surface.

The placenta is connected to the fetus via the ________________ _______________.

The placenta is ________________ after the fetus is delivered. It is known as the "________________"

The site of the former umbilical cord attachment is known as the _________________/_______________ (______________ _______________)

Placental functions-Provides _______________ and ______________ to the fetus.

Placental functions-Removes _______ and ____________ from fetus. Oxygen, nutrients and water pass from mother to fetus, while CO2 and waste pass from fetus to mother.

Placental functions-____________________ out some substances which may be harmful to the fetus.

Some harmful substances are NOT able to be filtered out by the placenta such as _______________. Several types of infections and viruses may also cross this barrier such as _________________, _______________ and _________________.

Placental functions-Production of ________________. Produces _________________ and ___________________ which are important in maintaining pregnancy.

Placental function depends on the proper placental development from _____________ derived from the mother (_______________) and fetus (_______________)

Any reference to the ________________ plate refers to the maternal side.

Any reference to the __________________ plate refers to the fetal side.

The placenta can be identified sonographically as early as _____(#) - ____(#) weeks

Attachment to the uterine wall can occur ___________________ within the uterine cavity.

Where the placenta attaches is where the _________________ implants.

Name the six locations of the placenta in alphebetical order

The apparent change in placental location during the first part of a pregnancy is referred to as ___________________ _____________________.

"Placental migration" is a misnomer, because in reality the placenta does not really move. There is growth in the _______________ _________________ _________________ during pregnancy which makes it appear as if the placenta moved upward. The enlarged uterus pulls the placenta toward the ____________ of the uterus.

_______________ ________________ is abnormal location of the placenta in the lower part of the uterus with a portion of teh cervix being covered.

Placenta previa occurs when the _________________ ___________________ _______________ is covered by the placenta. (Incidence is 1:_____(#) -_____(#) at >20-24 weeks.)

_________________ _________________ is the most common cause of painless pleeding in the second and third trimesters.

Placenta previa is most common in-

• Multiparous women

• Patients with prior cesarean section or uterine surgery (Triple the risk due to scar tissue)

• Advanced maternal age

• Previous ectopic pregnancies

• Closely spaced pregnancies

• Women with PID

• Cigarette smoking

Painful bleeding is a sign of _______________ _________________.

Signs and symptoms of placenta previa include painless vaginal bleeding in _____________ and _______________ trimesters.

Name the four classifications of placenta previa in alphabetical order.

_______________ ______________ placenta is technically not a true previa. The placental edge is in the lower uterine segment, but not covering the internal os. Placental edge is within 2cm of cervical os without covering it.

_________________ placenta previa is when the placental edge reaches the margin of internal os, not covering it. The placental edge extends up to, but not covering os. Requires follow up later in pregnancy.

______________ _______________ is when a small edge or segment of the placenta extends over the margin of the internal os.

______________ _______________ is when the placenta covers the entire internal os. An overdistended bladder may mimic this.

The maternal side of the placenta is ______________ and _______________.

The Basilar plate is divided into ______________, or functional lobes with irregular grooves.

The fetal surface is ___________ and covered by a ______________.

Average placental size at maturity-Weight- ______(#) to _____(#) gramsSize- ______(#)  to _____(#) cmThickness: _____(#) cm (AP dimension)

As a general rule, after 23 weeks, the placenta should be no thinner than ____(#) cm or thicker than ___(#) cm.

Large placenta size is associated with-

• Maternal gestational diabetes

• Rh sensitivity

• Multiparous

• Chromosomal anomaly

• Intrauterine infection

Thin placenta is associated with-

• IUGR

• Maternal gestational diabetes

• Maternal hypertension

• Pre-eclampsia

• Placental insufficiency

Sonographic evaluation-Examination of the placenta is an important part of every obstetric sonogram. It is of critical importance when there is any indication of _____________ _____________, for example, in the setting of ______________ ______________.

Sonographic evaluationExamination of the placenta can also give important clues regarding ______________ _______________, _______________, ________________, etc.

Sonographic evaluationthe placenta is a relatively ______________ organ that may exhibit varying degrees of ______________(late pregnancy) and _______________ spaces. (placental ________)

List the four things the placenta should be evaluated for in alphabetical order-