Abnormal Placentation

by Veronica Gillispie, MD, FACOG

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    Let's discuss placental abnormalities. Before we discuss what's abnormal, let's discuss what normal placenta looks like. When we talk about the anatomy of normal placenta, we notice the placenta disc. And that's divided into the basal plate which is the maternal side of the placenta. And the chorionic place that's the fetal side of the placenta as you can see here. We have the membranes. And then we have a three vessel umbilical cord. Now unlike the other structures in the human body, this three vessel cord, has two arteries and one vein. Now let's talk about some of the placental structural abnormalities. First let's talk about succenturiate lobe. So this abnormality is one in which an extra lobe separates from the placenta. The clinical manifestation of this can be postpartum hemorrhage. At times that extra lobe can separate. And when you're delivering the placenta, that extra lobe does not come out. And it can be a cause of postpartum hemorrhage because of retained products. Next let's talk about velamentous insertion. So with the velamentous insertion the umbilical vessels traverse the membranes. As you can see here. The vessels are easily compressible. And so that's the clinical manifestation. Also it can be associated with placenta previa. Vasa previa. So with vasa previa the vessels traverse the cervical os. So you can see here in the picture that the vessels are in front of the fetal head. Now that can be problematic. If those vessels lacerated during the cervical exam, or artificial rupture of membranes, the baby can exsanguinate. So it's important to know if the patient has a vasa previa prior to delivery. Let's go through a question abnormal placentation. A patient is known to have a velamentous insertion. What is the most likely fetal abnormality to be seen on...

    About the Lecture

    The lecture Abnormal Placentation by Veronica Gillispie, MD, FACOG is from the course Antenatal Care. It contains the following chapters:

    • Placenta
    • Abnormal Placenta Presentation
    • Abnormal Placental Location

    Included Quiz Questions

    1. Velamentous cord insertion
    2. Succenturiate placental lobe
    3. Vasa previa
    4. Placenta increta
    5. Placenta previa
    1. Cesarean section
    2. Cesarean section and hysterectomy
    3. Normal vaginal delivery of fetus and placenta
    4. Normal vaginal delivery of fetus followed by operative delivery of the placenta
    5. Induction of labor at 35 weeks gestation
    1. Delivery by cesarean section followed by hysterectomy
    2. Delivery by cesarean section only
    3. Normal vaginal delivery followed by hysterectomy
    4. Normal vaginal delivery only
    5. Normal vaginal delivery followed by operative delivery of the placenta
    1. Placental previa
    2. Placental accreta
    3. Placental increta
    4. Placental procreta
    5. Placental succenturiate lobe
    1. Placenta percreta
    2. Placenta increta
    3. Placenta accreta
    4. Placenta previa
    5. Placental abruption

    Author of lecture Abnormal Placentation

     Veronica Gillispie, MD, FACOG

    Veronica Gillispie, MD, FACOG

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