1.
The umbilical cord normally inserts _____________ within the placenta.
Explanation
The umbilical cord normally inserts centrally within the placenta, meaning that it is attached to the middle or center of the placenta. This is the typical and expected location for the umbilical cord to be connected to the placenta, allowing for proper blood flow and nutrient exchange between the fetus and the mother.
2.
Many conditions of umbilical cord insertion are not apparent before delivery.
Correct Answer
A. True
Explanation
This statement is true because umbilical cord insertion conditions, such as velamentous cord insertion or marginal cord insertion, are not always visible or detectable before delivery. These conditions can only be confirmed through ultrasound or during the delivery process. Therefore, it is accurate to say that many conditions of umbilical cord insertion are not apparent before delivery.
3.
______________ (marginal) placenta is when the cord inserts along the margin of the placenta and is usually of _______ clinical significance.
Correct Answer
battledore, no
Explanation
In a battledore placenta, the umbilical cord inserts along the margin of the placenta instead of the center. This condition is usually of no clinical significance, meaning it does not have any major impact on the health or well-being of the mother or baby.
4.
_________________ (membranous) cord insertion is when the cord inserts beyond the placental edge into the ___________ membranes of the placenta.
Correct Answer
Velamentous, free
Explanation
Velamentous cord insertion is a condition where the umbilical cord inserts into the membranes of the placenta rather than attaching directly to the placental edge. In this condition, the blood vessels of the umbilical cord are not protected by the Wharton's jelly and are vulnerable to compression or rupture. The term "free" refers to the absence of any abnormal cord insertion, indicating a normal attachment of the cord to the placental edge.
5.
Prenatal identification of a _______________ insertion of the umbilical cord is a desirable clinical goal since these pregnancies have higher risks for adverse perinatal outcome.
Correct Answer
velamentous
Explanation
A velamentous insertion of the umbilical cord refers to a condition where the umbilical cord inserts into the fetal membranes rather than attaching directly to the placenta. This condition is associated with higher risks for adverse perinatal outcomes. Therefore, prenatal identification of a velamentous insertion of the umbilical cord is considered a desirable clinical goal in order to monitor and manage these pregnancies more effectively and reduce the potential risks to the fetus.
6.
Velamentous insertion may be complicated by ___________ of the umbilical vessels because they __________ (are or aren't) protected by Wharton's jelly
Correct Answer
rupture, aren't
rupture, are not
Explanation
Velamentous insertion refers to a condition where the umbilical cord inserts into the fetal membranes instead of attaching directly to the placenta. In this condition, the umbilical vessels are not protected by Wharton's jelly, a gelatinous substance that surrounds and cushions the vessels in a normal insertion. Without this protection, the umbilical vessels are more vulnerable to rupture, leading to potential complications. Therefore, the correct answer is "rupture, aren't" or "rupture, are not".
7.
Velamentous insertion is associated with ____________ and _____________ _____________.
Correct Answer
IUGR, vasa previa
Explanation
Velamentous insertion is a condition where the umbilical cord inserts into the fetal membranes instead of attaching directly to the placenta. This abnormal insertion is associated with two complications: intrauterine growth restriction (IUGR) and vasa previa. IUGR refers to the poor growth of the fetus, leading to a smaller size than expected for the gestational age. Vasa previa, on the other hand, is a dangerous condition where fetal blood vessels cross the cervix, making them vulnerable to rupture during labor or delivery.
8.
Risks of velamentous insertion-
_______________ is vessels are torn. ____________ easily diagnosed on ultrasound.
Correct Answer
hemorrhage, not
Explanation
Velamentous insertion refers to the abnormal attachment of the umbilical cord to the fetal membranes rather than the placenta. This condition poses several risks, one of which is hemorrhage. When the umbilical vessels are not protected by the placenta, they are more susceptible to tearing, leading to bleeding. This can be a life-threatening situation for both the mother and the baby. However, velamentous insertion is not easily diagnosed on ultrasound, making it important for healthcare providers to be vigilant and consider this condition when there are signs of fetal distress or abnormal placental location.
9.
A rare cord abnormality that is life threatening where the blood vessels of the umbilical cord cross the cervical os is known as _____________ ______________. This may be difficult to detect on routine obstetrical sonography but _______________ ______________ imaging can demonstrate it.
Correct Answer
vasa previa, color doppler
Explanation
Vasa previa is a rare cord abnormality where the blood vessels of the umbilical cord cross the cervical os, which can be life-threatening. It may not be easily detected on routine obstetrical sonography, but color Doppler imaging can demonstrate it.
10.
With vasa previa, the _____________ _____________ is the presenting part.
Correct Answer
umbilical cord
Explanation
In cases of vasa previa, the umbilical cord is the presenting part. Vasa previa is a condition where the blood vessels of the umbilical cord or placenta cross or lie close to the cervical opening. This can be dangerous during labor as pressure or rupture of these vessels can lead to severe bleeding and harm to the baby. Therefore, identifying the umbilical cord as the presenting part is crucial in managing and delivering the baby safely.
11.
With vasa previa, it is usually _______________, but possibly ______________ bleeding in ____________ and _____________ trimester.
Correct Answer
asymptomatic, painless, second, third
asymptomatic, painless, 2nd, 3rd
Explanation
Vasa previa is a condition where fetal blood vessels cross or run near the cervix. It is typically asymptomatic and painless, meaning that the affected individual may not experience any noticeable symptoms. This condition is most commonly observed in the second and third trimesters of pregnancy. Therefore, both options provided in the answer are correct and interchangeable, as they convey the same information.
12.
Complications of vasa previa include lack of ____________ to the fetus due to compression of cord during ____________.
Correct Answer
oxygen, delivery
Explanation
Complications of vasa previa include lack of oxygen to the fetus due to compression of the cord during delivery. Vasa previa is a condition where the fetal blood vessels, unsupported by the placenta or umbilical cord, run across the cervix. This can lead to the vessels being compressed or ruptured during delivery, resulting in a lack of oxygen supply to the fetus.
13.
Vasa previa
Umbilical vessels may rupture during labor/delivery causing ____________ ______________.
Correct Answer
fetal demise
Explanation
During labor or delivery, if the umbilical vessels rupture, it can lead to fetal demise. This means that the baby's death can occur as a result of the rupture. The umbilical vessels are responsible for carrying oxygen and nutrients from the placenta to the fetus, so if they rupture, the baby may not receive the necessary oxygen and nutrients, leading to fetal demise.
14.
Vasa Previa
If undetected, the fetus will likely die at delivery from ruptured _____________ _____________ vessels or lack of ______________.
Correct Answer
umbilical cord, oxygen
Explanation
If undetected, the fetus will likely die at delivery from ruptured umbilical cord vessels or lack of oxygen. This is because the umbilical cord is responsible for supplying oxygen and nutrients to the fetus. If the umbilical cord vessels rupture, the fetus will not receive the necessary oxygen and nutrients, leading to its death.
15.
Vasa previa is associated with ______________ cord insertion
Correct Answer
velamentous
Explanation
Vasa previa is a condition where the fetal blood vessels, specifically the umbilical cord vessels, are not protected by the placental tissue and are instead located between the fetal membranes. This condition is associated with velamentous cord insertion, where the umbilical cord inserts into the fetal membranes instead of directly into the placenta. This abnormal cord insertion increases the risk of the blood vessels being compressed or ruptured, leading to potential complications such as fetal hemorrhage.
16.
Vasa Previa
A vaginal birth is required.
Correct Answer
B. False
Explanation
C-section is required
17.
Name the cyst-
Remnants of the allantois (a fluid filled structure that extends from the developing bladder in the base of the umbilical cord). These cysts tend to be closer to the fetal end of the cord, and most are small, typically 1-2 cm in diameter.
Correct Answer
Allantoic duct cyst
Explanation
An allantoic duct cyst is named after the remnants of the allantois, which is a fluid-filled structure that extends from the developing bladder in the base of the umbilical cord. These cysts are usually found closer to the fetal end of the cord and are typically small, measuring about 1-2 cm in diameter.
18.
Name the cyst-
Remnants of the vitteline duct. May be up to 6 cm in size, located close to the fetal end of the cord.
Correct Answer
omphalomesenteric duct cyst
Explanation
An omphalomesenteric duct cyst is a type of cyst that forms from remnants of the vitteline duct. It can grow up to 6 cm in size and is typically located near the fetal end of the umbilical cord. This cyst is named after the omphalomesenteric duct, which is a structure that connects the developing embryo to the yolk sac during early development.
19.
Difference between Allantoic and Omphalomesenteric duct cysts are only distinguishable by __________examination. They may be seen in association with anomalies of ___________________ and ___________________ tracts because they are developmentally related.
Correct Answer
histologic, gastrointestinal, genitourinary
histologic, gastrointestinal, genito-urinary
Explanation
Allantoic and Omphalomesenteric duct cysts can only be distinguished through histologic examination. These cysts are often found in association with anomalies of the gastrointestinal and genitourinary tracts because they are developmentally related.
20.
Name the umbilical cord mass-
Benign tumor or the umbilical cord, may appear as echogenic mass located near the placental cord insertion. May cause vascular obstruction if becomes large in size.
Correct Answer
hemangioma
Explanation
A hemangioma is a benign tumor that can occur in the umbilical cord. It is characterized by an echogenic mass near the placental cord insertion. If the hemangioma grows in size, it can cause vascular obstruction.
21.
Name the umbilical cord mass-
Rare, rupture of wall of umbilical vein secondary to trauma or weakness that causes bleeding into jelly. Can be a lethal condition as it puts pressure on vein and results in umbilical vein thrombus.
Correct Answer
hematoma
Explanation
The given description suggests that the umbilical cord mass is a hematoma. A hematoma refers to a localized collection of blood outside the blood vessels, usually caused by trauma or injury. In this case, the rupture of the wall of the umbilical vein leads to bleeding into the surrounding tissue, forming a hematoma. This condition can be dangerous as it puts pressure on the vein and can result in the formation of a blood clot (thrombus) within the umbilical vein.
22.
Name the umbilical cord mass-
Defined as a midline defect of the abdominal wall with extrusion of the abdominal contents into the base of the umbilical cord.
Correct Answer
omphalocele
Explanation
An omphalocele is a condition characterized by a midline defect in the abdominal wall, resulting in the protrusion of abdominal contents into the base of the umbilical cord. This is a correct answer because it accurately describes the umbilical cord mass in question.
23.
Omphalocele
Occurs in approximately ____(#) per 10,000 births. There is a high incidence between omphalocele and ___________ anomalies (40-60%). There is also an association with ______________ defects.
Correct Answer
2, chromosomal, cardiac
two, chromosomal, cardiac
Explanation
Omphalocele occurs in approximately two per 10,000 births. There is a high incidence between omphalocele and chromosomal anomalies (40-60%). There is also an association with cardiac defects.
24.
With omphalocele, there will be elevated ____________ _____________ ______________ (_______________) and is seen sonographically as a mass in the ____________ of the umbilical cord.
Correct Answer
maternal serum alpha-fetoprotein, MS-AFP, base
Explanation
With omphalocele, there will be elevated maternal serum alpha-fetoprotein (MS-AFP) levels. This can be seen on a sonogram as a mass in the base of the umbilical cord.
25.
Prognosis depends on ___________ of omphalocele and presence of other ______________. Treatment is _______________ after birth.
Correct Answer
size, defects, surgery
Explanation
The prognosis of omphalocele depends on the size of the defect and the presence of other associated defects. The larger the size of the omphalocele, the higher the risk of complications and poorer prognosis. Additionally, the presence of other associated defects can also impact the prognosis. Treatment for omphalocele typically involves surgery after birth to repair the defect and ensure the proper development and function of the abdominal organs.