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The anomaly scan, also sometimes called the anatomy scan, 20-week ultrasound, or level 2 ultrasound, evaluates anatomic structures of the fetus, placenta, and maternal pelvic organs. This scan is an important and common component of routine prenatal care . [ 1 ]
An important risk factor for placenta accreta is placenta previa in the presence of a uterine scar. Placenta previa is an independent risk factor for placenta accreta. Additional reported risk factors for placenta accreta include maternal age and multiparity, other prior uterine surgery, prior uterine curettage, uterine irradiation, endometrial ablation, Asherman syndrome, uterine leiomyomata ...
In the second trimester, a standard ultrasound exam typically includes: [12] Fetal number, including number of amnionic sacs and chorionic sacs for multiple gestations; Fetal cardiac activity; Fetal position relative to the uterus and cervix; Location and appearance of the placenta, including site of umbilical cord insertion when possible
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Both abdominal and vaginal ultrasound may be used, but vaginal ultrasound allows for earlier visualization of the pregnancy. With obstetric ultrasonography the gestational sac (intrauterine fluid collection) can be visualized at 4.5 to 5 weeks gestation , the yolk sac at 5 to 6 weeks gestation, and fetal pole at 5.5 to 6 weeks gestation.
Placenta praevia is when the placenta attaches inside the uterus but in a position near or over the cervical opening. [1] Symptoms include vaginal bleeding in the second half of pregnancy . [ 1 ] The bleeding is bright red and tends not to be associated with pain. [ 1 ]
In a circumvallate placenta, the chorionic plate, which forms the fetal surface of the placenta, tends to be smaller than the basal plate, which forms the maternal surface of the placenta. This results in the elevation of the placental margin and the appearance of an annular shape. [3]
Histopathology of placenta with increased syncytial knotting of chorionic villi, with two knots pointed out. The following characteristics of placentas have been said to be associated with placental insufficiency, however all of them occur in normal healthy placentas and full term healthy births, so none of them can be used to accurately diagnose placental insufficiency: [citation needed]