Placenta: Difference between revisions
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*Examine the '''umbilical cord''' | *Examine the '''umbilical cord''' | ||
:*Measure the '''distance''' between the insertion point and the nearest placental margin | :*Measure the '''distance''' between the insertion point and the nearest placental margin | ||
:*Measure the cord '''length''' and give proximal and distal diameter. In placental pathology, the ''proximal'' umbilical cord refers to the segment closest to the placenta, and ''distal'' is the segment closest to the fetus.<ref group= | :*Measure the cord '''length''' and give proximal and distal diameter. In placental pathology, the ''proximal'' umbilical cord refers to the segment closest to the placenta, and ''distal'' is the segment closest to the fetus.<ref group=note>In contrast, in embryology and fetal medicine, the ''proximal'' umbilical cord refers to the segment closest to the fetus:<br>- {{cite journal| author=Wyburn GM| title=The formation of the umbilical cord and the umbilical region of the anterior abdominal wall. | journal=J Anat | year= 1939 | volume= 73 | issue= Pt 2 | pages= 289-310.9 | pmid=17104757 | doi= | pmc=1252509 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17104757 }}<br>{{cite web|url=https://medicine.yale.edu/obgyn/kliman/placenta/research/Umbilical%20Cord%20EOR_163162_284_18220_v1.pdf|title=The Umbilical Cord (from The Encyclopedia of Reproduction)|author=Harvey J. Kliman, M.D., Ph.D.|website=Yale School of Medicine|date=2006-10-29}}</ref> | ||
:*Count the number of '''vessels''' away from the insertion | :*Count the number of '''vessels''' away from the insertion | ||
*'''Weigh''' the trimmed disk, after having trimmed away the cord and membranes, and after having removed excess amounts of loose retroplacental blood clots over the maternal surface. | *'''Weigh''' the trimmed disk, after having trimmed away the cord and membranes, and after having removed excess amounts of loose retroplacental blood clots over the maternal surface. | ||
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==Microscopic examination== | ==Microscopic examination== | ||
*Look for '''inflammation''', especially by the fetal surface in the intervillous spaces and around the fetal blood vessels.<ref group= | *Look for '''inflammation''', especially by the fetal surface in the intervillous spaces and around the fetal blood vessels.<ref group=note>Minor inflammation in the decidua can be ignored as it doesn't have a clinical significance for the fetus.</ref> | ||
<gallery mode=packed heights=200> | <gallery mode=packed heights=200> | ||
File:Histopathology of subchorionic intervillositis, annotated.jpg|Acute '''subchorionic intervillositis''', with neutrophils (annotated) in Langhan’s layer of fibrinoid (by the fetal surface, at the base of a chorionic villus, seen at top right). | File:Histopathology of subchorionic intervillositis, annotated.jpg|Acute '''subchorionic intervillositis''', with neutrophils (annotated) in Langhan’s layer of fibrinoid (by the fetal surface, at the base of a chorionic villus, seen at top right). | ||