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13 Female Genital and Gestational > 13.6 Gestational pathology > Flashcards

13.6 Gestational pathology Flashcards

1
Q

ecotpic pregnancy

  • key risk factor
  • classic presentation
A

scarring (eg PID, endometriosis)

-L quadrant abdominal pain a few weeks after mised period. Surgical emergency

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2
Q

HELLP

A

preeclampsia with thrombotic microangiopathy involving liver. characterized by:

Hemolysis–shisctocytes from clots

Elevated Liver enzymes–clotted liver

Low Platelets–used for clots

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3
Q

Eclampsia

-tx

A

usu immediate delivery

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3
Q

Hydatidiform mole

  • mech
  • general histology appearance (2)
A
  • abnormal conception, characterized by:
    1. swollen and edamtous villi
    2. with proliferation of trophoblasts
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4
Q

placenta accreta

  • presentation
  • tx
A

‘accretion’

Placenta attaches to myometrium, with little intervening decidua

  • difficult delivery, postpartum bleeding
  • often requires hysterectomy
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4
Q

hydatidiform mole

-most feared complication

A

development of choriocarcinoma, after suction curretage

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5
Q

preeclampsia

  • clinical presentation (3)
  • frequency
  • cause
A
  1. severe HTN (can lead to HA, visual abnormalities)
  2. proteinuria
  3. edema

presents during 3rd trimester in 5% of pregnancies

-due to abnormality of maternal-fetal vascular interface in placenta. resolves with delivery

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6
Q

Eclampsia

A

preeclampsia with seizures

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7
Q

Partial vs Complete mole:

  1. villous edema
  2. trophoblastic proliferation
  3. risk for choriocarcinoma
A
  1. partial: ‘partial hydropic’–some villi are edematous, some not
    complete: most villi are hydropic
  2. partial: ‘partial proliferation’ –focal proliferation present arond ydropic villi
    complete: diffuse, proliferation around entire villi
  3. partial: ‘partial risk’-minimal risk
    complete: ‘complete’ risk–2-3%
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8
Q

Choriocarcinoma:

  • divided into 2 types
  • how are they different
A

2 Flavors of CC

  1. spontaneous germ cell tumor
  2. can arise from gestational complication (eg mole, spont abortion, normal pregnancy)

CC from gestational pathway respond well to chemo, germ cell CC’s do not.

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9
Q

spontaneous abortion

  • occurs before what week
  • how common?
  • most common cause
  • other causes include (3)
A
  • miscarriage before 20 weeks (usu in 1st trimester)
  • 1/4 of pregnancies
  • chromosomal anomalies (esp trisomy 16)
    1. congenital infection
    2. teratogens (esp 1st 2 weeks)
    3. hypercoag states (eg lupus)
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11
Q

Teratogen effect on fetus based on time:

1st 2 weeks

weeks 3-8

months 3-9

A

1st 2 weeks–spont. abortion

weeks 3-8: organ malformation

months 3-9: organ hypoplasia

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12
Q

hydatidiform mole

  • tx
  • what to do after tx and why?
A
  • suction curettage
  • monitor B-hCG levels to:
    1. make sure all is removed
    2. screen for development of choriocarcinoma (CC can arise from complication of gestation, including mole. Also arises as germ cell tumor)
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13
Q

Partial vs Complete mole:

  1. genetics
  2. fetal tissue
A
  1. partial: 69 chromosomes, 2 sperm
    complete: 46 chr, 2 sperm
  2. partial: yes fetal tissue (‘partial fetus’)
    complete: no
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14
Q

what congenital chromosomal anomaly is most common for miscarriage?

A

Trisomy 16. always fatal

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15
Q

Placenta previa

  • presentation
  • tx
A

‘preview’ the placenta

Placenta implants in the lower part of uterus at cervical os. Danger when fetus presses on it.

  • 3rd trimester bleeding.
  • delivery by C section
15
Q

placental abruption

-presentation

A
  • separation of placenta from uterus
  • common cause of stillbirth
  • 3rd trimester bleeding, fetal insufficiency
17
Q

hydatidiform mole

  1. how does female pt present when mole is still in uterus?
  2. what lab value to look at?
  3. appearance on US
  4. how and when does it present when female releases it
A
  1. uterus much bigger than normal in pregnancy
  2. B-hCG much higher than expected at gestation date
  3. ‘snowstorm’ appearance
  4. classically presents in 2nd trimester as passage of grape-like masses through vaginal canal
19
Q

HELLP

-tx

A

usu immediate delivery

20
Q

SIDS

-risk factors (3)

A

sudden infant death syndrome

  • death of infant 1 month to 1 year
    1. sleeping on stomach
    2. exposure to cigarette smoke
    3. prematurity
21
Q

spontaneous abortion

-presentation (3)

A
  1. vaginal bleeding
  2. cramp like pain
  3. passage of fetal tissues

13 Female Genital and Gestational (6 decks)

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