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All the things continued > 13.7 Gestational Path > Flashcards

13.7 Gestational Path Flashcards

1
Q

What is the most common site for an ectopic pregnancy?

A

Lumen of the fallopian tube

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2
Q

What is the key risk factor for ectopic pregnancy?

A

Scarring of the uterus (e.g. asherman syndrome, PID, endometriosis)

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3
Q

What is the classic presentation of an ectopic pregnancy?

A

Lower quadrant abdominal pain weeks after a missed period

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4
Q

What is the treatment for an ectopic pregnancy?

A

Surgical emergency

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5
Q

What is the definition of a spontaneous abortion?

A

Miscarriage of the fetus, before 20 weeks gestation

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6
Q

What is the classic presentation of spontaneous abortions?

A

Vaginal bleeding, cramp-like pain, and passage of fetal tissue

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7
Q

What is the most common cause of spontaneous abortions?

A

Chromosomal anomalies

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8
Q

What is the classic hypercoagulable state that can produce recurrent miscarriages?

A

SLE–lupus anticoagulant

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9
Q

Exposure to a teratogen within the first 2 weeks of gestation usually leads to what?

A

spontaneous abortion

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10
Q

Exposure to a teratogen between 3-8 weeks gestation usually leads to what?

A

malformations

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11
Q

Exposure to a teratogen between 3-9 months usually leads to what?

A

Organ hypoplasia

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12
Q

What is placenta previa?

A

Implantation of the placenta in the lower uterine segment, overlying the os

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13
Q

How does placenta previa usually present?

A

Third trimester bleeding

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14
Q

What is the treatment for placenta previa?

A

C-section

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15
Q

What is placental abruption?

A

Separation of the placenta from the decidua, prior to delivery of the fetus

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16
Q

Placental abruption usually leads to what?

A

Still birth

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17
Q

What is the usual presentation of placental abruption?

A

Third trimester bleeding and fetal insufficiency

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18
Q

What are the gross characteristics of placental abruption?

A

Large blood clots between placenta and uterine wall

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19
Q

What is placenta accreta?

A

Improper implantation of the placenta into the myometrium with little or no intervening decidua

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20
Q

What is the usual presentation of placental accreta?

A

Difficult delivery of the placenta and postpartum bleeding

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21
Q

What is the treatment for placenta accreta?

A

Hysterectomy

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22
Q

What is preeclampsia? What causes it?

A

Pregnancy-induced HTN, proteinuria, and edema in the 3rd trimester, d/t abnormality of maternal-fetal vascular interface in placenta

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23
Q

What is seen in the vessels of the placenta with preeclampsia?

A

Fibrinoid necrosis

24
Q

What is eclampsia?

A

seizure induced by HTN from baby

25
Q

What is HELLP syndrome?

A

Preeclampsia with thrombotic microangiopathy involving the liver

26
Q

What are the labs that are elevated with HELLP syndrome? (3)

A

Hemolysis
Elevated LFTs
Low platelets

27
Q

What causes the hemolysis with HELLP?

A

Platelet deposition in the blood vessels leading to schistocyte formation

28
Q

What is SIDS? What is the age range that this occurs in?

A

Death of a healthy infant between 1 month to 1 year

29
Q

What type of sleeping is a risk factor for the development of SIDS?

A

Sleeping on the stomach

30
Q

What are the environmental risk factors for SIDS?

A

Smoking in house

Prematurity

31
Q

What are hydatidiform moles?

A

Abnormal conception characterized by swollen and edematous villi, with proliferation of the trophoblasts

32
Q

What are the classic s/sx of hydatidiform moles? (2)

A
  • Uterus bigger than expected for dates of gestation

- beta-HCG higher than expected

33
Q

What are the gross characteristics of hydatidiform moles?

A

Swollen and edematous villi

34
Q

What are the presenting s/sx of a hydatidiform mole w/o prenatal care?

A

Passage of grape-like masses through the vaginal canal in the 2ns trimester

35
Q

What are the grape-like masses that are passed with hydatidiform moles composed of?

A

Large, edematous villi

36
Q

What are the classic US findings of hydatidiform moles?

A

Snow-storm appearance

37
Q

What is the presentation of hydatidiform moles WITH prenatal care?

A

US with snowstorm appearance and without fetal heart sounds

38
Q

What is the difference in partial and complete moles in terms of: genetics?

A

Partial = normal ovum fertilized by 2 sperm (69 chromosomes)

Complete = a-genetic ovum, fertilized by 2 sperm (46 chromosomes)

39
Q

What is the difference in partial and complete moles in terms of: presence of fetal tissue

A

Present with partial moles

Absent with complete

40
Q

What is the difference in partial and complete moles in terms of: villi appearance?

A

Partial = some normal, some edematous

Complete= all villi are hydropic

41
Q

What is the difference in partial and complete moles in terms of: trophoblastic proliferation?

A

Partial = focal proliferation present around hydropic villi

Complete = diffuse, circumferential proliferation around hydropic villi

42
Q

What is the difference in partial and complete moles in terms of: risk for choriocarcinoma?

A 
Partial = minimal
Complete = 2-3%
43
Q

What is the difference in partial and complete moles in terms of: beta-HCG levels? Why?

A 
Complete = super high
Partial = high, but not as high

Trophoblasts secrete HCG, and there are more aberrant trophoblasts in complete moles

44
Q

What is the treatment for a mole?

A

D and C, following beta-HCG to ensure all tissue is expelled, and ensure no choriocarcinoma

45
Q

What are the villi like in choriocarcinoma?

A

There are none–proliferation of syncytiotrophoblasts and cytotrophoblasts

46
Q

What are the two ways to get choriocarcinomas?

A

complication of a mole, or arise primarily from germ cell tumor

47
Q

How do you differentiate between choriocarcinomas 2/2 moles vs primary?

A

ones from moles respond well to chemo, whereas primary do NOT

48
Q

What is the effect of EtOH on the developing fetus?

A

MR

Long philtrum

49
Q

What is the effect of cocaine on the developing fetus?

A

IUGR, and placental abruption

50
Q

What is the effect of thalidomide on the developing fetus?

A

Limb defects

51
Q

What is the effect of cigarette smoke on the developing fetus?

A

IUGR

52
Q

What is the effect of isotretinoin on the developing fetus?

A

Spontaneous abortion
Hearing loss
Visual impairments

53
Q

What is the effect of tetracyclines on the developing fetus?

A

Discolored teeth

54
Q

What is the effect of Warfarin on the developing fetus?

A

Fetal bleeding

55
Q

What is the effect of phenytoin on the developing fetus?

A

Digit hypoplasia

cleft lip/palate

All the things continued (28 decks)

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