13.7 Gestational Pathology

Question 1

Ectopic Pregnancy

Answer 1

Implantation of ovum at site other than the uterine wall

Question 2

What is the most common site of ectopic pregnancy?

Answer 2

Lumen of the fallopian tube

Question 3

What is the key risk factor of ectopic pregnancy?

Answer 3

Scarring - often due to PID

Question 4

What is the presentation of ectopic pregnancy?

Answer 4

Lower quadrant abdominal pain several weeks after a missed period

Question 5

Spontaneous Abortion

Answer 5

Miscarriage of fetus 20 weeks before gestation

Question 6

What is the most common cause of spontaneous abortion?

Answer 6

Chromosomal abnormalities

Question 7

What are some other causes of spontaneous abortions?

Answer 7

• Hypercoaguable states
• Congenital infection
• Exposure to teratogens

Question 8

Placenta Previa

Answer 8

Implantation of the placenta in the lower part of the uterine wall

Question 9

Placenta Abruption

Answer 9

Separation of the placenta from the decidua prior to delivery

Question 10

What does placenta abruption commonly cause?

Answer 10

Still birth

Question 11

Placenta Accreta

Answer 11

Improper implantation of the placenta directly into the myometrium

Question 12

How will placenta accreta present?

Answer 12

Difficulty delivering the placenta - often hysterectomy is required

Question 13

Preeclampsia

Answer 13

Pregnancy-induced HTN with proteinuria and edema

Question 14

What will be seen in the vessels of the placenta with preeclampsia?

Answer 14

Fibrinoid Necrosis

Question 15

What is eclampsia?

Answer 15

Preeclampsia with seizures

Question 16

HELLP Syndrome

Answer 16

Preeclampsia with thrombotic microangiopathy involving the liver that will have hemolysis, elevated liver enzymes and low platelets

Question 17

Sudden Infant Death Syndrome

Answer 17

Death of a healthy infant from 1 month to 1 year without cause - often in sleep

Question 18

What are risks for SIDS?

Answer 18

• Sleeping on stomach
• Smoking in house
• Premature

Question 19

Hydatiform Mole

Answer 19

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

Question 20

What are 2 features that can separate a hydatiform mole from a normal pregnancy?

Answer 20

• Uterus will be larger than it should be

- There will be more beta-hCG than normal

Question 21

What will be seen on ultrasound with hydatiform moles?

Answer 21

Snow-storm appearance

Question 22

What will be seen in the second trimester with a hydatiform mole?

Answer 22

Passing of grape-like masses

Question 23

Partial Mole

Answer 23

Normal ovum fertilized with 2 or more sperm - minimum is triploidy (69 chromosomes)

Question 24

Complete Mole

Answer 24

Empty ovum fertilized by two sperm - or one that duplicates chromosomes (46 chromosomes)

Question 25

In what type of mole will fetal tissue be present?

Answer 25

Partial Mole

Question 26

What is the amount of villous edema in complete moles?

Answer 26

Near completely - almost all villi are edematous

Question 27

Which mole type has the higher risk for choriocarcinoma?

Answer 27

Complete Mole

Question 28

What is the proliferation of trophoblasts like in complete mole?

Answer 28

Trophoblasts completely cover the villi

Question 29

What type of mole will have higher beta-hCG?

Answer 29

Complete mole

Question 30

What is the treatment for molar pregnancy?

Answer 30

Dilation of the cervix and curettage

Question 31

Choriocarcinoma of Gestation

Answer 31

Arises as a complication of gestation - risk is increased with a complete mole

Question 32

How does gestational choriocarcinoma respond to chemotherapy?

Answer 32

Well