13.7 Gestational Pathology Flashcards
Ectopic Pregnancy
Implantation of ovum at site other than the uterine wall
What is the most common site of ectopic pregnancy?
Lumen of the fallopian tube
What is the key risk factor of ectopic pregnancy?
Scarring - often due to PID
What is the presentation of ectopic pregnancy?
Lower quadrant abdominal pain several weeks after a missed period
Spontaneous Abortion
Miscarriage of fetus 20 weeks before gestation
What is the most common cause of spontaneous abortion?
Chromosomal abnormalities
What are some other causes of spontaneous abortions?
- Hypercoaguable states
- Congenital infection
- Exposure to teratogens
Placenta Previa
Implantation of the placenta in the lower part of the uterine wall
Placenta Abruption
Separation of the placenta from the decidua prior to delivery
What does placenta abruption commonly cause?
Still birth
Placenta Accreta
Improper implantation of the placenta directly into the myometrium
How will placenta accreta present?
Difficulty delivering the placenta - often hysterectomy is required
Preeclampsia
Pregnancy-induced HTN with proteinuria and edema
What will be seen in the vessels of the placenta with preeclampsia?
Fibrinoid Necrosis
What is eclampsia?
Preeclampsia with seizures
HELLP Syndrome
Preeclampsia with thrombotic microangiopathy involving the liver that will have hemolysis, elevated liver enzymes and low platelets
Sudden Infant Death Syndrome
Death of a healthy infant from 1 month to 1 year without cause - often in sleep
What are risks for SIDS?
- Sleeping on stomach
- Smoking in house
- Premature
Hydatiform Mole
Abnormal conception characterized by swollen and edematous villi with proliferation of trophoblasts
What are 2 features that can separate a hydatiform mole from a normal pregnancy?
- Uterus will be larger than it should be
- There will be more beta-hCG than normal
What will be seen on ultrasound with hydatiform moles?
Snow-storm appearance
What will be seen in the second trimester with a hydatiform mole?
Passing of grape-like masses
Partial Mole
Normal ovum fertilized with 2 or more sperm - minimum is triploidy (69 chromosomes)
Complete Mole
Empty ovum fertilized by two sperm - or one that duplicates chromosomes (46 chromosomes)
In what type of mole will fetal tissue be present?
Partial Mole
What is the amount of villous edema in complete moles?
Near completely - almost all villi are edematous
Which mole type has the higher risk for choriocarcinoma?
Complete Mole
What is the proliferation of trophoblasts like in complete mole?
Trophoblasts completely cover the villi
What type of mole will have higher beta-hCG?
Complete mole
What is the treatment for molar pregnancy?
Dilation of the cervix and curettage
Choriocarcinoma of Gestation
Arises as a complication of gestation - risk is increased with a complete mole
How does gestational choriocarcinoma respond to chemotherapy?
Well
