13.7 Gestational Pathology Flashcards
What is the MC site of ectopic pregnancy
fallopian tube
what is key risk factor for ectopic pregnancy?
scarring
What 2 conditions usually lead to scarring that causes ectopic pregnancy
pelvic inflammatory disease
endometriosis
Where is pain of ectopic pregnancy usually present
lower quadrant abdominal pain
two major complications of ectopic pregnancy
hematosalpinx- bleeding into fallopian tube
rupture of “ “
define spontaneous abortion
miscarriage before 20 weeks(1st trimester)
frequency of spontaneous abortion
1/4 pregnancies
MC cause of spontaneous abortion
chromosomal abnormalities (trisomy 16 usually)
3 causes of spontaneous abortion other than chromosomal abnormality
hypercoagulable states (SLE)
congenital infection
teratogens
effect of teratogen exposure in first 2 weeks
spontaneous abortion
effect of teratogen exposure weeks 3-8
organ malfunciton
effect of teratogen exposure months 3-9
organ hypoplasia
Define placenta previa`
placenta covers cervical os
placenta previa` presents as what, when?
3rd trimester bleeding
tx for placenta previa`
C-section
define placental abruption
separation of placenta from decidua prior to delivery
what is placental abruption a comon cause of
still birth
placental abruption presents with what 2, when?
fetal insufficiency (no oxygen to fetus) bleeding in 3rd trimester
define placenta accreta
improper implantation of placenta into myometrium (with little or no decidua)
how does placenta accreta present (2)
delivery of placenta
postpartum bleeding
tx for placenta accreta?
often requires hysterectomy
cocaine leads to what 2 fetal effects
intrauterine growth retardation, placental abruption (dt vasoconstriction)
Alcohol leads to what 3 fetal effects
mental retardation
microcephaly
facial abnormalities
Thalidomide leads to whatfetal effect
limb defects
Cigarette smoke leads to what fetal effect
intrauterine growth retardation
Isotretinoin leads to what 3 fetal effects
spontaneous abortion, hearing and visual impairment
tetracycline leads to what fetal effect
discolored teeth
Phenytoin leads to what 2 fetal effects
digit hypoplasia, cleft lip/palate
define preeclampsia (3 things)
pregnancy induced HTN with proteinuria and edema
when does preeclampsia arise (during pregnancy- duh)
3rd trimester
What presentaitons may be assc with HTN in preeclampsia (2)```
headaches, visual disturbances
What is the cause of preeclampsia
abnormality of maternal-fetal vascular interface
define eclampsia
preeclampsia with seizures
What organ does HELLP involve
liver
define HELLP
preeclampsia with thrombotic microangiopathy involving liver
what does HELLP stand for
Hemolysis
Elevated Liver enzymes
Low Platelets
what is tz for both HELLP and preeclampsia
immediate delivery
SID occurs between what ages
1 mo-1 year
SID occurs when
while baby is sleeping
risk factors for SID (3)
second-hand cigarette smoke
sleeping on stomach
prematurity
a hytadidiform mole is a prliferation of what cells?
trophoblasts
hytadidiform mole is chcized by swollen and edematous what?
villi
What two things are larger/elevated in hytadidiform mole
uterus is larger than expected for preganacy
B-hCG is highly elevated
hytadidiform mole classicaly presents when, how? (in cases of no prenatal care)
2nd trimester - passage of grape-like mass
how does hytadidiform mole present in cases of prenatal care (when, how)
1st trimester
US shows “snowstorm appearance”
what is tx for hytadidiform mole
curretage (D&C)
what do you monitor after curretage in hytadidiform mole
B-hCG
What is elevated B-hCG after a hytadidiform mole removal evidence of? (lethal complication)
choriocarinoma
How can choriocarinoma arise (2 ways)
gestation-
germ cell tumor
when choriocarinoma arises from gestation, what are 3 possible outcomes?
spontaneous abortion
normal pregnancy
hytadidiform mole
Which of the two causes of choriocarcinoma responds well to chemotherapy
gestation cause- responds well
germ cell- does not respond well
two classifications of hytadidiform mole
complete
partial
What class of hytadidiform mole shows 3 chromosomes
partial
regarding gestation: paternal and maternal genes control what aspect? (between fetus and placenta)
paternal - placenta
maternal - fetus
hytadidiform mole is a consequence of excess of whose genes
father
an empty ovum fertilized by 2 sperm is what class of hytadidiform mole
complete
fetal tissue is absent in what type os hytadidiform mole
complete
when only some vili are hydropic what class of hytadidiform mole is it?
partial
diffuse, circumfereantial proliferation of trophoblasts is seen in what class of hytadidiform mole
complete
which class of hytadidiform mole has increased risk for choriocarcinoma
complete
blood on the maternal surface of a placenta is found in what
placental abruption
