1st Trimester

Question 1

What is a soft tissue mass within the uterine cavity that consists of chorionic villus trophoblasts and grows rapidly?

Answer 1

Gestational trophoblastic neoplasia (GTN)

Question 2

By 2nd trimester, trophoblastic tissue becomes markedly what?

Answer 2

Hydropic

Question 3

Increased amount of trophoblasts results in high _______, which results in ___________ and __________.

Answer 3

HCG, bilateral theca lutein cysts, and hyperemesis

Question 4

Classifications of GTN

Answer 4

1) hydatidiform mole

2) persistent gestational trophoblastic neoplasia

Question 5

Types of hydatidiform mole

Answer 5

Complete and partial

Question 6

Types of PGTN

Answer 6

Invasive mole

Choriocarcinoma

Question 7

Complete hydatidiform mole is the most common form.

T/F

Answer 7

True

Question 8

What is a complete hydatidiform mole?

Answer 8

Benign trophoblastic tumor confined to endometrial cavity

Question 9

Complete moles arise from?

Answer 9

Fertilization of ovum with no maternal chromosomes, no fetus present

Question 10

After mole is removed HCG levels are closely monitored because they must _____________?

Answer 10

Return to zero

Question 11

What’s a coexistant mole?

Answer 11

Twin gestation in which one twin is normal and other is mole

Question 12

What’s a partial mole?

Answer 12

Molar transformation of placenta in association with a triploid fetus
69XXY or 69XX

Question 13

What else may you see with triploid fetus?

Answer 13

IUGR
Oligohydramnios
Males demonstrate Hydropic chorionic villi
May develop theca lutein cysts

Question 14

Triploidy is not a lethal condition.

T/F

Answer 14

False, it is lethal

Question 15

What’s another name for an invasive mole?

Answer 15

Chorioadenoma destruens

Question 16

Invasive mole is:

Answer 16

Recurrence of trophoblastic neoplasia with (nonmetastatic) invasion into myometrium

Question 17

How is invasive mole diagnosed?

Answer 17

When HCG levels plateau or rise instead of falling after uterine evacuation

Question 18

Choriocarcinoma is a highly metastatic trophoblastic tumor that metastasizes to:

Answer 18

Lungs, spleen, kidney, intestines, liver and brain

Question 19

Low risk patients with potential Choriocarcinoma are given:

Answer 19

Methotrexate

Question 20

The higher the HCG the higher the risk of Choriocarcinoma.

T/F

Answer 20

True

Question 21

When is treatment for PGTN considered successful?

Answer 21

If HCG measurements are normal for at least 12 months and no evidence metastatic disease

Question 22

What can GTN resemble in the 1st trimester?

Answer 22

Blighted ovum or incomplete abortion

Question 23

When would you see the “snowstorm” appearance with GTN?

Answer 23

In the 2nd trimester

Question 24

What is a subchorionic hemorrhage?

Answer 24

Crescent shaped fluid collection between gestational sac and uterine wall

Question 25

Subchorionic hemorrhage increases risk of:

Answer 25

Spontaneous miscarriage Preeclampsia Placental abnormalities Preterm delivery

Question 26

Patients with complete hydatidiform moles present with:

Answer 26

Large for dates uterus | Possible vaginal bleeding

Question 27

Patients with complete hydatidiform moles may develop:

Answer 27

``` Anemia Hyperemesis Toxemia Hyperthyroidism Respiratory insufficiency ```

Question 28

Placentamegaly is when the placenta measures greater than _________ before _____ weeks

Answer 28

4cm, 24

Question 29

Placenta too thin when:

Answer 29

Less than or equal to 1.5 cm

Question 30

When do the chorion and amnion fuse together?

Answer 30

At 14 weeks

Question 31

How do amniotic sheets form?

Answer 31

Amnion forms over intrauterine synechiae, forming sheet across uterus in one scan plane and free floating edge scanned in orthogonal plane

Question 32

What is amniotic band syndrome?

Answer 32

When amnion ruptures during first trimester, the sticky side adheres to and entraps fetal structures causing malformations from fibrous strands of amnion

Question 33

What’s another term for amniotic band syndrome?

Answer 33

Amnion rupture sequence

Question 34

Fetal malformations associated with amniotic band syndrome

Answer 34

``` Noncentral cephalocele Asymmetric face Facial clefts Anencephaly Acrania Constriction rings Amputation defects Joint contractures Club feet Ventral wall defects ```