1st Trimester Flashcards
What is a soft tissue mass within the uterine cavity that consists of chorionic villus trophoblasts and grows rapidly?
Gestational trophoblastic neoplasia (GTN)
By 2nd trimester, trophoblastic tissue becomes markedly what?
Hydropic
Increased amount of trophoblasts results in high _______, which results in ___________ and __________.
HCG, bilateral theca lutein cysts, and hyperemesis
Classifications of GTN
1) hydatidiform mole
2) persistent gestational trophoblastic neoplasia
Types of hydatidiform mole
Complete and partial
Types of PGTN
Invasive mole
Choriocarcinoma
Complete hydatidiform mole is the most common form.
T/F
True
What is a complete hydatidiform mole?
Benign trophoblastic tumor confined to endometrial cavity
Complete moles arise from?
Fertilization of ovum with no maternal chromosomes, no fetus present
After mole is removed HCG levels are closely monitored because they must _____________?
Return to zero
What’s a coexistant mole?
Twin gestation in which one twin is normal and other is mole
What’s a partial mole?
Molar transformation of placenta in association with a triploid fetus
69XXY or 69XX
What else may you see with triploid fetus?
IUGR
Oligohydramnios
Males demonstrate Hydropic chorionic villi
May develop theca lutein cysts
Triploidy is not a lethal condition.
T/F
False, it is lethal
What’s another name for an invasive mole?
Chorioadenoma destruens
Invasive mole is:
Recurrence of trophoblastic neoplasia with (nonmetastatic) invasion into myometrium
How is invasive mole diagnosed?
When HCG levels plateau or rise instead of falling after uterine evacuation
Choriocarcinoma is a highly metastatic trophoblastic tumor that metastasizes to:
Lungs, spleen, kidney, intestines, liver and brain
Low risk patients with potential Choriocarcinoma are given:
Methotrexate
The higher the HCG the higher the risk of Choriocarcinoma.
T/F
True
When is treatment for PGTN considered successful?
If HCG measurements are normal for at least 12 months and no evidence metastatic disease
What can GTN resemble in the 1st trimester?
Blighted ovum or incomplete abortion
When would you see the “snowstorm” appearance with GTN?
In the 2nd trimester
What is a subchorionic hemorrhage?
Crescent shaped fluid collection between gestational sac and uterine wall
Subchorionic hemorrhage increases risk of:
Spontaneous miscarriage
Preeclampsia
Placental abnormalities
Preterm delivery
Patients with complete hydatidiform moles present with:
Large for dates uterus
Possible vaginal bleeding
Patients with complete hydatidiform moles may develop:
Anemia Hyperemesis Toxemia Hyperthyroidism Respiratory insufficiency
Placentamegaly is when the placenta measures greater than _________ before _____ weeks
4cm, 24
Placenta too thin when:
Less than or equal to 1.5 cm
When do the chorion and amnion fuse together?
At 14 weeks
How do amniotic sheets form?
Amnion forms over intrauterine synechiae, forming sheet across uterus in one scan plane and free floating edge scanned in orthogonal plane
What is amniotic band syndrome?
When amnion ruptures during first trimester, the sticky side adheres to and entraps fetal structures causing malformations from fibrous strands of amnion
What’s another term for amniotic band syndrome?
Amnion rupture sequence
Fetal malformations associated with amniotic band syndrome
Noncentral cephalocele Asymmetric face Facial clefts Anencephaly Acrania Constriction rings Amputation defects Joint contractures Club feet Ventral wall defects
