3.1.1 Diseases of Pregnancy Flashcards
What are some of the etiologies of placental inflammation and infection?
What is placenta praevia?
Implantation over internal cervical os
Associated w/ placenta accreta
Post partum bleeding
Despite the case fatality decreasing over time, what continues to be the 2nd leading cause of maternal mortality in US?
Ectopic pregnancy
Name 4 unusual shapes of placentas
Placenta succenturiate - Accessory lobes
Velamentous insertion of umbilical cord
Battledore placenta - Marginal insertion of umbilical cord
Placenta circumvallata - White ring
What these be?
Left: Placenta accreta
Right: Placenta percreta
What is chorioadenoma destruens? clinical features?
Invasive mole
What this be?
Twin gestation
Which morphology of placental inflammation?
Varicella Zoster Villitis
What are some of the dz’s of pregnancy?
Placental inflammation and infections
Placental abnormalities and twin placentas
Spontaneous abortion
Ectopic pregnancy
Toxemia of pregnancy
Gestational trophoblastic dz’s
What patholgies are associated with ectopic pregnancy?
What are the most common sites of ectopic pregnancy?
Fallopian tubes, ovaries, abdomen, other sites
What number of vessels are found in the umbilical cord?
What this be?
Left, top: Ectopic tubal pregnancy, early
Left, bottom: ectopic tubal pregnancy, late
What are the four morphologic variants of gestational trophoblastic dz?
What are some of the predisposing factors for placental inflammation and infection?
Premature rupture of membranes (most common)
Induce abortion
Hematogenous spread (least common)
Sex during 3rd trimester
What this be?
Choriocarcinoma
What are some of the complications of ectopic pregnancy?
Which abnormal placental shape?
Accessory (succenturiate) lobe
What are the three sequelae with toxemia of pregnancy?
Which surface of the fetus?
Maternal Surface
(comparable to a hamburger in appearance)
What do these represent?
Spontaneous abortion
Which abnormal placental shape?
Accessory (succenturiate) lobes
Which abnormal placental shape?
Accessory (succenturiate) lobes
Describe the morphology of hydatidiform mole?
Which morphology of placental inflammation?
Chorioamnionitis - notice blue spots
What these be?
Top: Decidual changes and hemmorhorage
Bottom left: 1st trimester chorionic villi
Bottom right: fetus
What are the possible pathogenesises of toxemia of pregnancy?
What this be?
Trophoblastic tumor
What are gestational trophoblastic dz?
What should be included in the differental diagnosis of varicella zoster villitis?
TB
Congenital CMV
Congenital syphilis
Congenital toxoplasmosis
Malaria
Parvovirus B19
Listeriosis
Group B Strep
Candida
What is the symptom complex in toxemia of pregnancy?
HTN, proteinuria, edema
What are some ways to identify ectopic pregnancy?
Unilateral lower abdominal pain, vaginal bleeding, positive serum beta-HCG test, transvaginal US
Identify chorion or amnion
Top (A,C,C,A) Bottom
What this be?
Twin placenta
When does toxemia of pregnancy typically present?
3rd trimester
Which abnormal placental shape?
Battledore placenta
What are the three different morphologies of placental inflammation and infection?
Placentitis (villitis)
Chorioamnionitis (fetal membranes)
Funisitis (umbilical cord)
What is the cytogenic mechanism of hydatidiform mole?
Explain the ways in which amnion and chorion can vary in twins
Id these features of hydatidiform mole
Choriocarcinoma incidence?
What is ectopic pregnancy? How often does it occur?
What are the clinical features of choriocarcinoma?
Which abnormal placental shape?
Placenta circumvallata - white ring
What are the two forms of toxemia of pregnancy?
Pre-eclampisa and eclampsia (severe)
What’s going on here?
Placental torsion
Describe the hydatidiform mole form of gestational trophoblastic dz
Which abnormal placental shape?
Battledore placenta - marginal insertion
What are the treatment options for ectopic pregnancy?
what this be?
Ectopic pregnancy
What % of pregnancies end in spontaneous abortion? What are some possible causes?
What is the morphology of choriocarcinoma?
What syndrome is associated with toxemia of pregnancy in 10% of cases?
HELLP syndrome
(Hemolysis, Elevated liver ezymes, Low plt)
What is the mechanism of toxemia of pregnany?
loss of resistnance to vasocontriction, decrease prod of prostaglandin, increase prod of renin
Which side of the fetus?
Left: Fetal
Right: Maternal
What are two issues that can arise within the umbilical cord?
Knots (no significance if loose, fetal death if tight)
Torsion (marked spiraling that can compromise blood flow)
What are the different types of abnormal pentration of placenta into uterine wall?
Placenta accreta, increta, and percreta
What this be?
Invasive mole
What are some of the etologic considerations for ectopic pregnancy?
