Abnormal Implantation Flashcards

1
Q

What is an ectopic pregnancy?

A

Occurs outside the uterus

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2
Q

Where is the most common place for an ectopic pregnancy to occur and what % occur here?

A

Majority occur in uterine tube with 80% occurring in the ampulla

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3
Q

What are the dangers of a tubal implantation?

A

Can rupture the uterine tube once the embryo grows too big. Danger of mother haemorrhaging due to connection of blood supplies. Can also affect future pregnancies

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4
Q

What can an implantation in the right uterine tube be confused with?

A

Appendicitis

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5
Q

Patients suffering with an ectopic pregnancy can be prescribed methotrexate. What is the result of this?

A

Inhibits the enzyme dihydrofolate reductase which is essential for the synthesis of purines and pyrimidines. This inhibits the production of DNA, preventing the growth of the embryo before a rupture occurs. The pregnancy is resorbed.

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6
Q

Patients suffering with an ectopic pregnancy can be offered a laparoscopic salpingectomy. What does this involve and what is the outcome?

A

Small incisions in the lower abdomen are made and a laparoscope is inserted into the pelvis –> keyhole surgery. The camera guides the surgeon and the Fallopian tube/tissue is removed

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7
Q

What is job of the fimbriae?

A

There is a gap between the ovary and the uterine tube. In normal pregnancies, the fimbriae (at end of uterine tube) sweep the fertilised egg into the uterine tube.

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8
Q

What causes an abdominal implantation to occur?

A

The fimbiae fail to sweep the fertilised egg into the tube and it drops out of this gap and enters the abdominal cavity

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9
Q

If the egg implants between the uterus and the rectum, what is this called?

A

The rectouterine pouch

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10
Q

What happens if it implants into the mesentery?

A

Usually wouldn’t survive and body resorbs the pregnancy (mother unaware)

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11
Q

When is a lithopaedion formed?

A

When the pregnancy is too big for the body to resorb. Instead, it calcifies it, forming a lithopaedion.

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12
Q

What is purpose of lithopaedion?

A

Thought to protect mother from neurotic tissue of foetus (usually remains uncovered for years)

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13
Q

What happens if implantation occurs in place with good blood supply e.g. liver?

A

Embryo can develop and grow to almost full term, C-section is required.

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14
Q

What is placenta previa?

A

When implantation occurs in the uterus but near the cervix (i.e. not ectopic)

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15
Q

What has happened during placenta previa?

A

Placenta lies low in the uterus and partially or completely covers the cervix

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16
Q

What is the problem with placenta previa during late pregnancy if it doesn’t resolve?

A

Can cause severe bleeding or blood supply loss to the baby

17
Q

How can placenta previa be picked up and what is solution?

A

Normally picked up during screening. A C-section is suggested if the baby grows to full-term

18
Q

What is a hydatidiform mole? What does it suggest?

A

Development of trophoblast without an embryonic tissue. Only contains paternal genes.

Suggests that paternal genes are mainly concerned with the formation of trophoblasts (support structures)

19
Q

How does a hydatidiform mole occur

A

A sperm fertilises an empty egg without a nucleus

20
Q

Why would a hydatidiform mole give a false positive pregnancy?

A

Syncytiotrophoblasts produce hCG