Ch 18 : Female Reproductive System: Pregnancy Pathology

Question 1

Two types of placental infection are:

(1) chorioamnionitis
(2) villitis

Which type results from an ascending infection from the maternal birth canal?

Which type results from maternal hematogenous infection that crosses the placenta?

Answer 1

Chorioamnionitis
-ascending infection from birth canal

Villitis
-hematogenous infection that crosses placenta

Question 2

Placenta: percreta / increta / accreta

1) villi attach to uterine surface without invading myometrium = ?
2) villi invade the uteran surface + underlying myometrium = ?
3) villi penetrate the full thickness of the uterine wall = ?

Answer 2

1) Placenta accreta
- -villi attach to uterine surface without invading myometrium

2) Placentra increta
- -villi invade the uteran surface + underlying myometrium

3) Placenta percreta
- -villi penetrate the full thickness of the uterine wall

Question 3

Placenta accreta, increta, and percreta form a pathological spectrum characterized by abnormal adherence of the placental villi to the uterine wall.

Clinical features:

1) third trimester bleeding
2) post-partum hemorrhage due to failure of the placenta to separate from the uterine wall

These placental disorders share a common cause, which is the absence of ______ during pregnancy?

Answer 3

Decidua

Decidua = uterine endometrium of pregnancy

Absent in placenta accreta, increta, and percreta.

Question 4

Preeclamspia = HTN + proteinuria + edema.

In preeclampsia, what vessels undergo faulty remodeling, and thus never dilate – leading to placental ischemia?

Answer 4

Preeclampsia

faulty remodeling of **uterine spiral arteries **

Question 5

During delivery, a pregnant woman develops ARDS and DIC, and the woman expires shortly after delivery.

At autopsy, fetal squamous epithelial cells are found in the pulmonary microvasculature (image).

What is the most likely diagnosis?

Answer 5

Amniotic Fluid Embolism

Amniotic fluid material enters the maternal circulation, triggering an anaphylactic reaction and complement activation.

Question 6

1) Complete Mole or Partial Mole?

–diploid karyotyped lacking maternal chromosomes

–fetal tissue is absent

–diffusely swollen villi

2) What is the most serious complication?

Answer 6

1) Complete Hydatiform Mole

• -diploid karyotype lacking maternal chromosomes
• -fetal tissue is absent
• -diffusely swollen villi

2) Choriocarcinoma

Question 7

Complete Mole or Partial Mole?

–triploid karyotype containing both maternal and paternal chromosomes

–spontaneous abortion occurs and fetal tissue is present

–some villi are swollen, others are normal

Answer 7

Partial Hydatiform Mole

–triploid karyotype, both maternal and paternal chromosomes present

–fetal tissue is present

–some villi are swollen, others are normal

Question 8

A woman presents with abnormal uterine bleeding. The patient had previously been treated for complete hydatiform mole. Fearing choriocarcinoma, you order a pan-CT scan to check for metastases.

Choriocarcinoma is a malignant tumor derived from what fetal tissue?

Answer 8

Choriocarcinoma

malignant tumor derived from fetal trophoblast