Class: Gestational pathology

Question 1

maternal component of placenta

Answer 1

decidua basalis

Question 2

fetal component of placenta

Answer 2

chorion

Question 3

What connects chorion to decidua basalis

Answer 3

chorionic villi

Question 4

What is the outermost layer of the chorion (facing the mother)

Answer 4

syntiotrophoblast

Question 5

What 2 things does the trophoblast secrete and what do thewy do

Answer 5

hCG, placental lactogen –> they supprt the placenta

Question 6

How many veins/arteries are in the umbilical cord

Answer 6

2veins, 1 artery

Question 7

define vasa previa

Answer 7

fetal Vessels running over (or very near) to the cervical os

Question 8

what other condition is Vasa Previa associated with and define it

Answer 8

Associated with velamentous cord: vessels don’t insert properly = increased risk of rupture

Question 9

Classic triad of sx of Vasa Previa

Answer 9

painless vaginal beleding
fetal bradycardia
membrane rupture

Question 10

Tx for Vasa Previa

Answer 10

Emergency C-section . Could lead to fetal death!

Question 11

what does “previa” mean

Answer 11

obstruction (in childbirth)

Question 12

Placenta previa most Often occurs when?

Answer 12

> 20 weeks

Question 13

risk factor for placenta previa

Answer 13

PRIOR c-SCETION

Question 14

define Abruptio Placentae

Answer 14

premature detachment of the placenta from the uterine wall

Question 15

Cause of abruptio placentae

Answer 15

bleeding between decidua and placenta–> separation

Question 16

findings in placental abruption (4)

Answer 16

abrupt, painful bleeding
DIC
maternal shock
fetal distress (heart monitor)

Question 17

Risk factors for placental abruption (4)

Answer 17

Proir placental abruption, cocaine, abdominal trauma, HTN

Question 18

Define placenta acreta

Answer 18

defective decidua–> abnormal attachment and separation of placenta after delivery

Question 19

Risk factors for placenta acreta (3) - really only need forst for class- the other 2 are from FA

Answer 19

prior C-section, inflammation, placenta previa

Question 20

What are the 3 types of abnormal decidua –> abnormal placental implantiation and how are they defined?

Answer 20

pLACENTA AccRETA- placenta attaches to myometrium
Increta- invades myometrium
percreta - perforates myometrium - can perforate entire uterine wall

Question 21

How is placent accreta dx?

Answer 21

prenatal US shows hazy interface between placenta and decidua

Question 22

complication of placenta accreta

Answer 22

Sheehan syndomre

Question 23

defining finding in abruptio placentae (2)

Answer 23

fetal bradycardia, low maternal BP

Question 24

what is MC fetal cause of spontaneous abortion

Answer 24

chromosomal abnormality (50%)

Question 25

What are some common maternal risk factors for sponataneous abortion (5)

Answer 25

maternal age weight extremes DM, HTN low folate

Question 26

What is the only population in which we treat asymptomatic bacteriuria,

Answer 26

Pregnant women

Question 27

Define Chorioamnionitis

Answer 27

infection of the chorion and amniotic fluid

Question 28

two findings in Chorioamnionitis

Answer 28

green/pyuric placenta | neutrophil infiltrate of chorion and amniotic fluid

Question 29

Presenting sx of Chorioamnionitis (1st one is the only important one)

Answer 29

maternal fever, uterine tenderness, maternal tachycardia, leukocytosis

Question 30

What condition --> highest risk for Chorioamnionitis

Answer 30

pre-term deliveries

Question 31

MC cause of Chorioamnionitis

Answer 31

Group B strep

Question 32

3 other causes of Chorioamnionitis (other than GBS)

Answer 32

PROM, PPROM congenital infx (TORCH) procedures (amniocentesis)

Question 33

How is Chorioamnionitis prevented (specifically)

Answer 33

swab for GBS at 37 weeks

Question 34

If mom has a fever, placenta looks cloudy, or baby does anything weird at all what is tx

Answer 34

ABX right away. send to NICU

Question 35

What can Chorioamnionitis cause in newborn

Answer 35

PNA, meningitis, sepsis

Question 36

Define PIH (pregnancy induced HTN) (3 criteria)

Answer 36

>140/90 and >20 weeks gestation no proteinuria or end-organ dmage

Question 37

5 drugs for HTN in pregnancy

Answer 37

``` alpha-methyl dopa clonidine labetalol Hydralazine CCBs ```

Question 38

Define preeclampsia

Answer 38

widespread maternal endothelial dysfunciton-->new-onset HTN with either proteinuria or end-organ dysfunction > 20 weeks

Question 39

What does HELLP stand for

Answer 39

Hemolysis, Elevated Liver enzymes, Low Platelets

Question 40

what causes HELLP

Answer 40

preecclampsia endothelial dysfunction --> thrombosis--> microangiopathic hemolytic anemia, etc

Question 41

presentation of eclampsia (2 for mother, 1 for baby)

Answer 41

Tonic-clonic seizure or coma accompanied by fetal bradycardia

Question 42

tx for eclampsia (2)

Answer 42

IV magnesium Sulfate | immediate delivery

Question 43

molar pregnancies are an abnormality of what process

Answer 43

fertilization

Question 44

molar pregnancies are dt what cause?

Answer 44

excess paternal chromos

Question 45

What is the pathological thing in molar pregnancies?

Answer 45

cystic swelling of chorionic villi and proliferation of the chorionic epithelium (trophoblast only)

Question 46

3 associateions of Molar pregnancy

Answer 46

Hyperemesis gravidarum Theca lutein cysts Hyperthyroidism

Question 47

How many sets of genes and fetal parts present or not and why?: complete mole

Answer 47

two sets of genes 46XX, 46XY | no fetal parts becuase all paternal genetic info

Question 48

How many sets of genes and fetal parts present or not and why: partial mole

Answer 48

three sets of genes 69 XXY, 69 XYY, 69XXX | yes, fetal parts

Question 49

which type of molar pregnancy shows SUPER elevated hCG

Answer 49

complete

Question 50

which type of molar pregnancy shows snowstorm moles on US

Answer 50

complete

Question 51

which type of molar pregnancy MC progresses to choriocarcinoma

Answer 51

complete

Question 52

what causes Choriocarcinoma

Answer 52

persistent trophoblastic layer

Question 53

what 2 anaplastic cell types are found in Choriocarcinoma and what 1 structure is not found

Answer 53

Anaplastic cytotrophoblasts and syncytiotrophoblasts with no chorionic vili

Question 54

px for choriocarcinoma

Answer 54

highly treatbale