common pathologies in pregnancy Flashcards
what does progesterone turn the endometrium into ?
decidua
increased vascularity
stromal cells enlarge and become procoagulant
what type of cell is on the outer edge of the chorion ?
trophoblast cells
what hormone to trophoblasts produce ?
beta-human chorionic gondotrophin
what is the function of B-HCG ?
stimulates corpus luteum to produce progesterone which stops decide from shedding
what are some causes of miscarriage ?
chromosomal abnormality
infection
maternal issue - ill health, trauma, hormones
what is a clinical presentation of a molar pregnancy ?
+ve pregnancy test
USS - some placental tissue, no fetus
B-hCG raised
biopsy- enlarged abnormal chorionic villi with abundant trophoblasts
what do maternal and paternal methylation changes promote in fatal development ?
maternal changes promote early baby growth
paternal changes promote early placental growth via trophoblast proliferation
what is the common pathophysiology of molar pregnancy ?
2 sperm fertilise 1 egg with no chromosomes
a form of precancerous of trophoblast cells
persistence can rarely give rise to malignant choriocarcinoma
how do you treat molar pregnancy ?
if B-hCG returns to normal - no further treatment
if B-hCG stays high - cure by methotrexate
what are common problems causes by diabetes in pregnancy ?
malformations
diabetic cherub babies
intrauterine death - metabolic and hypoxic problems
neonatal hypoglycaemia
what is acute chorioamnionitis ?
acute inflammation
neutrophils present in membranes, cord and fatal plate of placenta
what causes acute chorioamnionitis ?
bacteria (E.coli) ascend vagina and enter amniotic sac
how does acute chorioamnionitis affect the baby ?
neutrophils produce cytokine storm, activated brain cells which are damaged by normal hypoxia of labour
intra uterine death
ill in first days of life
cerebral palsy later in life
what is placental abruption ?
separation of placenta from uterine wall
results on hypoxia
often antepartum haemorrhage in mother
what causes placental abruption ?
hypertension
trauma
cocaine
