Common Pathologies of Pregnancy 1, 2 & 3 Flashcards
What are the common symptoms of miscarriage?
- Bleeding
- Abdominal pain
- Cramping
- Tissue passing from the vagina
What are the common causes of miscarriage?
- Unknown cause very common
Other causes include:
- Chromosomal abnormality
- Infection
- Maternal health issues (ill-health, trauma, hormonal problems)
What are the pathological processes involved in miscarriage?
1 - Fetus is ejected from the uterus
2 - Membranes and decidua lining uterus are left behind in the uterus
How is miscarriage defined?
Miscarriage is also known as the spontaneous abortion or death of the embryo or fetus before 20 weeks or before the fetus is able to support itself independently
What is the definition of an ectopic pregnancy?
When the embryo develops outside the uterus, in the wrong anatomical site (most commonly in fallopian tube)
What are the common symptoms of an ectopic pregnancy?
- Vaginal bleeding
- Sudden lower abdo pain
- Raised hCG
What are the pathological processes involved in ectopic pregnancies?
1) Cilia of fallopian tubes become damaged
2) Embryo fails to travel along the tubes into the uterus
3) Embryo implants into fallopian tube
What are the medical signs that can indicate an ectopic pregnancy?
- BhCG raised
- USS will show thickened lining of endometrial cavity and expansion of a fallopian tube
How are ectopic pregnancies treated?
Medical - Methotrexate will terminate the growth of the fetus if delivered early enough, resulting in an abortion
Surgical:
- Salpingostomy = removal of the pregnancy from the tube
- Salpingectomy - removal of the entire fallopian tube
What is a molar pregnancy?
An abnormal type of pregnancy that occurs when a non-viable fertilized egg implants in the uterus but fails to go to term.
The non-viable fertilized egg often does not contain original maternal nucleus
What are the symptoms of a molar pregnancy?
- Painless vaginal bleeding usually occuring during 4th or 5th months of pregnancy
- Enlarged ovaries or uterus
Under the microscope, how would a molar pregnancy appear?
- Enlarged abnormal chorionic villi with abundant trophoblasts
What are the pathological processes that occur in molar pregnancies?
1) 2 sperm fertilise one egg with no chromosomes
2) This results in an embryo with 2 lots of dad’s methylated genes
3) Due to the methylation of dad’s genes (adding methyl to stretches of DNA), there is massive overgrowth of trophoblast cells and therefore overgrowth of placenta
4) The over methylated embryo means that there will be none or very little fetal growth
What are the complications of molar pregnancies if left untreated?
- Choriocarcinoma (malignant)
How are molar pregnancies treated?
1) If BhCG returns to normal - no further treatment required
2) If BhCG stays high - cure by methotrexate
What are the medical signs and symptoms of Down syndrome (Trisomy 21) during pregnancy?
1) USS showing nuchal thickening
2) Cardiac abnormalities (enlarged ventricles)