Common Pathologies of Pregnancy Flashcards
What are examples of common pathologies of pregnancy?
Ectopic pregnancy Molar pregnancy Diabetic cherub (macrosomia) Acute chorioamnionitis Overtwisted cord Placental abruption
What is ectopic pregnancy?
Pregnancy outside of the uterine cavity, most commonly in the fallopian tube.
Lack of proper decidual layer and small size of tube predispose to haemorrhage and rupture.
What is molar pregnancy? How would it characteristically show on imaging?
Enlarged abnormal chorionic villi with abundant trophoblast.
Snowstorm, grape-like vesicles
For your ease of understanding wth is going on in molar pregnancy, just read this
Usually:
• 23 chromosomes from mum: promotes early baby growth
• 23 chromosomes from dad: promotes placental growth and trophoblast proliferation
What is the pathophysiology of molar pregnancy?
0 chromosomes from mum, 46 from dad.
More trophoblastic proliferation. Massive overgrowth of trophoblast cells and therefore overgrowth of placenta.
For your ease of understanding partial vs complete molar pregnancy, just read this
Partial: 1 set from mum and 2 set dad
Complete: 2 set dad
What are the complications of molar pregnancy?
Form of precancer of trophoblast cells, can give rise to choriocarcinoma (malignancy).
What’s the management for molar pregnancy?
- If BhCG returns to normal, no further treatment
* If BhCG stays high, cure with methotrexate
What is a diabetic cherub?
Diabetic mother giving rise to a huge baby with big shoulders.
What is the pathophysiology of
diabetic cherub?
- Mother’s glucose crosses placenta, raising baby’s glucose and insulin.
- Glucose keeps coming, so insulin still high. Baby grows massively.
What are the complications of diabetic cherub?
1st trimester - malformations
3rd trimester - Risk of intrauterine death (IUD)
Labour - Huge, so obstruct
Neonatal period - Hypoglycaemia (too used to high levels of glucose)
What is acute chorioamnionitis?
Acute inflammation of the fetal membranes.
Neutrophils present in membranes, cord and foetal side of placenta.
How does acute chorioamnionitis occur?
Bacteria present in perineal or perianal flora, ascend vagina and get into amniotic sac
What is the pathophysiology of acute chorioamnionitis?
Neutrophils produce cytokine storm, activates foetal brain cells which get damaged in normal hypoxia of labour.
(they were not meant to be activated, activation allows them to be destroyed)
How would the mother present in acute chorioamnionitis ?
Mother can be ill with fever and increased neutrophils but mother can also be well
