Common pathologies pregnancy

Question 1

once the egg is fertilized what happens to progesterone

Answer 1

progesterone levels continue to rise

continuing thickening the lining - turns endometrium into decidua - increasing vascularity

between glands and vessels the stromal cells enlarge and become procoagulant stopping the bleeding

Question 2

what are the hormones produced in the hormonal cycle

Answer 2

progesterone
oestrogen

Question 3

what hormone do trophoblast cells produce

Answer 3

B-hCG or Beta-human Chorionic Gonadotrophin

function is to stimulate corpus luteum to produce progestogen, which stops decidua from shedding

Question 4

why is bhCG hormone important

Answer 4

Forms basis of pregnancy tests
Stimulates the ovary to produce progesterone throughout pregnancy, and stops decidua from shedding.

Question 5

Woman, 26 yrs
Misses period
Pregnancy test positive
Vaginal bleeding 7 weeks after missed period
What has probably happened?

Answer 5

US scan: No fetus present but membranes and decidua lining uterus still there = miscarriage
Removal of remaining tissue by obstetrician to avoid bleeding and infection
Tissue sent to pathology:

Question 6

why do miscarriages happen

Answer 6

Unknown in this case (it is very common for no cause to be obvious)
Causes include:
1. Fetal problem eg chromosomal abnormality,
2. Placenta/membranes/cord problem eg infection,
3. Uterus/cervix problem (eg cervical incompetence)
4. Maternal health issues (eg drug taking)

Question 7

Woman, 32 years old
Misses period.
8 weeks pregnant 🡪 Small amount of bleeding per vagina

Answer 7

BhCG raised
Ultrasound: Thickened lining of endometrial cavity. Expanded fallopian tube on 1 side.
Diagnosis = ectopic pregnancy
Considered using methotrexate – but opted for operative removal of fallopian tube 🡪 tissue sent to pathology

Question 8

Woman 23 years
Sudden severe abdominal pain. Collapses.
Admission to A&E 🡪 Pulse fast. BP low.

Answer 8

Blood given.
Emergency laparotomy:
At operation - several litres of blood in abdomen
Blood flowing from fallopian tube area - clamped, removed and sent to pathology
Pathology:

Microscopy = blood, fragments of fallopian tube and occasional chorionic villi (part of what will become the placenta and therefore tissue which confirms pregnancy)
Diagnosis = ruptured ectopic pregnancy