Disorders of Pregnancy

Question 1

“miscarriage” aka… and define

Answer 1

=spontaneous abortion. Pregnancy loss before 20 weeks of gestation (although most occur before 12 weeks)

Question 2

Incidence of miscarriage

Answer 2

10-15% of clinically recognized pregnancies

Question 3

causes of miscarriage (general)

Answer 3

fetal cause (chromosomal issue), maternal cause (co-morbidities),,unknown

Question 4

fetal causes of early spontaneous abortion

Answer 4

chromosomal anomalies (aneuploidy, polyploidy, translocations) and subtle genetic defects

Question 5

maternal causes of early spontaneous abortion

Answer 5

infections (bacterial, viral), genetic reason, luteal-phase defect (CL not producing enough progesterone), poorly controlled DM, uncorrected endocrine disorders, physical defects of uterus, and systemic disorders affecting maternal vasculature

Question 6

Name some physical defects of mother’s uterus that could cause an early miscarriage

Answer 6

Bicornuate uterus, submucosal leiomyomas, polyps, and malformations

Question 7

Name systemic disorders that affect maternal vasculature causing an early potential miscarriage

Answer 7

antiphospholipid Ab syndrome (SLE), HTN, coagulopathies (Factor V Leiden)

Question 8

ascending maternal infections causing spontaenous aboritons more commonly occur in what trimester?

Answer 8

2nd

Question 9

Gold standard for genetic testing in finding reason behind spontaneous abortion

Answer 9

After 3 miscarriages, esp if miscarriages close together and mom and dad are healthy. probably genetic factor playing a role.

Question 10

maternal infections causing early miscarriage include:

Answer 10

TORCH syndrome (toxoplasmosis, other agents, rubella, CMV, HSV), mycoplasma, listeria

Question 11

occurrence of ectopic pregnancies

Answer 11

1 in every 150 pregnancies

Question 12

most common site of ectopic pregnancy

Answer 12

fallopian tubes (90%). Other sites include ovary, abdominal cavity, and cornua (intrauterine portion of fallopian tube)

Question 13

is ectopic pregnancy a disorder of early or late pregnancy?

Answer 13

early

Question 14

Predisposing conditions for tubal ectopic pregnancies

Answer 14

Prior PID- MOST COMMON (resulting in fallopian tube scarring), appendicities, endometriosis, previous surgery, IUD

Question 15

what percentage of people that have tubal ectopic pregnancies have it d/t prior PID?

Answer 15

35-50%

Question 16

chronic follicular salpingitis

Answer 16

inflammation of fallopian tube - can be caused by prior PID

Question 17

IUD increases the risk of tubal ectopic pregnancy by..

Answer 17

2.5 fold

Question 18

hematosalpinx

Answer 18

blood filled fallopian tube

Question 19

most common cause of hematosalpinx

Answer 19

tubal ectopic pregnancy

Question 20

Patient presents with severe abdominal pain. LNMP was 6 weeks ago. Has hemorrhagic shock with signs of an acute abdomen. Hx includes previous diagnosis of PID. What do you suspect and how do you diagnose?

Answer 20

Ectopic pregnancy (probably tubal). Diagnosis: chorionic gonadotropin assay, ultrasound studies, and laparoscopy

Question 21

hydatiform mole characterized histoligically by

Answer 21

cystic swelling of the chorionic villi and variable trophoblastic proliferation

Question 22

acute atherosis

Answer 22

intraintimal lipid deposition

Question 23

hydatifiform moles development?

Answer 23

10% will develop into persistent/invasive moles, 2.5% of complete moles develop into choriocarcinomas