Female Genitral Tract 4 - Dobson Flashcards
What are the most common causes of late pregnancy (20 wks - 3rd trimester) loss?
Placental/vascular Cord Abruptio placenta disruption of fetal placental vessels uteroplacental malperfusion
Preeclampsia may lead to what?
HELLP syndrome
Hemolysis, elevated liver enzymes, low platelets
Rupture of ectopic pregnancy can lead to what?
Intraperitoneal hemorrhage which can be fatal
What kind of twins are involved in twin-twin Transfusion Syndrome?
What may be present?
Can cause what?
Monochorionic
AV shunt
Discordance in fetal size and amniotic fluid volume
What presents w/irregular vaginal bleeding of bloody, brown fluid (not related to mensturation) w/ enlarged uterus and a very high hCG?
Choriocarcinoma
How does a PST tumor present?
Prognosis?
Uterine mass w/bleeding or amenorrhea
Inc. hCG, Inc. hPL
Excellent if localized
What are the causes of spontaneous abortion?
Chromosomal abnormalities in fetus
Defects in uterus (leiomyoma)
Infections
When is hydatidiform mole diagnosed?
What age increased risk?
2x as common where?
Early in pregnancy (9 weeks) by sonogram
Teens and 40-50
Southeast Asia
Complete mole karyotype?
Increased what?
Risk of choriocarcinoma?
Rise of persistent mole?
Fetal tissue present?
46 XX
hCG
2.5%
15%
No
What is described by a complete absence of the decidua, villous tissue adheres directly to myometrium which leads to failure of placental separation at birth?
Placenta accreta
Morphology of hydatiform mole?
Edematous hydropic villi
Central cavities or cisterns
Extensive trophoblastic proliferation
Where does choriocarcinoma metastasize to most often?
Lung, vagina, brain
What is a rapidly invasive malignant neoplasm of trophoblastic cells derived from previous or abnormal pregnancy?
Choriocarcinoma
Placental site trophoblastic tumor produces what?
Human placental lactogen (hPL)
What are the TORCH infections that cause spontaneous abortion?
Toxoplasmosis Other (syphilis, VZV, Parvovirus B19, Listeria, HIV, Coxsackievirus) Rubella CMV Herpes virus
What anti-angiogenic factors are activated in preeclampsia?
sFlt1
Endoglin
Treatment for choriocarcinoma of gestational origin?
Nongestational choriocarcinoma treatment?
Chemo - 100%
Resistant to chemo
What is preeclampsia?
HTN
Edema
Proteinuria
How does an invasive mole present?
Treatment?
Vaginal bleeding and irregular uterine enlargement w/persistently elevated hCG
Chemo and hysterectomy
What is eclampsia?
Preeclampsia + seizure
Medical emergency
Choriocarcinomas arise from what setting?
50% complete mole
25% previous abortion
22% after normal pregnancy
What kind of necrosis does the placenta undergo?
Coagulative
Describe a hydatiform mole
Cystic swelling of chorionic villi, trophoblastic proliferation
Complete placenta previa covers internal cervical os and requires what?
C-section
