Gestation and Breast Flashcards
Implantation if fertilised ovum at site other than the uterine wall
Ectopic pregnancy
What is the most common site of ectopic pregnancy
Lumen of the Fallopian tube
What is the key risk factor for ectopic pregnancy
Pelvic inflammation disease and endometriosis
Presents with lower quadrant pain weeks after missed period and is a sergical emergency
Ectopic pregnancy
Miscarriage of fetus (20 weeks before gestation)
Pretty common and occurs in about 1/4 of pregnancies
Presents as vaginal pain bleeding and passage of feral tissue
Spontaneous abortion
What are the causes of spontaneous abortions
Most often due to chromosomal anomalies, also hyper coagulable state seen in lupus or congenital infection and teratogens
Implantation of placenta in lower uterine segment
Placenta overlies cervical
Requeuires deliver by C-section and presents as 3rd trimester bleeding
Placenta previa
Separation of placenta from decidua prior to delivery of fetus
Common cause of still birth
Causes 3rd trimester bleeding and feral insufficiency
Placental abruption
Improper implantation of placenta in to myometrium with little to no decidua
Presents with difficult delivery of placenta because placenta is stuck and post parturition bleeding
Placenta Accreta
- Abnormal eonception characterised by swollen and edmematous villi with proliferation of trophoblasts
- uterus expands as if it’s a normal pregnancy is present, but uterus will be bigger than normal and B-hcg (Human chorionic gonadotropin) is more than normal.
Hydatidiform mole
Hydatidiform mole without prenatal care
Classically presents in 2nd trimester, passage of grape like masses through the vaginal canal
(The large Edematous villi is what is passing)
Hydatidiform mole with prenatal care
Diagnosed by routine USG, fetal heart sounds are absent
SNOW STORM appearance on USG
Hydatidiform mole can be classified in to 2
Complete mole and partial mole
Is Hydatidiform mole caused by the father or the mother?
It is caused by the father
- when two sperms come in molar pregnancy so all genetic material is from the father)
(Complete mole -> completely from the dad)
No fetal tissue, since it is a complete mole all villi are edematous and complete proliferation of trophoblasts, in complete mole, B-HCG is way higher and complete has complete risk for chriocsrcinoma 2-3%
Complete mole (empty ovum with 2 sperms)
Normal ovum fertilised by two sperm (69 chrom) feral tissue is “partially”present some villi are edematous (hydropic) and focal proliferation of trophoblasts around hydropic villi also minimal risk of choriocarcinoma
Partial mole
•Proliferation of trophoblasts, villi are absent
- May arise as a complication of gestation or spontaneous germ cell tumour
- Gestational pathway responds well to chemotherapy-> can be due to molar pregnancy, spontaneous abortion or normal pregnancy
- Germ cell parhway doesn’t respond well to chemotherapy
Choriocarcinoma