Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro 2 > gestational and placental disorders > Flashcards

gestational and placental disorders Flashcards

1
Q

defined as pregnancy loss before 20 weeks of gestation

A

spontaneous abortion or “miscarriage”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the most important causes of spontabous abortion

A
  • fetal chromosomal anomalies: most common Turner (45X)
  • Maternal endocrine factors
  • Physical defects of the uterus
  • Systemic disorders affecting the maternal vasculature (antiphospholipid syndrome)
  • infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

most common site for ectopic pregnancy

A

extrauterine fallopian tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most important predisposing condition for ectopic pregnancy

A

-prior pelvic inflammatory disease resulting in intraluminal fallopian tube scarring (chronic salpingitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what else besides PID increases risk for ectopic pregnancy

A
  • peritubal scarring and adhesions: may be casued by appendicitis, endometriosis, previous surgery
  • intrauterine contraceptive device . . 2x increase
  • smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the most common cause of hematosalpinx (blood in fallopian tube)?

A

Tubal pregnancy . . should always be suspected when a tubal hematoma is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

rupture of a tubal pregnancy is a medical ______?

A

emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The clinical course of an ectopic tubal pregnancy is characterized by what?

A
  • onset of moderate to severe abdominal pain
  • vaginal bleeding 6 to 8 weeks after last menstrual period, correlating with distention and then rupture of the fallopian tube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

diagnosis of ectopic pregnancy is based on what

A
  • determination of chorionic gonadotropin titers (hCG)
  • pelvic sonography
  • endometrial biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the most common microorganisms implicated in intrauterine infections leading to preterm labor

A
  • ureaplasma urealyticum
  • mycoplasma hominis
  • Gardnerella vaginalis
  • trichomonas
  • Gonorrhea
  • Chlamydia

developing countries: malaria and HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

infections that cause spontaneous abortion

A
  • viruses (CMV, HSV2, parvovirus, rubella)
  • Toxo
  • Mycoplasma
  • Listeria
  • chlamydia
  • Ureaplasma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

spontaneous abortion occurs due to what

A

ascending infections in second trimester or hematogenous dissemination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what ultrasound sign is found with ectopic pregnancy

A

donut sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

disorders that occur in the third trimester of pregnancy are related to what?

A

the complex anatomy of the maturing placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is abruptio placentae

A

retroplacental hemorrhage at the interface of placenta and myometrium that threatens both mother and fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is a common cause of second trimester fetal loss

A

infections (ascending most common)

  • chorioamnionitis –> PROM
  • fetal response is vasculitis of cord (funisitis)
  • TORCH infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the TORCH infections

A
  • Toxoplasma
  • Other: syphilis, listeria, HIV, VZV, Parvovirus B19, Coxsackievirus
  • Rubella
  • Cytomegalovirus
  • Herpes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can cause Uteroplacental Malperfusion? or Uteroplacental Vascular Insufficiency (UPVI)

A
  • diabetes
  • HTN
  • maternal conditions predisposing to blood clots
  • smoking
  • cocaine or other drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when you get imbalanced blood flow between twins in utero

A

Twin-Twin transfusion syndrome (TTTS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A condition in which the placenta implants in the lower uterine segment or cervix, often leading to serious third trimester bleeding

A

placenta previa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A complete placenta previa covers the internal cervical os and thus requires what

A

delivery via cesarean section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

caused by partial or complete absence of the decidua, such that the placental villous tissue adheres directly to the myometrium, which leads to failure of placental separation at birth

A

Placenta accreta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Placenta accreta is an important cause of what

A

severe, potentially life threatening postpartum bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

common predisposing factors to placenta accreta

A
  • placenta previa

- history of previous cesarean sections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

infections in the placenta develop by what two pathways

A
  • ascending infections through the birth canal

- hematogenous (transplacental) infection

26
Q

a systemic syndrome characterized by widespread maternal endothelial dysfunction that presents during pregnancy with HTN, edema, and proteinuria

A

Preeclampsia

27
Q

preeclampsia is usually in who

A
  • last trimester

- more common in primiparas (first pregnancy)

28
Q

what is eclampsia

A

women with preeclampsia develops convulsions

29
Q

what are the critical abnormalities in preeclampsia

A
  • diffuse endothelial dysfunction
  • vasoconstriction
  • increased vascular permeability
30
Q

What factors are higher in women with preeclampsia

A
  • sFltl (antagonized VEGF)

- endoglin (antagonizes TGF-beta –>decreased NO)

31
Q

what are the microscopic changes of the placenta associated with preeclampsia

A
  • infarcts
  • exaggerated ischemic changes in chorionic villi and trophoblast, consisting of increased syncytial knots
  • frequent retroplacental hematomas
  • abnormal decidual vessels
32
Q

what are the risk factors for preeclampsia

A
  • age over 40
  • black
    • FH
  • multiple gestation
  • chronic renal disease
  • chronic HTN
  • DM
  • clotting disorders
  • 1st pregnancy
33
Q

what syndrome can develop in women with preeclamsia

A

HELLP in 10-20%

34
Q

describe the hypercoaguable state in preeclampsia

A
  • reduced endothelial production of PGI2
  • leads to thrombi in arterioles and capillaries throughout the body
  • particularly in liver, kidneys, brain, and pituitary
35
Q

when does preeclampsia start

A
  • most commonly after 34 weeks gestation

- earlier in women with hydatidiform mole or preexisting kidney disease, HTN, or coagulopathies

36
Q

describe the onset of preeclampsia

A
  • typically insidious, characterized by HTN and edema with proteinuria following within several days
  • headaches and visual disturbances are serious events
37
Q

what are the hallmarks of HELLP syndrome

A
  • Hemolysis
  • elevated liver enzymes
  • low platelets
38
Q

This encompasses a spectrum of tumors and tumor like conditions characterized by proliferation of placental tissue, either villous or trophoblastic

A

gestational trophoblastic disease

39
Q

Hydatidiform moles are important to recognized because they are associated with an increased risk of what?

A
  • persistent trophoblastic disease (invasive mole)

- choriocarcinoma

40
Q

moles are characterized histologically by what

A

cystic swelling of the chorionic villi accompanied by variable trophoblastic proliferation

41
Q

What are the major gestational trophoblastic disease

A
  • hydatidiform (noninvasive) mole (complete or partial)
  • invasive mole
  • choriocarcinoma
  • placental site trophoblastic tumor
42
Q

increased risk of molar pregnancy in who

A
  • teens

- and age 40-50

43
Q

Hydatidiform mole is diagnosed when and how

A
  • early in pregnancy (average of 9 weeks)

- by sonogram

44
Q

where are molar pregnancies more common?

A

2x more common in southeast asia

45
Q

this type of mole is fertilization of an empty egg

A

complete

46
Q

complete moles have what karyotype

A
  • 46XX (90%)

- or 46 XY

47
Q

complete mole increases risk for what

A
  • choriocarcinoma
  • invasive mole

partial moles are NOT associated with choriocarcinoma but are at increased risk for persistent invasive mole

48
Q

morphology of complete mole

A

grapelike clusters

49
Q

which mole has NO maternal DNA or fetal tissue?

which usually has fetal tissue?

A
  • complete

- partial

50
Q

karyotype of partial mole

A
  • -69XXY

- 92,XXXY

51
Q

clinical presentation for molar pregnancy

A
  • spontaneous miscarriage or ultrasound abnormality

- elevate beta-hCG and increased rate of rise (especially complete mole)

52
Q

defined as a mole that penetrates or even perforates the uterine wall

A

-invasive mole

53
Q

invasive mole is manifested clinically by what

A
  • vaginal bleeding and
  • irregular uterine enlargement
  • persistently elevated hCG
54
Q

A rapidly invasive malignant neoplasm of trophoblastic cells derived from a previous normal or abnormal pregnancy

A

-choriocarcinoma . .also called gestational choriocarcinoma

55
Q

what conditions can choriocarcinoma arise from

A
  • complete mole (50%)
  • previous abortion (25%)
  • normal pregnancy (22%)
  • ectopic pregnancy (rest)
56
Q

clinical presentation of choriocarcinoma

A
  • irregular vaginal bleeding of bloody, brown fluid (not related to menstruation)
  • Enlarged uterus
  • May present with mets to lung, vagina, brain, liver, bone, kidney
  • hCG USUALLY VERY HIGH, unless tumor is necrotic
57
Q

treatment for choriocarcinoma

A

chemo very effective. . 100% cure

58
Q

neoplastic proliferations of extravillous trophoblasts, also called intermediate trophoblasts

A

placental site trophoblastic tumor (PSTT)

59
Q

clinical presentation of PSTT

A
  • uterine mass with bleeding or amenorrhea
  • MODERATE HCG ELEVATION, INCREASE
  • 1/2 follow normal pregnancy
  • also seen after spontaneous abortion or molar pregnancy
60
Q

prognosis for PSTT

A

if localized then excellent

Repro 2 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions