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► Med - Pathology > Gestational and Placental Disorders > Flashcards

Gestational and Placental Disorders Flashcards

1
Q

What is the function of the placenta?

A

Establish effective communication between mother and developing fetus while maintaining immune and genetic integrity of both individuals.

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2
Q

Amnion

A

Inner layer of the amniotic cavity

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3
Q

Chorion

A

Outer layer of the amniotic cavity

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4
Q

Decidua

A

The endometrium of pregnancy and where the chorion attaches

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5
Q

Chorionic Villi

A

They sprout from the chorion to provide a large contact area between fetal and maternal circulations

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6
Q

Do the maternal and fetal blood mix?

A

Under normal circumstances maternal and fetal blood do not “mix”.

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7
Q

What is the main cause of spontaneous abortions?

A

Chromosomal abnormalities

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8
Q

Ectopic Pregnancy

A

Implantation of embryo occurs outside of the uterus

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9
Q

What kind of chorion implies identical twins?

A

Monochorionic

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10
Q

Placenta Previa

A

Attachment of placenta to lower uterine segment or cervix that causes 3rd trimester bleeding as the cervix dilates.

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11
Q

Placenta Accreta

A

Partial or complete absence of decidua with adherence of placental villous tissue directly to myometrium which causes postpartum bleeding.

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12
Q

What are some predisposing factors for placenta accreta?

A

– Placenta previa

– Hx previous cesarean section

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13
Q

Abruptio Placentae

A

Premature separation of placenta prior to delivery leading to the formation of retroplacental blood clot - can compromise the blood supply to the fetus

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14
Q

What process fails in preeclampsia-eclampsia?

A

Cytotrophoblasts outside invade the vasculature
in the media and allow them to remodel and be more
accommodating which fails in preeclampsia-eclampsia.

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15
Q

What are some risks for preeclampsia-eclampsia?

A
  • HTN
  • DM
  • Obesity
  • Very young or very old
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16
Q

What are the features of preeclampsia?

A
  • HTN
  • Edema
  • Proteinuria
17
Q

Severe Preeclampsia

A

Preeclampsia with headaches and vision changes

18
Q

Eclampsia

A

Preeclampsia with convulsions

19
Q

HELLP Syndrome

A

Severe preeclampsia with hemolysis, elevated liver

enzymes and low platelets.

20
Q

What must be done for treatment of preeclampsia-eclampsia?

A

If the disease is severe, delivery must be done regardless of fetal age

21
Q

What are drugs used to treat maternal HTN?

A
  • Labetalol
  • Methyldopa
  • Hydralazine
22
Q

What is the most common pathway for placental infection?

A

Ascending infection. Hematogenous spread is much more uncommon.

23
Q

What will be seen histologically with Acute Chorioamnionitis?

A

PMN infiltrates. Green color on gross specimen.

24
Q

What are the TORCH infections?

A
  • Toxoplasma gondii
  • O –Others Parvovirus B 19, Syphillis, TB, listeria
  • Rubella
  • CMV
  • HSV and HIV
25
Q

Features of these illnesses in the neonate include: fever, encephalitis, chorioretinitis, hepatosplenomegaly, pneumonitis, myocarditis, hemolytic anemia and vesicular or hemorrhagic skin lesions.

A

TORCH Infections

26
Q

Cystic swelling of chorionic villi with trophoblastic proliferation.

A

Hydatiform Moles

27
Q

What is a lab characteristic of hydatiform moles?

A

Elevated hCG

28
Q

Complete Mole

A
  • Most villi are enlarged
  • Made from 2 sperms fertilizing empty ovum OR one sperm that has DNA copied to diploidy
  • Embryo dies early -> rarely see fetal parts
29
Q

Partial Mole

A
  • Only some villi are edematous

- Made from one egg and 2 or more sperm (minimum triploidy)

30
Q

Is there an increased risk of choriocarcinoma with partial mole?

A

No

31
Q

Invasive Mole

A

• Mole that penetrates uterine wall
• Hydropic chorionic villi invade myometrium
– May embolize to distant sites

32
Q

Gestational Choriocarcinoma

A

Malignant, invasive and widely metastatic and is a neoplasm of trophoblast derived cells

33
Q
  • Proliferationof neoplastic cystotrophoblasts and syncytiotrophoblasts
  • NO chorionic villi
  • Presents as vaginal blood, brown fluid spotting
A

Gestational Choriocarcinoma

34
Q

How effective is chemotherapy in gestational choriocarcinoma?

A

VERY effective

► Med - Pathology (203 decks)

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