Gestational and Placental Pathology Flashcards
What is the greatest risk factor for development of an ectopic pregnancy?
PID causing chronic salpingitis
IUD’s are associated with an _____ risk of ectopic pregnancy
Increased
Sx’s = severe ab pain and vaginal bleeding 6-8 wks after LMP
Ectopic pregnancy
Def: retroplacental hemorrhage at the interface of the placenta and myometrium
Placental abruption
Def: placenta implants in lower uterine segment of cervix leading to serious 3rd trimester bleeding
Placenta previa
Def: partial/complete absence of the decidua so the placental villous tissue adheres directly to the myometrium leading to a failure of placental separation at birth
Placenta accreta
Morph: chorion-amnion contains an infiltrate of neutrophils accompanied by edema and congestion of the vessels
Placental Infections
HTN, edema, and proteinuria developing during pregnancy
Preeclampsia
What is HELLP syndrome?
Hemolysis (anemia)
Elevated Liver enzymes
Low Platelets
What is the definition of eclampsia?
Preeclampsia + convulsions
What is the pathogenesis of eclampsia?
Abnormal trophoblastic implantation and failure of physiologic remodeling of maternal vessels –> placental ischemia –> imbalance of angiogenic and anti-angiogenic factors
What anti-angiogenic factors are elevated in eclampsia and what do they antagonize?
FMS-like TK (sFltl) –> VEGF
Endoglin –> TGF-ß
Lack of TGF-ß causes a decrease in production of what mediator leading to vasoconstriction?
NO
Morph: placenta with infarcts, exaggerated ischemic changes, frequent retroplacental hematomas, and abnormal decidual vessels
Eclampsia
Women who develop preeclampsia have an increased risk of developing _____ and _____ within 7 years
HTN
Microalbuminuria
Preeclampsia is associated with an increased risk of vascular disease of the _____ and _____
Heart
Brain
Morph: delicate, friable mass of thin-walled, translucent, cystic, grape-like structures with swollen edematous villi
Hydatidiform mole
Mole associated with choriocarcinoma and elevated hCG levels
Complete mole
Mole associated with an increased risk of persistent molar disease
Partial mole
Sx’s = vaginal bleeding and irregular uterine enlargement with persistently elevated hCG levels
Invasive mole
Def: malignant neoplasm of trophoblastic cells derived from a previously normal/abnormal pregnancy
Choriocarcinoma
Morph: soft, fleshy, yellow-white tumor with large pale areas of necrosis and extensive hemorrhage
Choriocarcinoma
Sx’s = irregular vaginal spotting of bloody, brown fluid
Choriocarcinoma
How are hCG levels in choriocarcinoma compared to hydatidiform moles?
Much higher hCG in choriocarcinoma
Def: neoplastic proliferations of extravillous trophoblasts
Placental Site Trophoblastic Tumor
Sx’s = uterine mass with abnormal uterine bleeding or amenorrhea and moderately elevated hCG
Placental Site Trophoblastic Tumor
Morph: malignant trophoblastic cells diffusely infiltrating the endomyometrium
Placental Site Trophoblastic Tumor
