Gestational and Placental Pathology

Question 1

What is the greatest risk factor for development of an ectopic pregnancy?

Answer 1

PID causing chronic salpingitis

Question 2

IUD’s are associated with an _____ risk of ectopic pregnancy

Answer 2

Increased

Question 3

Sx’s = severe ab pain and vaginal bleeding 6-8 wks after LMP

Answer 3

Ectopic pregnancy

Question 4

Def: retroplacental hemorrhage at the interface of the placenta and myometrium

Answer 4

Placental abruption

Question 5

Def: placenta implants in lower uterine segment of cervix leading to serious 3rd trimester bleeding

Answer 5

Placenta previa

Question 6

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

Answer 6

Placenta accreta

Question 7

Morph: chorion-amnion contains an infiltrate of neutrophils accompanied by edema and congestion of the vessels

Answer 7

Placental Infections

Question 8

HTN, edema, and proteinuria developing during pregnancy

Answer 8

Preeclampsia

Question 9

What is HELLP syndrome?

Answer 9

Hemolysis (anemia)
Elevated Liver enzymes
Low Platelets

Question 10

What is the definition of eclampsia?

Answer 10

Preeclampsia + convulsions

Question 11

What is the pathogenesis of eclampsia?

Answer 11

Abnormal trophoblastic implantation and failure of physiologic remodeling of maternal vessels –> placental ischemia –> imbalance of angiogenic and anti-angiogenic factors

Question 12

What anti-angiogenic factors are elevated in eclampsia and what do they antagonize?

Answer 12

FMS-like TK (sFltl) –> VEGF

Endoglin –> TGF-ß

Question 13

Lack of TGF-ß causes a decrease in production of what mediator leading to vasoconstriction?

Answer 13

NO

Question 14

Morph: placenta with infarcts, exaggerated ischemic changes, frequent retroplacental hematomas, and abnormal decidual vessels

Answer 14

Eclampsia

Question 15

Women who develop preeclampsia have an increased risk of developing _____ and _____ within 7 years

Answer 15

HTN

Microalbuminuria

Question 16

Preeclampsia is associated with an increased risk of vascular disease of the _____ and _____

Answer 16

Heart

Brain

Question 17

Morph: delicate, friable mass of thin-walled, translucent, cystic, grape-like structures with swollen edematous villi

Answer 17

Hydatidiform mole

Question 18

Mole associated with choriocarcinoma and elevated hCG levels

Answer 18

Complete mole

Question 19

Mole associated with an increased risk of persistent molar disease

Answer 19

Partial mole

Question 20

Sx’s = vaginal bleeding and irregular uterine enlargement with persistently elevated hCG levels

Answer 20

Invasive mole

Question 21

Def: malignant neoplasm of trophoblastic cells derived from a previously normal/abnormal pregnancy

Answer 21

Choriocarcinoma

Question 22

Morph: soft, fleshy, yellow-white tumor with large pale areas of necrosis and extensive hemorrhage

Answer 22

Choriocarcinoma

Question 23

Sx’s = irregular vaginal spotting of bloody, brown fluid

Answer 23

Choriocarcinoma

Question 24

How are hCG levels in choriocarcinoma compared to hydatidiform moles?

Answer 24

Much higher hCG in choriocarcinoma

Question 25

Def: neoplastic proliferations of extravillous trophoblasts

Answer 25

Placental Site Trophoblastic Tumor

Question 26

Sx’s = uterine mass with abnormal uterine bleeding or amenorrhea and moderately elevated hCG

Answer 26

Placental Site Trophoblastic Tumor

Question 27

Morph: malignant trophoblastic cells diffusely infiltrating the endomyometrium

Answer 27

Placental Site Trophoblastic Tumor