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ENRP > Gestational Disorders > Flashcards

Gestational Disorders Flashcards

1
Q

What is an Ectopic pregnancy? Where is a common location?

A

Implantation of the fetus outside of the uterine cavity

– usually fallopian tube

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2
Q

What is a major risk factor for having an Ectopic pregnancy?

A

PID

– chlamdyia/gonnorhea

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3
Q

What are the symptoms of an Ectopic pregnancy?

A

Abdominal pain

Bleeding 6-8 weeks after last period

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4
Q

Abdominal pain and bleeding 6-8 weeks after last period is likely?

A

Ectopic pregnancy

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5
Q

2 ways to diagnose an Ectopic pregnancy?

A

Transvaginal US

B-HCG

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6
Q

If the Ectopic pregnancy ruptures, what are the symptoms?

A

Severe pain and hemorrhagic shock

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7
Q

What are the gross findings with an Ectopic pregnancy? (3)

A

Swollen fallopian tube
Hemorrhage
Fetal villi/fetus

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8
Q

Miscarriage (spontaneous abortion)

A

Pregnancy loss before 20 weeks

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9
Q

What are some causes for a Miscarriage?

A
  • TORCH infections
  • Fetal or Uterine abnormalities
  • Endocrine factors
  • Thrombosis/vasculature issues
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10
Q

How do you get Dizygotic “Fraternal” Twins?

A

Fertilization of 2 oocytes by 2 sperm

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11
Q

What type of placenta will Dizygotic “Fraternal” twins ALWAYS have?

A

Dichorionic Diamnionic placenta

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12
Q

How do you get Monozygotic “Identical” twins?

A

Fertilization of 1 oocyte by 1 sperm that morulas split

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13
Q

What type of placenta will Monozygotic “identical” twins have?

A

MANY different types

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14
Q

In what type of twins does Twin-to-Twin Transfusion Syndrome occur?

A

Monochorionic –> Identical twins

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15
Q

What causes Twin-to-twin Transfusion Syndrome?

A

Arteriovenous anastomoses deep in the placenta

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16
Q

What is the result of Twin-to-Twin Transfusion Syndrome?

A

One twin is underperfused while the other is fluid overloaded
–> Can result in death
(due to arteriovenous anastomoses deep in placenta)

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17
Q

What are 2 abnormal placenta implantation conditions?

A
  1. Placenta Accreta Spectrum

2. Placenta Previa

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18
Q

What happens with Placenta Accreta Spectrum?

A

Absence of the Decidua

–> Fetal villi adhere directly to myometrium

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19
Q

With Placenta Accreta Spectrum, what will happen at/after birth?

A

Placenta fails to separate

=> POST-PARTUM HEMORRHAGE

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20
Q

What happens with Placenta Previa?

A

Placenta implants in lower uterus or cervix

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21
Q

What is the symptom of Placenta Previa and what is the treatment?

A

3rd trimester bleeding
– Need C-section
(placenta implants in lower uterus/cervix)

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22
Q

What is Preeclampsia and when does it occur?

A

> 20 weeks gestation

= New onset hypertension (>140/90) with proteinuria

23
Q

New onset hypertension and proteinuria during pregnancy, especially after 20 weeks

A

Preeclampsia

24
Q

If Preeclampsia is severe, what can occur?

A

Eclampsia = grand mal seizure

Headache and visual changes as well

25
Eclampsia
Grand mal seizure due to Preeclampsia (HTN)
26
Describe the pathogenesis of Preeclampsia
``` - Abnormal placenta vasculature (lack of vessel enlargement causes ischemia) - Maternal vasoconstriction (hypertension) - Hypercoagulable state (fibrin thrombi) ```
27
Describe the pathogenesis of Preeclampsia
``` - Abnormal placenta vasculature (lack of vessel enlargement causes ischemia) - Maternal vasoconstriction (hypertension) - Hypercoagulable state (fibrin thrombi) ```
28
What will be seen on the placenta side with Preeclampsia?
Infarcts | Abnormal decidual vessels
29
What will be seen on the mother's side with Preeclampsia?
Fibrinoid necrosis | Fibrin thrombi in liver/kidney/brain
30
HELLP Syndrome
H- Hemolysis; microangiopathic anemia with schistocytes EL- Elevated Liver enzymes LP- Low Platelets
31
HELLP Syndrome
H- Hemolysis; Microangiopathic anemia with schistocytes EL- Elevated Liver enzymes LP- Low Platelets
32
When will HELLP Syndrome present and can it have features of preeclampsia?
``` 3rd trimester (28-37 weeks) YES ```
33
What is a Hydatiform Mole?
Abnormal pregnancy with cystic swelling of chorionic villi
34
Abnormal pregnancy with cystic swelling of chorionic villi
Hydatiform Mole
35
When is Hydatiform Mole diagnosed and what is elevated in the serum?
9 weeks gestation with an US | -- Elevated B-HCG
36
What are the 2 types of Hydatiform Moles?
- Complete Molar | - Partial Molar
37
A Complete Molar Hydatiform Mole derives its genetic material from?
PATERNALLY - father | = 46XX or 46XY
38
How will a Complete Molar Hydatiform Mole look and is there fetal parts?
Multi-cystic mass lesion | NO FETAL PARTS
39
If a "snow-storm" US appears, what is the diagnosis?
Complete Molar Hydatiform Mole
40
With a Complete Molar Hydatiform Mole, what is the patient at risk of?
Choriocarcinoma and invasive mole
41
A Partial Molar Hydatiform Mole derives its genetic material from?
BOTH parents | = 69XXX or 69XXY
42
How will a Partial Molar Hydatiform Mole look and is there fetal parts?
Enlarged/abnormal villi mixed with normal villi | YES FETAL PARTS
43
What stain can differentiate a Partial Molar from a Complete Molar Hydatiform Mole?
(+) P57 | -- maternally expressed so will be positive with a Partial Molar
44
What stain can differentiate a Partial Molar from a Complete Molar Hydatiform Mole?
(+) P57 | -- maternally expressed so will be positive with a partial molar
45
What is a Gestational Choriocarcinoma?
Malignant trophoblastic tumor
46
Malignant trophoblastic tumor
Gestational Choriocarcinoma
47
What is the risk factor for a Gestational Choriocarcinoma?
Complete mole! | malignant trophoblastic tumor
48
What is often present at the time of diagnosis with a Gestational Choriocarcinoma and what will be VERY elevated in the serum?
Widespread metastases | -- Elevated B-HCG
49
What is a Placental Site Trophoblastic Tumor?
Malignant tumor of intermediate trophoblasts
50
Malignant tumor of intermediate trophoblasts
Placental Site Trophoblastic tumor
51
When does a Placental Site Trophoblastic Tumor occur and what will be mildly elevated in the serum?
Follows a miscarriage or normal pregnancy | - Mild elevated of B-HCG
52
Symptoms of a Placental Site Trophoblastic Tumor?
Uterine mass with bleeding or amenorrhea
53
Uterine mass with bleeding or amenorrhea is likely which gestational trophoblastic disease?
Placental Site Trophoblastic Tumor

ENRP (45 decks)

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