Gestational Pathology 1 Flashcards
What is the most common site of ectopic pregnancy and what is the most important risk factor for?
Lumen of Fallopian tube
Scarring
What two conditions can lead to scarring which would put the patient at risk for ectopic pregnancy?
Endometriosis and PID
What is the classic presentation for ectopic pregnancy?
Woman presents with lower abdominal quadrant pain weeks after missed period
When do spontaneous abortions occur and what are the 3 things a women will present with?
Before 20 weeks
Vaginal bleeding, cramp like pain, and passing of fetal tissue
Most common cause of of abortion?
Chromosomal anomalies
What is placenta Previa and how does it present?
Where the placenta implants in the lower uterus and blocks part or all of the cervical os.
Third trimester bleeding
What is placenta abruption?
When the placenta abruptly detaches from the uterine wall.
2 clinical presentations of placenta abruption?
Third trimester bleeding and fetal insufficiency
Placental abruption is a common cause of what?
Still birth
What is placenta accreta?
When the placenta implants to implants all the way into the myometrium
What are 2 complications of placenta accreta and what does it often require?
Very difficult to deliver the placenta, so it often stays
Staying causes post partum bleeding
Requires hysterectomy
What is preeclampsia?
Pregnancy induced HTN, proteinuria, and edema usually presenting in 3rd trimester
What is the cause of preeclampsia?
Maternal-fetal vascular interface in the placenta
What can be found in the placental blood vessels of a women with preeclampsia?
Fibrinoid necrosis
What is eclampsia?
Preeclampsia with seizures
What is a complication of preeclampsia?
HELLP
Hemolysis, elevated liver enzymes, low platelets
What are 3 risk factors for sudden infant death syndrome?
Sleeping on stomach, exposure to cigarette smoke and prematurity
What is a hydatidiform mole?
Abnormal conception that causes the villi to be swollen and edematous with proliferation of the trophoblastic surrounding the villi
What effect does this have on the uterus?
Uterus is much larger than the gestational date and the beta hCG is much higher as well.
How are these moles diagnosed, what are the two ways we can find them?
Well, if the lady does not have prenatal care, then she will begin passing the moles out of the vaginal canal in the early second trimester.
If she does have prenatal care, then they will be diagnosed on ultra sound. Fetal heart sounds absent along with the snow storm appearance.
What are the two classifications for moles?
Partial or complete
What are the 4 criteria I am asking to classify a mole to be partial or complete?
Genetics
Fetal tissue
Villus edema
Trophoblastic proliferation
What is the specific criteria of those 4 things for a complete mole?
Empty ovum fertilized by two sperms giving 46 chromosomes
Fetal tissue is absent
All villi are edematous
Completely covered by trophoblastic proliferation
Which one has a higher risk for choriocarcinoma
Complete mole
Which mole has a higher level of beta hCG and why?
Complete mole because beta hCG comes from syncytiotrophoblast and there is more proliferation in a complete mole.
Choriocarcinoma is a tumor of what type of cells?
Trophoblast cells
What are absent with a choriocarcinoma?
Bill are absent
What are the two pathways that lead to a choriocarcinoma and what is the main difference for purposes of exams?
Sporadic germ cell pathway and being a complication of gestation.
Gestational pathway choriocarcinoma responds well to chemotherapy and sporadic pathway ones do not.
