Gestational Pathology Flashcards
what is ectopic pregnancy and what is the most common location
- implantation of fertilized ovum at site other than uterine wall
- ampulla of fallopian tube
what is a key risk factor for ectopic pregnancy ?what can cause this risk factor
scarring
secondary to pelvic inflammatory disease or endometriosis
clinical presentation for ectopic pregnancy
lower quadrant abdominal pain few weeks after missed period
how is ectopic pregnancy treated? complications?
surgical emergency
- bleeding into fallopian tube (hematosalpinx) and rupture
what is spontaneous abortion
miscarriage of fetus occurring before 20 weeks gestation (usually first trimester)
clinical symptoms of spontaneous abortion
vaginal bleeding
cramp-like pain
passage of fetal tissues
what are causes of spontaneous abortion
- chromosomal anomalies ( trisomy 16)
- hypercoagulable states ( antiphospholipid syndrome)
congenital infection - exposure to teratogens ( especially first 2 weeks of embryogenesis)
what happens in baby is exposed to teratogens first 2 weeks of gestation
spontaneous abortion
what happens in baby is exposed to teratogens during weeks 3-8 of gestation
risk of organ malformation
what happens in baby is exposed to teratogens during months 3-9 of gestation
risk of organ hypoplasia
what is the most common cause of mental retardation in a fetus
alcohol- can also cause facial abnormalities and microcephaly
Cocaine to fetus can cause
intrauterine growth retardation
placental abruption
Thalidomide to fetus can cause
limb defects
Cigarette smoking to fetus can cause
intrauterine growth retardation
Isotretinoin to fetus can cause
spontaneous abortion
hearing and visual impairments
Tetracycline to fetus can cause
discolored teeth
Warfarin to fetus can cause
fetal bleeding
Phenytoin to fetus can cause
digit hypoplasia
cleft lip/palate
what is placenta previa
implantation of placenta in lower uterine segment
placenta overlies cervical os ( opening)
-third trimester bleeding
-requires C section
what is placental abruption
separation of placenta from decidua prior to delivery of fetus
-common cause of still birth
what is placenta accreta
improper implantation of placenta into myometrium with little or no intervening decidua
-difficult delivery of the placenta and postpartum bleeding
If a patient has placenta accreta, what does she often require after
hysterectomy
What is preeclampsia? when does it usually occur
pregnancy-induced hypertension, proteinuria, and edema
- usually 3rd trimester
hypertension in preeclampsia can lead to what clinical symptoms
headaches and visual abnormalities
what is eclampisa
preeclampsia with seizures
How is preeclampsia resolved
resolves after delivery
what is HELLP?
preeclampsia with thrombotic microangiopathy involving the liver
- Hemolysis
- Elevated Liver enzymes
- Low Platelets
what would you do if your patient had either eclampisa or HELLP
immediate delivery
sudden infant death syndrome?
death of a healthy infant (1 month - 1 year) without obvious cause
when do you infants usually expire in sudden infant death syndrome
during sleep
what are risk factors of sudden infant death syndrome
sleeping on stomach
exposure to cigarette smoke
prematurity
what is hydatidiform mole
abnormal conception characterized by swollen and edematous villi with proliferation of trophoblasts
what happens to the uterus and hormone levels in hydatidiform mole
- uterus expands like normal pregnancy, but uterus is much larger
- Beta-hCG much higher than expected for date of gestation
when does hydatidiform mole present? what does it look like like?
second trimester as passage of grape-like masses through vaginal canal
how is hydatidiform mole diagnoised
- -‘snowstrom’ appearance on ultrasound in early first trimester
- fetal heart sounds absent
what is the genetics of partial hydatidiform mole
normal ovum fertilized by 2 sperm (or
one sperm) that duplicates chromosomes
69 chromosomes
what is the genetics of complete hydatidiform mole
empty ovum fertilized by 2 sperm (or
one sperm) that duplicates chromosomes
46 chromosomes
is fetal tissue present/absent in partial or complete hydatidiform mole
partial: present
complete: absent
describe the villous edema in partial and complete hydatidiform mole
partial: some villi are hydropic, some normal
complete: most villi are hydropic (edema)
What is the risk of choriocarcinoma in partial and complete hydatidiform mole
partial: minimal
Complete: 2-3%
how is hydatidiform mole treated? what need to be monitored and why
D&C
- subsequent Beta-hCH monitoring is important to ensure adequate mole removal and screen for development of choriocarcinoma
Choriocarcinoma may arise as a complication of what
- gestation (spontaneous abortion, normal pregnancy, or hydatidiform mole)
- spontaneous germ cell tumor
