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Pathology 4 > Lecture 3 - Pregnancy Pathologies > Flashcards

Lecture 3 - Pregnancy Pathologies Flashcards

1
Q

what structure does the fertilization of the egg by the sperm result in?

A

zygote

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2
Q

how long does the fertilization process take?

A

~ 24 hours

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3
Q

how long is the sperms life span?

A

3-4 days

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4
Q

how long does it take the sperm to navigate the female reproductive track?

A

~ 10 hours

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5
Q

what is the route the sperm takes through the female reproductive track?

A

up vaginal canal, through cervix, into fallopian tubes - where fertilization begins

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6
Q

what happens during the acrosome reaction?

A

release of acrosome enzymes - hyaluronidase

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7
Q

what must occur before the sperm can fuse with the secondary oocyte?

A

the acrosome reaction that facilitates fertilization

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8
Q

what does the sperm come into contact with during fertilization?

A

corona radiata (ZP3) of oocyte

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9
Q

what aids in corona radiate penetration?

A

flagella action

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10
Q

what happens within 11 hours post fertilization?

A

oocyte has extruded a polar body with its excess chromonomes

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11
Q

what does the fusion of the oocyte and sperm nuclei mark?

A

creation of the zygote and end of fertilization

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12
Q

what step fallows creation of the zygote/ end of fertilization?

A

zygote begins to cleave

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13
Q

what occurs with each division (cleavage) of the zygote?

A

divides into 2 cells called blastomeres

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14
Q

how often does the zygotes cells divide again?

A

each division occurring about every 20 hours

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15
Q

what are 4 categories of causes of pregnancy pathologies/disorders?

A
  1. abnormal/pathologies of fertilization (ovum or sperm related)
  2. pathology of implantation
  3. pathology of placentation
  4. materono-fetal interaction
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16
Q

what are 4 factors relating to fertilization pathologies?

A
  1. ovum related
  2. sperm related
  3. genital organ related
  4. systemic related (DM, antibodies to spermatozoa or ova, psychological problems)
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17
Q

what are ovum related factors of fertilization pathologies?

A 
immature ovums (meiotic division is incomplete) or
inferior ovum quality (older women)
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18
Q

what % of normal ovum do not fertilize?

A

20%

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19
Q

what are sperm related factors of fertilization pathologies?

A

azoospermia (no living sperm), oligospemia (not enough sperm), or immotile spermatozoa

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20
Q

what are genital organ related factors of fertilization pathologies?

A

PID (fallopian tube pathology)

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21
Q

what % of infertility is caused by fallopian tube pathology?

A

30%

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22
Q

what is pelvic inflammatory disease?

A

fallopian tube is occluded or deformed by chronic inflammation or adhesion/scar tissue

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23
Q

what are 3 factors involved in implantation pathologies?

A
  1. uterus not hormonally primed with estrogen and progesterone so it cannot accept an embryo
  2. endometritis or uterine adhesions (Asherman’s syndrome)
  3. ectopic pregnancy
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24
Q

what is an ectopic/ extrauterine pregnancy?

A

implantation occurs outside the uterus

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25
where is the most common location of a ectopic pregnancy?
fallopian tubes (often affected with PID) - 95% (ovary and abdominal cavity are also locations)
26
what are 4 risk factors of ectopic pregnancy?
PID induced abortion STI IUD
27
what are 3 factors that ectopic pregnancies are related to?
delayed egg transport decreased fallopian tube motility distorted anatomy
28
what are 5 clinical manifestations of ectopic pregnancy?
1. pelvic pain 2. cramps 3. irregular bleeding/spotting 4. amenorrhea 5. fainting
29
what is the definition of an abortion?
ending of pregnancy by the removal or forcing out of the fetus/embryo from the womb before it is viable
30
what are the two main types of abortions and the subtypes?
1. induced/elective (medically indicated) | 2. spontaneous: includes, complete, incomplete, missed and threatened
31
what time frame are abortions the safest to perform?
within the first 6-10 weeks after the last menstrual period (13-24 have higher complication rate)
32
what situation would permit an abortion to be performed after 24 weeks of pregnancy?
mothers life is in danger
33
what are 3 methods of induced/elective abortions?
``` vacuum aspiration (suction) infusion of saline solution surgical evacuation (scraping) ```
34
what is the name of the pill used in a non surgical abortion?
RU 486
35
what does the non surgical abortion pill do?
its an anti progestin drug that causes uterine lining to collaspse and embryo is lost - menstruation occurs
36
what is the time frame that the non surgical abortion pill can be taken?
up to 5 weeks after conception
37
what is the definition for placenta?
temporary organ that joins the mother and fetus - tranfers oxygen and nutrients from mother to fetus and permits release of cardbon dioxide and waste products from the fetus
38
what are 4 categories of placental anomalies?
abnormalities in: | shape, size, placental cord (transfer), and amniotic fluid (inside)
39
what is placenta accreta?
serious pregnancy condition that occurs when blood vessels and other parts of the placenta grow too deeply into the uterine wall (muscularis)
40
with placenta accreta, what occurs with the placenta at time of delievery?
placenta does not shells out spontaneously from uterus and this may lead to extensive bleeding
41
what is the treatment for placenta accreta?
manual extraction of the placenta to remove it from the uterus after delievery
42
what is the definition of placenta previa?
implantation of the placenta over or near the cervix in the lower part of the uterus - the placenta may completely or partially cover the cervix
43
what can make women more susceptible to placenta previa?
having had more than one pregnancy or structural abnormalities of the uterus - such as fibroids
44
what can placenta previa cause in late pregnancy?
painless bleeding from the vagina that begins suddenly and may become profuse, endangering the life of women and the fetus - C section is almost always performed before labour begins
45
what can ultrasonography help doctors identify?
placenta previa and distinguish it from a prematurely detached placenta
46
define 'abruptio placentae'
premature detachment of a normally positioned placenta from uterine wall
47
what is a major risk factor of abruptio placentae?
eclampsia
48
who is more likely to have a prematurely detached placenta?
women with high BP or cocaine users
49
what do symptoms of abruptio placentae depend on?
degree of detachment and amount of blood lost (can be massive for some women - can die quickly from hypovolemic shock and infection)
50
what is the treatment for abruptio placentae?
bed rest and c section
51
when do symptoms of preeclampsia usually appear?
after 34th week of pregnancy
52
what does the triad of preeclmapsia include?
hypertension (gestational HTN) edema proteinuria
53
what clinical manifestations does eclampsia include?
all those from the preeclampsia triad (HTN, edema and proteinuria) plus seizures
54
what is the prognosis of eclampsia if diagnosed early?
good - its a common pathology
55
what is the rate of prevalence of preeclampsia and eclampsia, respectively?
3-4% : 6% of all pregnancies
56
what pregnancy is preeclampsia and eclampsia most likely to occur?
first one
57
how is preeclampsia and eclampsia treated?
HTN med, bed rest and c section
58
what does the HELLP syndrome present with in regards to HTN complications, surrounding preeclampsia and eclampsia?
Hemolysis Elevated Liver enzymes Low platelets
59
what does gestational diabetes cause?
high blood sugar that can affect pregnancy and baby's health
60
what condition does gestational diabetes put women at risk for?
type 2 diabetes
61
for most women - what are the symptoms present of gestational diabetes?
for most it does not cause noticeable SSx
62
what are 4 risk factors of gestational diabetes?
older than 25 family or personal health hx (ex. being pre-diabetic) excess body weight race (increased risk for black, hispanic, american indian or asian)
63
what are 4 complications of gestational diabetes that may affect baby?
xs birth weight premature birth/respiratory distress syndrome hypoglycemia (could lead to seizures) later development of type 2 diabetes
64
what are 2 complications of gestational diabetes that may affect mother?
high BP and preeclampsia | future diabetes - during future pregnancy the risk of gestational diabetes goes up and type 2 later in life
65
define 'gestational trophoblastic disease'
abnormalities of placentation that lead to tumor like changes in placenta
66
what is hydatidiform mole?
benign form of gestational trophoblastic disease
67
what are 2 common forms of gestational trophoblastic disease (hydatidiform mole)?
1. complete mole - fetus cannot be identified in amniotic sac due to chromosomal abnormality 2. incomplete mole: placenta tumor usually attached to fetal parts and partially preserve normal placental tissue - due to oocyte fertilized with 2 spermatozoa
68
what are 3 clinical signs of gestational trophoblastic disease?
enlarged uterus without any signs of fetal movement high hCG levels moles are aborted spontaneously (mid pregnancy - if diagnosed early an abortion is performed)
69
what is the malignant form of gestational trophoblastic disease?
choriocarcinoma - malignant tumor composed of placental cells
70
where are 3 source that choricocarcinoma develops from and the rate of occurrence from that source?
50% from hydatidiform mole 25% from placental cells after abortion 25% from normal placenta
71
choriocarcinoma is highly invasive and secretes what hormone?
hCG
72
how is choriocarcinoma highly invasive?
penetrates the wall of uterus, invading the veins which then metastasizes to the lung, liver and brain (tumor responds well to chemotherapy)
73
what is the cure rate for choriocarcinoma if treated before brain metastasis?
80-100%

Pathology 4 (4 decks)

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