LOs - Aetiology/Risk Factors

Question 1

What is the aetiology of amniotic fluid embolism and what are its risk factors?

Answer 1

Clear cause is unknown
RFs
- Maternal age
- Induction of labour

Question 2

What is the aetiology of Asherman’s Syndrome and what are its risk factors?

Answer 2

Surgical trauma to uterus wall (usually a D&C procedure after pregnancy)

Question 3

What is the aetiology of atrophic vaginitis and what are its risk factors?

Answer 3

Oestrogen stimulates the vaginal/urinary tract epithelial lining to thicken, become more elastic, and produce more secretions. When women enter menopause, oestrogen levels fall so the lining goes the opposite way, becoming more prone to inflammation.

Question 4

What is the aetiology of Bartholin’s Cyst/Abscess and what are its risk factors?

Answer 4

The Bartholin’s glands are a pair of glands either side of the vaginal opening involved in vaginal lubrication. When the ducts for secretion become blocked, the glands swell and become tender, a Bartholin’s cyst. If a cyst becomes infected, they become a Bartholin’s abscess.

RFs

• Infection
• Injury or surgery in the area
• Nulliparous + child-bearing age
• STIs

E. Coli most common cause of abscess.

Question 5

What is the aetiology of cervical cancer/CIN and what are their risk factors?

Answer 5

Main cause is HPV – detected in 99% of cervical cancer – serotypes 16, 18, 33

Risk factors

• Exposure to HPV
• Impaired immune response to HPV infection (inability to clear the virus) (HIV)
• Smoking
• Early first intercourse/many sexual partners
• High parity
• Low socioeconomic status
• Combined OCP

Mechanism of cause

• HPV 16 & 18 produce oncogenes E6 and E7 respectively
• E6 inhibits p53 tumour suppressor gene
• E7 inhibits RB suppressor gene

Almost all cases originate from the ecto-endocervical mucosa in the ‘transformation zone’ (area between old and new squamocolumnar junction)