Pathology - Pregnancy Complications Flashcards
What is Placental abruption (abruptio placentae)
Premature separation (partial or complete) of placenta from uterine wall before delivery of infant.
What are the risk factors for placental abruption? (5)
trauma (eg, motor vehicle accident) smoking, hypertension preeclampsia cocaine abuse
What presents with sudden-onset, painful bleeding (concealed or apparent) in third trimester; possible DIC, maternal shock, fetal distress. Life threatening for mother and fetus.
Placental Abruption - abruptio placentae
What is Placenta accreta?
placenta attaches to myometrium without penetrating it; most common type.
What is Placenta increta?
placenta penetrates into myometrium.
What is Placenta percreta?
placenta penetrates (“perforates”) through myometrium and into uterine serosa (invades entire uterine wall)
What causes Placenta accreta/increta/precreta?
Defective decidual layer -> abnormal attachment and separation after delivery.
What are the risk factors for Placenta accreta/increta/precreta? (3)
prior C-section, inflammation, placenta previa.
What placental issue can result in placental attachment to rectum or bladder.
Placenta Percreta
What placental issue is most common type?
Placenta Accreta
What presents with: often detected on ultrasound prior to delivery. No separation of placenta after delivery postpartum bleeding
Placenta Accreta/increta/accreta
What can Placenta Accreta/increta/accreta cause?
Sheehan Syndrome
What is Placenta previa
Attachment of placenta to lower uterine segment over (or
What are risk factors for Placenta previa? (2)
multiparity, prior C-section.
How does Placenta Previa present?
painless third-trimester bleeding
What is Vasa Previa?
Fetal vessels run over, or in close proximity
to, cervical os.
What may result in vessel rupture, exsanguination -> fetal death.
Vasa Previa
What is the Vasa Previa Triad?
Presents with triad of membrane rupture
painless vaginal bleeding
fetal bradycardia
Treatment for Vasa Previa?
Emergency C-Section
What is a velamentous umbilical cord insertion
Cord inserts in chorioamniotic membrane rather than placenta fetal vessels travel to placenta unprotected by Wharton jelly
What is associated with a velamentous umbilical cord insertion?
Vasa Previa
What are the 4 Ts of postpartum hemorrhage?
Tone (uterine atony; most common)
Trauma (lacerations, incisions, uterine rupture)
Thrombin (coagulopathy)
Tissue (retained products of conception).
Most common location for an ectopic pregnancy?
Most often in ampulla of fallopian tube
Ectopic pregnancy can frequently be misdiagnosed as what?
acute appendicitis
what imaging is used to confirm ectopic pregnancy?
ultrasound
When should you suspect ectopic pregnancy?
Suspect with history of amenorrhea, lower-than-expected rise in hCG based on dates, and sudden lower abdominal pain
Key risk factor for ectopic pregnancy?
Scarring secondary to pelvic inflammatory disease
Risk factors for ectopic pregnancy? (5)
Prior ectopic pregnancy History of infertility Salpingitis (PID) Ruptured appendix Prior tubal surgery
Fetal malformations that cause polyhydramnios?
esophageal/duodenal atresia, anencephaly; both result in inability to swallow amniotic fluid
What other risk factors are there for polyhydramnios (3)
maternal diabetes, fetal anemia, multiple gestations.
What are the causes of oligohydramnios? (3)
placental insufficiency, bilateral renal agenesis, posterior urethral valves (in males)
What can occur with oligohydramnios?
Potter Sequence
