Placenta path II Flashcards
what are the 2 patterns of infection for placenta
“Prolonged rupture of membranes”: ascending infection from microbiome of vagina and cervix
hematogenous (transplacental) pathogens from maternal infection: TORCH
what can cause the ascending infection to placenta
group B strep
acute chorioamnionitis, funisitis, villitis
premature rupture of membrane
neonatal pneumonia, sepsis and meningitis
what an give placenta green coloring
pus or meconium stained from release from the fetus in utero- fetal stress
why is meconium bad for fetus
toxic to airways
meconium released from fetus can cause what condition
acute chorioamnionitis
why does a ruptured amnionic sac increase change chorioamnionitis
because now mucus plug is gone and infections can ascend
villitis is typical from what organisms
TORCH and syphilis and listeria
Sx of preeclampsia and eclampsia
HTN after 20 weeks
edema and proteinuria
what is eclampsia
convulsions/ hyper-reflexia, severe can develop HELLP syndrome
what causes ecclampsia
maternal endothelial dysfunction due to under perfusion of the placenta from abrnomal adaptation of spiral aa to pregnancy
fibrinoid thickening of small aa
maternal complications of ecclampsia
DIC
kidney damage
HTN long term
What is HELLP syndrome
hemolysis
elevated liver enzymes
low platelets
What is an invasive hydatidiform mole
penetrates uterine wall and can even invade or mets
how do we detect hydatidiform moles
produce beta hCG
what can lead to complete hydatidiform moles
- single sperm empty ovum and the sperms chromosomes duplicate
- dispermy and empty ovum
Can have 46 XX(mono or dispermy) or 46XY(dispermy)
what can lead to partial hydatidiform mole
dispermy with fertilized ovum
69XXX
69XXY
69XYY
find a hydatidiform mole that has a few grape like clusters with identifiable fetal parts
what kind is it
partial
the micro of hydatidiform mole has villous edema with diffuse trophoblastic proliferation
complete or partial?
complete
risk of chorioCA in complete mole?
partial mole?
high in complete
low in partial
clincal presentation of hydatidiform mole or “gestational trophoblastic disease”
no fetal heart sounds or movements with uterus too large for date hyperemesis pregnancy induced HTN thyrotoxicosis painless! vaginal bleeding in 4th moth increased incidenc theca lutein cysts
why can moles cause thyrotoxicosis
hCG is similar in structure to TSH
hydatidiform moles are more common in what popylation
teens, 5th decade
asian countries
CA dfound to have a central core of cytotrophoblasts surrounded by syncytiotrophoblasts
chorioCA
Tx chorioCA
chemo– usually 100% cure or remission
is pregnancy a good or bad factor is also have chorioCA
good
non-gestational chorioCA is much more Resistant to therapy
drug of choice for chorioCA
MTX
