Placenta path II

Question 1

what are the 2 patterns of infection for placenta

Answer 1

“Prolonged rupture of membranes”: ascending infection from microbiome of vagina and cervix
hematogenous (transplacental) pathogens from maternal infection: TORCH

Question 2

what can cause the ascending infection to placenta

Answer 2

group B strep
acute chorioamnionitis, funisitis, villitis
premature rupture of membrane
neonatal pneumonia, sepsis and meningitis

Question 3

what an give placenta green coloring

Answer 3

pus or meconium stained from release from the fetus in utero- fetal stress

Question 4

why is meconium bad for fetus

Answer 4

toxic to airways

Question 5

meconium released from fetus can cause what condition

Answer 5

acute chorioamnionitis

Question 6

why does a ruptured amnionic sac increase change chorioamnionitis

Answer 6

because now mucus plug is gone and infections can ascend

Question 7

villitis is typical from what organisms

Answer 7

TORCH and syphilis and listeria

Question 8

Sx of preeclampsia and eclampsia

Answer 8

HTN after 20 weeks

edema and proteinuria

Question 9

what is eclampsia

Answer 9

convulsions/ hyper-reflexia, severe can develop HELLP syndrome

Question 10

what causes ecclampsia

Answer 10

maternal endothelial dysfunction due to under perfusion of the placenta from abrnomal adaptation of spiral aa to pregnancy
fibrinoid thickening of small aa

Question 11

maternal complications of ecclampsia

Answer 11

DIC
kidney damage
HTN long term

Question 12

What is HELLP syndrome

Answer 12

hemolysis
elevated liver enzymes
low platelets

Question 13

What is an invasive hydatidiform mole

Answer 13

penetrates uterine wall and can even invade or mets

Question 14

how do we detect hydatidiform moles

Answer 14

produce beta hCG

Question 15

what can lead to complete hydatidiform moles

Answer 15

• single sperm empty ovum and the sperms chromosomes duplicate
• dispermy and empty ovum
  Can have 46 XX(mono or dispermy) or 46XY(dispermy)

Question 16

what can lead to partial hydatidiform mole

Answer 16

dispermy with fertilized ovum
69XXX
69XXY
69XYY

Question 17

find a hydatidiform mole that has a few grape like clusters with identifiable fetal parts
what kind is it

Answer 17

partial

Question 18

the micro of hydatidiform mole has villous edema with diffuse trophoblastic proliferation
complete or partial?

Answer 18

complete

Question 19

risk of chorioCA in complete mole?

partial mole?

Answer 19

high in complete

low in partial

Question 20

clincal presentation of hydatidiform mole or “gestational trophoblastic disease”

Answer 20

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

Question 21

why can moles cause thyrotoxicosis

Answer 21

hCG is similar in structure to TSH

Question 22

hydatidiform moles are more common in what popylation

Answer 22

teens, 5th decade

asian countries

Question 23

CA dfound to have a central core of cytotrophoblasts surrounded by syncytiotrophoblasts

Answer 23

chorioCA

Question 24

Tx chorioCA

Answer 24

chemo– usually 100% cure or remission

Question 25

is pregnancy a good or bad factor is also have chorioCA

Answer 25

good

non-gestational chorioCA is much more Resistant to therapy

Question 26

drug of choice for chorioCA

Answer 26

MTX