Placenta Pathology

Question 1

Detail the discriminatory zone of maternal hCG levels.

Answer 1

1,500 IUP by transvaginal US (5-6 weeks gestational age)

4,000 IUP by transabdominal US (7 weeks gestational age)

Question 2

What is the most common complication of ectopic pregnancy?

Answer 2

Hematosalpinx

Question 3

Define ectopic pregnancy.

Answer 3

Implantation other than intrauterine

Question 4

Define gestational trophoblastic disease.

Answer 4

Group of tumors that arise from cells that develop into placenta

Question 5

Define a complete mole.

Answer 5

Diandric diploid (all genetic material is from father)

Question 6

Define a partial mole.

Answer 6

Diandric triploid (2/3 genetic material from father, 1/2 from mother)

Question 7

Do you have a fetus in a complete mole?

Answer 7

No

Maternal DNA needed to drive fetal growth

Question 8

A snowstorm appearance on US indicates what type of mole?

Answer 8

Complete

Question 9

What are risk factors for diagnosis a complete mole?

Answer 9

Extremes of childbearing years

Hx of previous molar pregnancy

Question 10

How do you follow a molar pregnancy?

Answer 10

Serum hCG q1-2 weeks (3 consecutive negative measurements)

Then q3 months for 1 year

Question 11

Choriocarcinoma is a neoplasia of what cell types?

Answer 11

Cytotrophoblasts

Syncytiotrophoblasts

Question 12

Do choriocarcinomas have villi?

Answer 12

No

Question 13

What is the stroma of the umbilical cord referred to as?

Answer 13

Wharton’s Jelly

Question 14

What is the TPAL system used to indicated?

Answer 14

T- term delivery
P- preterm delivery
A- abortion
L- living children

Question 15

What histologic finding is an indication of a trans-placental infection?

Answer 15

Villitis

Question 16

What are the ToRCHS infections?

Answer 16

Toxoplasma
Rubella
CMV
HIV
HSV
Syphilis

Question 17

What is the most common ToRCHS infection?

Answer 17

CMV

Question 18

Define placenta accreta.

Answer 18

Chorionic villi attach to myometrium

Question 19

What is the greatest predisposing factor for placenta accreta?

Answer 19

Prior C section

Question 20

Define placenta increta.

Answer 20

Villi invade into myometrium

Question 21

Define placenta percreta.

Answer 21

Villi penetrate through serosa

Question 22

Define placenta previa.

Answer 22

Placenta covers os

Question 23

What is the clinical definition of pre-eclampsia?

Answer 23

HTN + proteinuria after 20 weeks gestation age

Question 24

Define placental abruption.

Answer 24

Detachment of placenta from decidua

Question 25

List the MCC of spontaneous abortion by trimester.

Answer 25

1st- chromosomal
2nd- structural defects
3rd- placental defects