Placental Dysfunction Flashcards

1
Q

Give two implantation defects

A
  • Ectopic pregnancy
  • Placenta praevia
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2
Q

What is an ectopic pregnancy?

A

Implantation at a site other than uterine body

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3
Q

What is the most common implantation site in ectopic pregnancy?

A

Ampulla of Fallopian tube, but can also be peritoneal or ovarian

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4
Q

What is the problem with ectopic pregnancy?

A

If implantation not in endometrium, no decidual cells to control it, and so the invasive process can rupture the uterine tubes

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5
Q

What is vulnerable if there is rupture of the uterine tubes in an ectopic pregnancy?

A

Big vessels in the pelvis

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6
Q

What is there a risk of if the big vessels in the pelvis are affected in an ectopic pregnancy?

A

Haemoperitoneum

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7
Q

What is placenta praevia?

A

Implantation in the lower uterine segment

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8
Q

Where does the placenta grow in placenta praevia?

A

Across the internal os

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9
Q

What can placenta praevia cause?

A

Haemorrhage in pregnancy

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10
Q

What is necessitated in placenta prevaeia?

A

C-section delivery

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11
Q

Why is C-section delivery required in placenta praevia?

A

Because the internal os is occluded by the placenta, the birth canal is not functional

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12
Q

What happens in pre-eclampsia, with regard to elaboration of the spiral arteries?

A

There is inadequate modification of the vessels walls - invasion is not enough, so there is ineffective remodelling of the spiral arteries

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13
Q

Describe the epidemiology of pre-eclampsia

A

Most common condition related to morbidity and mortality in pregnancy in the developing world

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14
Q

What does pre-eclampsia lead to?

A

Poor growth and development of fetus, and maternal syndrome

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15
Q

What does placental insufficiency lead to?

A

Poor growth and development of the fetus

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16
Q

Give two forms of trophoblast disease

A
  • Molar pregnancy (hydatidiform mole)
  • Gestational trophoblast disease
17
Q

What is gestational trophoblast disease?

A

When there is an overgrowth of placental tissue, but no embryo, so get very high hCG reading

18
Q

What is choriocarcinoma?

A

A malignant version of gestational trophoblast disease

19
Q

Why may hCG be monitored in choriocarcinoma?

A

To see how effective treatment is

20
Q

What is the result of the placenta not being a true barrier?

A

Teratogens access the getus via the placenta quite easily

21
Q

What teratogens can access the fetus via the placenta?

A
  • Alcohol
  • Therapeutic drugs
  • Drugs of abuse
  • Maternal smoking
22
Q

What is the importance of alcohol in pregnancy?

A

It is a small molecule, so can easily access, and damages the CNS

23
Q

When is the CNS vulnerable to damage?

A

Throughout gestation

24
Q

What does maternal smoking affect in pregnancy?

A

Fetal growth and development

25
What can antibody transport cause in pregnancy?
Haemolytic disease of the newborn
26
When does haemolytic disease of the newborn arise?
When there is a rhesus group incompatability of the mother and fetus q
27
What happens in haemolytic diseease of the newborn?
Leakage of fetal blood into the maternal circulation
28
Why is haemolytic disease of the newborn now uncommon?
Because of prophylactic treatment when known rhesus incompatability
29
How are infectious agents taken up by the placenta?
Pinocytosis
30
What infectious agents can be taken up into the placenta?
* Varicella zoster * Cytomegalovirus * Treponema pallidum * Toxoplasma gondii * Rubella
31
What is happening to the incidence of It fetal rubella syndrome?
It is decreasing in incidence due to mass immunisation
32
What does rubella syndrome?
* Microcephaly * PDA * Cataracts