Placental Pathology

Answer 1

hCG is normal pregnancy peaks at week 6 and then declines to a steady state

trophoblastic desease levels off at week 12

Answer 2

Molar pregnancy = not 1:1 ratio of

Complete mole = diandric diploid (all DNA from dad, 46 chromo); empty egg fertilized by one or two sperm

Partial mole is diandric triploid (two sperm fertilize normal egg)

Answer 3

Complete mole - snowstorm (cystically dilated spaces without fetal parts)

placental overgrowth

US findings

Answer 4

Without mom’s DNA, there is NO FETAL DEVELOPMENT

Question 5

Grape-like vesicles

Answer 5

complete mole

Question 6

complete mole

Answer 6

high hCG, uterine size greater than date, hyperemesis, bleeding, pre-eclampsia, hyperthyroidism

Answer 7

Complete moles can recur or become cancer

Incomplete moles do not

Question 8

Treat mole with methotrexate if needed

Answer 9

p57 is normally imprinted on dad’s gene and only expressed from mom

So, lack of p57 indicates all dad’s DNA

Answer 10

Complete moles can become choriocarcinoma

Question 11

Biphasic pattern with mononuclear cytotrophoblasts and multinuclear synciot

Answer 11

chorionic carcinoma

Answer 12

choriocarcinoma = lung mets

Answer 13

Fetal/Placental weight ratio increases with gestational age (eventually fetus grows faster)

Answer 14

Trophoblasts separate fetal and maternal blood

Answer 15

intravillous - fetal origin

intervillous - maternal origin

Answer 16

Answer 17

Answer 18

Answer 19