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Reproductive > reproductive pathology 2 > Flashcards

reproductive pathology 2 Flashcards

1
Q

pregnancy complications - types

A
  1. placental abruption (abruptio placentae)
  2. Placenta accreta/increta/percreta
  3. Placental previa
  4. Vasa previa
  5. Postpartum hemorrhage
  6. Ectopic pregnancy
  7. hypertension
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2
Q

placental abruption (abruptio placentae) - definition

A

premature separation (partial or complete) of placenta from uterine wall before delivery of infant

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3
Q

placental abruption (abruptio placentae) - risk factors

A
  1. trauma (eg. motor vehicle accident)
  2. smoking
  3. cocaine abuse
  4. hypertension
  5. preeclampsia
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4
Q

placental abruption (abruptio placentae) - presentation

A
  1. abrupt, painful bleeding (concealed or apparent) in 3 third trimester
  2. possible DIC
  3. materna shock
  4. fetal distress
  5. Life threatening for mother and fetus
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5
Q

Placenta accreta/increta/percreta general mechanism and results

A

defective decidual layer –> abnormal attachment and separation after delivery

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6
Q

Placenta accreta/increta/percreta - types (distinguished by) and MC

A

distinguishable by depth of penetration:

  1. Placenta accreta (MC)
  2. Placent increta
  3. Placenta percreta
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7
Q

Placenta accreta?

A

placenta attaches to myometrium without penetrating it

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8
Q

Placenta increta?

A

placenta panetrates INTO myometrium

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9
Q

Placenta percreta?

A

placenta penetrates myometrium and into uterine serosa (invades entire uterine wall) –> can result in placental attachment to rectum or bladder

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10
Q

Placenta accreta/increta/percreta - types, definition of every type and MC

A
  1. Placenta accreta (MC) –> placenta attaches to myometrium without penetrating it
  2. Placent increta –> placenta panetrates INTO myometrium
  3. Placenta percreta –> placenta penetrates myometrium and into uterine serosa (invades entire uterine wall) –> can result in placental attachment to rectum or bladder
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11
Q

Placenta accreta/increta/percreta - presentation

A
  1. often detecten on US prior to delivery

2. no separation of placenta after delivery –> postpartum bleeding (can cause Sheehan syndrome)

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12
Q

Placenta accreta/increta/percreta - risk factors

A
  1. prior C section
  2. inflammation
  3. placenta previa
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13
Q

Placenta previa?

A

attachment of placenta to lower uterine segment over (or less than 2 cm from) internal cervical os

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14
Q

Placenta previa - risk factors

A
  1. multiparity

2. prior C-secion

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15
Q

Placenta previa can also cause

A

Placenta accreta/increta/percreta

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16
Q

Placenta previa - types

A

compete –> covers all the os

partial –> covers not the entire os

17
Q

Vasa previa?

A

fetal vessels run over, or in close proximity to, cervical os

18
Q

Vasa previa - results in

A
  1. vessel rupture
  2. exsanguination (blood loss, to a degree sufficient to cause death)
  3. fetal death
19
Q

Vasa previa - presentation

A

TRIAD

  1. membrane rupture (rupture of the amniotic sac)
  2. painless vaginal bleeding
  3. fetal bradycardia (less than 110 beats/min)
20
Q

Vasa previa - management

A

emergency C-section

21
Q

Vasa previa is frequently associated with

A

velamentous umbilical insertion

22
Q

velamentous umbilical insertion?

A

cord inserts in chorioamniotic membrane rather than placenta –> fetal vessels travel to placenta unprotected by Wharton jelly

23
Q

Postapartum haemorrhage is due to (and MC)

A 
mnemonic 4Ts
Tone uterine atony (MC)
Trauma - lacerations, incisions, uterine rupture 
Thrombin - coagulopathy 
Tissue - retaind products of conception
24
Q

uterine atony –> hemorrhage - mechanism

A

Normally, contraction of the uterine muscle compresses the vessels and reduces flow

25
Q

ectopic pregnancy - presentation

A
  1. pain (clinically mistaken by appendicitis)

2. bleeding (+/-)

26
Q

ectopic pregnancy - risk factors

A
  1. prior ectopic pregnancy
  2. history of infertility
  3. salpingitis (PID)
  4. Ruptured appendix
  5. Prior tubal surgery
27
Q

ectopic pregnancy - confirm diagnosis with

A

US

28
Q

ectopic pregnancy - suspect it when

A
  1. history of amenorrhea
  2. lower tha excpected rise in hCG (based on dates)
  3. sudden lower abdominal pain
29
Q

ectopic pregnancy - most often area

A

Ampulla of fallopian tube

30
Q

treatment of an ectopic pregnancy is necessary to

A

prevent serious , even life threatening complications

31
Q

Amniotic fluid abnormalities - types and defintion

A
  1. Polyhydramnios: too much amniotic fluid

2. Oligohydramnios: too little amniotic fluid

32
Q

causes of polyhydramnions

A
  1. fetal malformations (eg. esophageal/duodenal atresia, anencephaly –>both inability to swallow amniotic fluid)
  2. maternal diabetes
  3. fetal anemia
  4. multiple gestations
33
Q

causes of oligohydramnios

A
  1. placental insuficiency
  2. bilateral renal agenesis
  3. posterior urethral valves (males)
  4. ARPKD
    (inability to excrete urine)
34
Q

oligohydramnios - complications

A

POTTER sequence

35
Q

Potter sequence (syndrome) - presentation

A
  1. limb deformites
  2. facial anomalies (low set ears, retrognathia, flattened nose)
  3. pulmonary hypoplasia

Reproductive (20 decks)

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