Some Common Pathologies in Pregnancy

Question 1

At what stage of the average uterine cycle does the menstrual phase occur?

days

Answer 1

days 1-5

Question 2

trophoblast cells produce which hormone?

Answer 2

Beta-human Chorionic Gonadotrophin (B-hCG)

Question 3

what is the target organ of B-hCG?

Answer 3

corpus luterum in ovary

Question 4

what is the function of B-hCG?

Answer 4

to stimulate corpus luteum to produce progesterone thoughout pregnancy, which stops decidua from shedding.

Question 5

what predisposes an ectopic pregnancy to rupture?

Answer 5

• lack of proper decidual layer and small size of tube

Question 6

molar pregnancy cause

Answer 6

• various causes but can be caused by 2 sperm fertilising one egg with no chromosomes
• result is imbalance in methylated (switched off) genes
• results in trophoblast overgrowth because they have too many of dads methylated genes, overgwoth of placenta
• no or all but non-existant fetal growth

Question 7

molar pregnancy treatment

Answer 7

If BhCG returns to normal – no further treatment.
If BhCG stays high (persistent disease) > cure by methotrexate

Question 8

A molar pregnancy is a form of precancer of trophoblast cells. If it persists, it can (rarely) give rise to a malignant tumour called a?

Answer 8

choriocarcinoma

Question 9

whats the most common cardiac defect in trisomy 21?

Answer 9

atrioventricular septal defect (AVSD)

Question 10

Regarding livebirth children with geneticabnormalities, which are the most common?

Answer 10

Down Syndrome is the most common (1:660 livebirths), followed by Edward’s syndome (Trisomy 18, 3:10000 livebirths, 3:1 F:M!), then Patau Syndrome (Tris 13, 1:5000 livebirths).

Question 11

diabetes in pregnancy - problems

Answer 11

1st trimester: Malformations
3rd trimester: Intrauterine death (probable sudden metabolic and hypoxic problems)
Labour: Huge babies that obstruct labour
Neonatal period: hypoglycaemia

Question 12

which organism causes acute chorioamnionitis?

Answer 12

e. coli

Question 13

what is the presentation of acute chorioamnionitis (ascending infection) in both the mother and baby?

Answer 13

mother:
- has fever and raised neutrophils in blood
- or asymptomatic

baby:
- intrauterine death
- ill in 1st days of life > neonatal unit
- cerebral palsy in later life

Question 14

how does ascending infection affect baby’s brain?

Answer 14

• neutrophils produce cytokine ‘storm’
• this activates some brain cells, which then get damaged by normal hypoxia of labour

Question 15

why is an overtwistd cord dangerous?

Answer 15

• results in poor blood flow (ischaemia) to and from baby
• common cause of IUD and neonatal illness

Question 16

what does placental abruption refer to?

Answer 16

• separation of placenta from uterine wall
• results in hypoxia in baby
• often causes antepartum haemorrhage in mother