Some Common Pathologies of Pregnancy 1,2 & 3

Question 1

What does progesterone do to the endometrium?

Answer 1

It thickens the lining, changes cells and turns the endometrium into decidua (increases vascularity and causes the stromal cells to enlarge and become procoagulant: stops bleeding)

Question 2

Which hormone is produced by trophoblast cells?

Answer 2

Beta-human chorionic gonadotrophin (B-hCG)

Question 3

What is the target for B-hCG and what is its function?

Answer 3

• Target is corpus luteum

- Stimulation of corpus luteum to produce progestogen which stops decidua from shedding

Question 4

What are common causes for miscarriage?

Answer 4

Chromosomal abnormality, infection and maternal issues (e.g. ill-health, trauma and hormonal problems)

Question 5

What is the most common cause of molar pregnancy?

Answer 5

2 sperm fertilising one egg with no chromosomes (imbalance in methylated genes)

Question 6

What happens during a molar pregnancy?

Answer 6

Massive overgrowth of trophoblast cells and therefore overgrowth of the placenta - no or almost no fetal growth

Question 7

What can happen if molar pregnancy persists?

Answer 7

It can give rise to a choriocarcinoma (malignant tumour)

Question 8

What is the treatment for a molar pregnancy?

Answer 8

If BhCG returns to normal: no treatment

If BhCG stays high: methotrexate