Some common pathologies of pregnancy Flashcards
what is ectopic pregnancy?
embryo implanted outside of the uterine cavity
where is EP most common?
fallopian tube
risk factors for EP?
- previous EP
- PID
- IUD
- assisted conception ie IVF
presentation of EP?
- pregnancy signs
- amenorrhoea + +ve pregnancy test
- vaginal bleeding
- pain in abdomen
investigations of EP?
- Pregnancy test
- B-HCG + progesterone levels
- US Scan
- no gestation sac seen in utero
pathology of EP rupture?
- lack of proper decidual layer (endometrium)
- small tube size
predisposes to haemorrhage and rupture
treatment of EP?
- operative, if impending rupture
- salpingectomy
- if not–> methotrexate
what is the action of Mifepristone and when is it given?
- abortion drug
- given in combination with misoprostol
- in presence of progesterone, is a competitive progesterone receptor antagonist
misoprostol action?
prostaglandin agonist
-pushes open cervix
what is the pathology of molar pregnancy?
normally:
- mum switches off certain genes by methylating them
- dad switches off certain genes by methylating them
in combination, these 2 processes balance each other so no issues –> balanced growth of baby & placenta
molar pregnancy:
caused by 2 sperm fertilising egg with no chromosomes –> imbalance in switched off genes
what can molar pregnancy go on to cause?
Rare cancer called choriocarcinoma
what is seen on microscopy in molar pregnancy?
enlarged abnormal chorionic villi with abundant trophoblasts
treatment of molar pregnancy?
- if B-HCG returns to normal –> no further treatment
- If B-HCG stays high –> methotrexate
what is Acute ChorioAmnionitis caused by?
ascending infection from vagina –> amniotic sac
what are the organism usually involved in Acute ChorioAmnionitis?
perineal flora typically ie E.Coli
