W01_08 Pediatric Pathology Flashcards
define developmental age
age from date of fertilization to intrauterine death or live birth
define gestational age
age from first day of mother’s last menstrual period to expulsion/removal of conceptus
if the baby dies in utero at 19 weeks, but the mother delivers stillbirth at 37 weeks, what’s the developmental age? gestational age?
developmental age: 19 weeks.
gestational age: 37 weeks
define embryonal period
period of organ development
0-8 weeks
define fetal period
9 weeks to birth
define perinatal period
from 28 wks (GA) to 1 week post partum
define spontaneous abortion
loss of conception prior to the period of viability
define stillbirth
late fetal death before COMPLETE expulsion or removal of the fetus from the mother
what are legal definitions of stillbirths?
fetus > 20 weeks (GA) or fetus > 500g;
no sign of life in the delivered fetus
define maceration
softening and degenerative changes in the fetus, as a result of death of the fetus and retention in utero
what’s the biggest cause of spontaneous abortion?
chromosomal abnormalities (accounts for 50%)
what’s the second biggest cause of spontaneous abortion?
luteal phase deficiency.
note that progesterone usually primes the endometrium for implantation. so when the corpus luteum doesn’t produce enough, it’s a spontaneous abortion
ectopic pregnancies usually implant where?
fallopian tube (90%)
what are two predisposing conditions to ectopic pregnancies?
PID, IUD usage (linked to PID)
what are some maternal illnesses that contribute to greater risk of sponatenous abortion?
diabetes mellitus; systemic lupus erythematosus; antiphospholipid antibody syndrome; materna hypertension; alcohol/cocaine abuse
what issues of the placenta can cause spontaneous abortion?
chorioamnionitis; villus of unknown etiology; decidual vasculopathy; placental abruption; multiple placental infarcts
note: canadian rates of stillbirth is 4.5/1000
ok
note: intrauterine asphyxia makes up a large part of stillbirth issues. what are signs of this?
thoracic petechiae, visceral congestion, hypoxic-ischemia injury, meconium discharge
hypoxic-ischemic encephalopathy (HIE) is seen as a result of what?
intrauterine asphyxiation
what’s eclampsia?
a disorder of a pregnant woman involving high blood pressure, neuro signs (coma, seizures)
what’s HELLP syndrome?
Hemolysis;
Elevated Liver enzymes;
Low Platelets
what are some maternal associations with toxemia?
maternal age < 20; elderly primigravida; multigravida; hypertension; smoking > 3 cigs/day; poor pregnancy weight gain
what are clinical symptoms of placental abruption?
uterine contractions;
abdominal and uterine pain;
vaginal hemorrhage
note: cord prolapse can cause hypoxia if it’s squeezed off during birth
ok
what’s the most dangerous type of twin placenta?
monochorionic twin placentae, as this can allow shared circulation - twin-twin transfusion;
note in monoamniotic placenta, there can be cord entanglement
what’s the kleihauer-betke test?
estimate the volume of hemoglobin F in the mother. fetal death can occur if volume is 20-50% of the infant volume
what are two major routes of intrauterine infection?
maternal hematogenous,
ascending amniotic;
also: direct from endometrium, ascending decidual, iatrogenic
what bacteria can cause acute chorioamnionitis?
normal vaginal flora, chlamydia, ureaplasma urealyticum, mycoplasma hominis, gardnerella vaginalis
note: blood borne infection can cause chronic villitus in the placenta
ok
what are the TORCH organisms
toxoplasmosis, other (syphillis), rubella, cytomegalovirus, herpes simplex 2
which trimester poses the greatest risk of congenital rubella?
1st;
can cause: growth restriction, microcephaly, deafness, cataracts, CHD
what’s fetal hydrops?
accumulation of extravascular fluid due to a variety of etiologies
