Wed-GTD Flashcards
36 y.o G5P3 at 13 weeks with uterine bleeding based on LMP, nausea and vomiting
what could she have?
what labs?
GDM twins wrong on dates gestational trophoblastic disease tumor, fibroids labs: CBC, hCG, US
US shows lots of areas of clear black space. bubbles.
Dx?
some type of mole
hCG is 150,00
suggests?
mole
or twins
Tx for woman “pregnant” with US suggestive of mole
D&C
what is gestational trophoblastic disease
abnormal proliferation of trophoblast of the placenta
most common cause gestational trophoblastic disease
hydatidiform mole
complete. partial and invasive
what is gestational trophoblastic neoplasia
local invasion
choriocarcinoma, placental trophoblastic tumor, epitheloid trophoblastic tumore
curable 85-100%
causes of complete mole
46 XX 36XY if fertilized by two sperm all paternal chromosomes empty ovum no fetal tissue
causes of incomplete or partial mole
69XXY
fertilizaiton of ovum with haploid maternal by 2 sperm
fetal tissue present
causes of moles
genomic imprinting
paternal: placental growth
maternal: fetal growth
complicaitons from moles are due to what
elevated hCG
what are the complications with molar pregnancy
ovarian enlargement from theca lutein cysts hyperemesis gravidarum early development of preeclampsia hyperthyroidism hemorrhage
incidence of molar pregnancy higher where
asian women and latin american countries
Sx of molar pregnancy
consistent with early pregnancy
vaginal bleeding– tumor separation from decidua
risk factors molar pregnancy
> 35 y.o
Hx of previous GTD
Dx molar pregnancy
no fetal heartbeat increased bhCG enlarged ovaries grapelike cluster expelled into vagina U/S- snowstorm apperance
Tx molar pregnancy
D&C to remove tissue
follow hCG levels
what to do if hCG stay elevated in GTN
chemo and/or excisional surgery
which type of mole more likely to become choriocarcinoma
complete
what is a threatened abortion
1st trimester bleeding
what is metrorrhagia
bleeding between menses
what is menometrorrhagia
heavy bleeding and bleeding in between menses
oligomenorrheag
intervals >35 days
4-9 periods/year
EGBUS
external genitalia
bartholins gland
uterus
skenes glands
