3.1.1 Diseases of Pregnancy

Question 1

What are some of the etiologies of placental inflammation and infection?

Answer 1

Question 2

What is placenta praevia?

Answer 2

Implantation over internal cervical os

Associated w/ placenta accreta

Post partum bleeding

Question 3

Despite the case fatality decreasing over time, what continues to be the 2nd leading cause of maternal mortality in US?

Answer 3

Ectopic pregnancy

Question 4

Name 4 unusual shapes of placentas

Answer 4

Placenta succenturiate - Accessory lobes

Velamentous insertion of umbilical cord

Battledore placenta - Marginal insertion of umbilical cord

Placenta circumvallata - White ring

Question 5

What these be?

Answer 5

Left: Placenta accreta

Right: Placenta percreta

Question 6

What is chorioadenoma destruens? clinical features?

Answer 6

Invasive mole

Question 7

What this be?

Answer 7

Twin gestation

Question 8

Which morphology of placental inflammation?

Answer 8

Varicella Zoster Villitis

Question 9

What are some of the dz’s of pregnancy?

Answer 9

Placental inflammation and infections

Placental abnormalities and twin placentas

Spontaneous abortion

Ectopic pregnancy

Toxemia of pregnancy

Gestational trophoblastic dz’s

Question 10

What patholgies are associated with ectopic pregnancy?

Answer 10

Question 11

What are the most common sites of ectopic pregnancy?

Answer 11

Fallopian tubes, ovaries, abdomen, other sites

Question 12

What number of vessels are found in the umbilical cord?

Answer 12

Question 13

What this be?

Answer 13

Left, top: Ectopic tubal pregnancy, early

Left, bottom: ectopic tubal pregnancy, late

Question 14

What are the four morphologic variants of gestational trophoblastic dz?

Answer 14

Question 15

What are some of the predisposing factors for placental inflammation and infection?

Answer 15

Premature rupture of membranes (most common)

Induce abortion

Hematogenous spread (least common)

Sex during 3rd trimester

Question 16

What this be?

Answer 16

Choriocarcinoma

Question 17

What are some of the complications of ectopic pregnancy?

Answer 17

Question 18

Which abnormal placental shape?

Answer 18

Accessory (succenturiate) lobe

Question 19

What are the three sequelae with toxemia of pregnancy?

Answer 19

Question 20

Which surface of the fetus?

Answer 20

Maternal Surface

(comparable to a hamburger in appearance)

Question 21

What do these represent?

Answer 21

Spontaneous abortion

Question 22

Which abnormal placental shape?

Answer 22

Accessory (succenturiate) lobes

Question 23

Which abnormal placental shape?

Answer 23

Accessory (succenturiate) lobes

Question 24

Describe the morphology of hydatidiform mole?

Answer 24

Question 25

Which morphology of placental inflammation?

Answer 25

Chorioamnionitis - notice blue spots

Question 26

What these be?

Answer 26

Top: Decidual changes and hemmorhorage Bottom left: 1st trimester chorionic villi Bottom right: fetus

Question 27

What are the possible pathogenesises of toxemia of pregnancy?

Answer 27

Question 28

What this be?

Answer 28

Trophoblastic tumor

Question 29

What are gestational trophoblastic dz?

Answer 29

Question 30

What should be included in the differental diagnosis of varicella zoster villitis?

Answer 30

TB Congenital CMV Congenital syphilis Congenital toxoplasmosis Malaria Parvovirus B19 Listeriosis Group B Strep Candida

Question 31

What is the symptom complex in toxemia of pregnancy?

Answer 31

HTN, proteinuria, edema

Question 32

What are some ways to identify ectopic pregnancy?

Answer 32

Unilateral lower abdominal pain, vaginal bleeding, positive serum beta-HCG test, transvaginal US

Question 33

Identify chorion or amnion

Answer 33

Top (A,C,C,A) Bottom

Question 34

What this be?

Answer 34

Twin placenta

Question 35

When does toxemia of pregnancy typically present?

Answer 35

3rd trimester

Question 36

Which abnormal placental shape?

Answer 36

Battledore placenta

Question 37

What are the three different morphologies of placental inflammation and infection?

Answer 37

Placentitis (villitis) Chorioamnionitis (fetal membranes) Funisitis (umbilical cord)

Question 38

What is the cytogenic mechanism of hydatidiform mole?

Answer 38

Question 39

Explain the ways in which amnion and chorion can vary in twins

Answer 39

Question 40

Id these features of hydatidiform mole

Answer 40

Question 41

Choriocarcinoma incidence?

Answer 41

Question 42

What is ectopic pregnancy? How often does it occur?

Answer 42

Question 43

What are the clinical features of choriocarcinoma?

Answer 43

Question 44

Which abnormal placental shape?

Answer 44

Placenta circumvallata - white ring

Question 45

What are the two forms of toxemia of pregnancy?

Answer 45

Pre-eclampisa and eclampsia (severe)

Question 46

What's going on here?

Answer 46

Placental torsion

Question 47

Describe the hydatidiform mole form of gestational trophoblastic dz

Answer 47

Question 48

Which abnormal placental shape?

Answer 48

Battledore placenta - marginal insertion

Question 49

What are the treatment options for ectopic pregnancy?

Answer 49

Question 50

what this be?

Answer 50

Ectopic pregnancy

Question 51

What % of pregnancies end in spontaneous abortion? What are some possible causes?

Answer 51

Question 52

What is the morphology of choriocarcinoma?

Answer 52

Question 53

What syndrome is associated with toxemia of pregnancy in 10% of cases?

Answer 53

HELLP syndrome (Hemolysis, Elevated liver ezymes, Low plt)

Question 54

What is the mechanism of toxemia of pregnany?

Answer 54

loss of resistnance to vasocontriction, decrease prod of prostaglandin, increase prod of renin

Question 55

Which side of the fetus?

Answer 55

Left: Fetal Right: Maternal

Question 56

What are two issues that can arise within the umbilical cord?

Answer 56

Knots (no significance if loose, fetal death if tight) Torsion (marked spiraling that can compromise blood flow)

Question 57

What are the different types of abnormal pentration of placenta into uterine wall?

Answer 57

Placenta accreta, increta, and percreta

Question 58

What this be?

Answer 58

Invasive mole

Question 59

What are some of the etologic considerations for ectopic pregnancy?

Answer 59