Gestational and Placental Disorders Flashcards Preview

Pathology > Gestational and Placental Disorders > Flashcards

Flashcards in Gestational and Placental Disorders Deck (34):
1

What is the function of the placenta?

Establish effective communication between mother and developing fetus while maintaining immune and genetic integrity of both individuals.

2

Amnion

Inner layer of the amniotic cavity

3

Chorion

Outer layer of the amniotic cavity

4

Decidua

The endometrium of pregnancy and where the chorion attaches

5

Chorionic Villi

They sprout from the chorion to provide a large contact area between fetal and maternal circulations

6

Do the maternal and fetal blood mix?

Under normal circumstances maternal and fetal blood do not “mix”.

7

What is the main cause of spontaneous abortions?

Chromosomal abnormalities

8

Ectopic Pregnancy

Implantation of embryo occurs outside of the uterus

9

What kind of chorion implies identical twins?

Monochorionic

10

Placenta Previa

Attachment of placenta to lower uterine segment or cervix that causes 3rd trimester bleeding as the cervix dilates.

11

Placenta Accreta

Partial or complete absence of decidua with adherence of placental villous tissue directly to myometrium which causes postpartum bleeding.

12

What are some predisposing factors for placenta accreta?

– Placenta previa
– Hx previous cesarean section

13

Abruptio Placentae

Premature separation of placenta prior to delivery leading to the formation of retroplacental blood clot - can compromise the blood supply to the fetus

14

What process fails in preeclampsia-eclampsia?

Cytotrophoblasts outside invade the vasculature
in the media and allow them to remodel and be more
accommodating which fails in preeclampsia-eclampsia.

15

What are some risks for preeclampsia-eclampsia?

- HTN
- DM
- Obesity
- Very young or very old

16

What are the features of preeclampsia?

- HTN
- Edema
- Proteinuria

17

Severe Preeclampsia

Preeclampsia with headaches and vision changes

18

Eclampsia

Preeclampsia with convulsions

19

HELLP Syndrome

Severe preeclampsia with hemolysis, elevated liver
enzymes and low platelets.

20

What must be done for treatment of preeclampsia-eclampsia?

If the disease is severe, delivery must be done regardless of fetal age

21

What are drugs used to treat maternal HTN?

-Labetalol
-Methyldopa
-Hydralazine

22

What is the most common pathway for placental infection?

Ascending infection. Hematogenous spread is much more uncommon.

23

What will be seen histologically with Acute Chorioamnionitis?

PMN infiltrates. Green color on gross specimen.

24

What are the TORCH infections?

• Toxoplasma gondii
• O –Others Parvovirus B 19, Syphillis, TB, listeria
• Rubella
• CMV
• HSV and HIV

25

Features of these illnesses in the neonate include: fever, encephalitis, chorioretinitis, hepatosplenomegaly, pneumonitis, myocarditis, hemolytic anemia and vesicular or hemorrhagic skin lesions.

TORCH Infections

26

Cystic swelling of chorionic villi with trophoblastic proliferation.

Hydatiform Moles

27

What is a lab characteristic of hydatiform moles?

Elevated hCG

28

Complete Mole

- Most villi are enlarged
- Made from 2 sperms fertilizing empty ovum OR one sperm that has DNA copied to diploidy
- Embryo dies early -> rarely see fetal parts

29

Partial Mole

- Only some villi are edematous
- Made from one egg and 2 or more sperm (minimum triploidy)

30

Is there an increased risk of choriocarcinoma with partial mole?

No

31

Invasive Mole

• Mole that penetrates uterine wall
• Hydropic chorionic villi invade myometrium
– May embolize to distant sites

32

Gestational Choriocarcinoma

Malignant, invasive and widely metastatic and is a neoplasm of trophoblast derived cells

33

• Proliferationof neoplastic cystotrophoblasts and syncytiotrophoblasts
• NO chorionic villi
• Presents as vaginal blood, brown fluid spotting

Gestational Choriocarcinoma

34

How effective is chemotherapy in gestational choriocarcinoma?

VERY effective

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