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ENRP > Gestational Disorders > Flashcards

Gestational Disorders Flashcards

1
Q

What is an Ectopic pregnancy? Where is a common location?

A

Implantation of the fetus outside of the uterine cavity

– usually fallopian tube

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2
Q

What is a major risk factor for having an Ectopic pregnancy?

A

PID

– chlamdyia/gonnorhea

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3
Q

What are the symptoms of an Ectopic pregnancy?

A

Abdominal pain

Bleeding 6-8 weeks after last period

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4
Q

Abdominal pain and bleeding 6-8 weeks after last period is likely?

A

Ectopic pregnancy

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5
Q

2 ways to diagnose an Ectopic pregnancy?

A

Transvaginal US

B-HCG

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6
Q

If the Ectopic pregnancy ruptures, what are the symptoms?

A

Severe pain and hemorrhagic shock

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7
Q

What are the gross findings with an Ectopic pregnancy? (3)

A

Swollen fallopian tube
Hemorrhage
Fetal villi/fetus

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8
Q

Miscarriage (spontaneous abortion)

A

Pregnancy loss before 20 weeks

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9
Q

What are some causes for a Miscarriage?

A
  • TORCH infections
  • Fetal or Uterine abnormalities
  • Endocrine factors
  • Thrombosis/vasculature issues
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10
Q

How do you get Dizygotic “Fraternal” Twins?

A

Fertilization of 2 oocytes by 2 sperm

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11
Q

What type of placenta will Dizygotic “Fraternal” twins ALWAYS have?

A

Dichorionic Diamnionic placenta

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12
Q

How do you get Monozygotic “Identical” twins?

A

Fertilization of 1 oocyte by 1 sperm that morulas split

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13
Q

What type of placenta will Monozygotic “identical” twins have?

A

MANY different types

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14
Q

In what type of twins does Twin-to-Twin Transfusion Syndrome occur?

A

Monochorionic –> Identical twins

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15
Q

What causes Twin-to-twin Transfusion Syndrome?

A

Arteriovenous anastomoses deep in the placenta

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16
Q

What is the result of Twin-to-Twin Transfusion Syndrome?

A

One twin is underperfused while the other is fluid overloaded
–> Can result in death
(due to arteriovenous anastomoses deep in placenta)

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17
Q

What are 2 abnormal placenta implantation conditions?

A
  1. Placenta Accreta Spectrum

2. Placenta Previa

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18
Q

What happens with Placenta Accreta Spectrum?

A

Absence of the Decidua

–> Fetal villi adhere directly to myometrium

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19
Q

With Placenta Accreta Spectrum, what will happen at/after birth?

A

Placenta fails to separate

=> POST-PARTUM HEMORRHAGE

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20
Q

What happens with Placenta Previa?

A

Placenta implants in lower uterus or cervix

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21
Q

What is the symptom of Placenta Previa and what is the treatment?

A

3rd trimester bleeding
– Need C-section
(placenta implants in lower uterus/cervix)

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22
Q

What is Preeclampsia and when does it occur?

A

> 20 weeks gestation

= New onset hypertension (>140/90) with proteinuria

23
Q

New onset hypertension and proteinuria during pregnancy, especially after 20 weeks

A

Preeclampsia

24
Q

If Preeclampsia is severe, what can occur?

A

Eclampsia = grand mal seizure

Headache and visual changes as well

25
Q

Eclampsia

A

Grand mal seizure due to Preeclampsia (HTN)

26
Q

Describe the pathogenesis of Preeclampsia

A 
- Abnormal placenta vasculature
(lack of vessel enlargement causes ischemia)
- Maternal vasoconstriction
(hypertension)
- Hypercoagulable state
(fibrin thrombi)
27
Q

Describe the pathogenesis of Preeclampsia

A 
- Abnormal placenta vasculature
(lack of vessel enlargement causes ischemia)
- Maternal vasoconstriction
(hypertension)
- Hypercoagulable state
(fibrin thrombi)
28
Q

What will be seen on the placenta side with Preeclampsia?

A

Infarcts

Abnormal decidual vessels

29
Q

What will be seen on the mother’s side with Preeclampsia?

A

Fibrinoid necrosis

Fibrin thrombi in liver/kidney/brain

30
Q

HELLP Syndrome

A

H- Hemolysis; microangiopathic anemia with schistocytes
EL- Elevated Liver enzymes
LP- Low Platelets

31
Q

HELLP Syndrome

A

H- Hemolysis; Microangiopathic anemia with schistocytes
EL- Elevated Liver enzymes
LP- Low Platelets

32
Q

When will HELLP Syndrome present and can it have features of preeclampsia?

A 
3rd trimester (28-37 weeks)
YES
33
Q

What is a Hydatiform Mole?

A

Abnormal pregnancy with cystic swelling of chorionic villi

34
Q

Abnormal pregnancy with cystic swelling of chorionic villi

A

Hydatiform Mole

35
Q

When is Hydatiform Mole diagnosed and what is elevated in the serum?

A

9 weeks gestation with an US

– Elevated B-HCG

36
Q

What are the 2 types of Hydatiform Moles?

A
  • Complete Molar

- Partial Molar

37
Q

A Complete Molar Hydatiform Mole derives its genetic material from?

A

PATERNALLY - father

= 46XX or 46XY

38
Q

How will a Complete Molar Hydatiform Mole look and is there fetal parts?

A

Multi-cystic mass lesion

NO FETAL PARTS

39
Q

If a “snow-storm” US appears, what is the diagnosis?

A

Complete Molar Hydatiform Mole

40
Q

With a Complete Molar Hydatiform Mole, what is the patient at risk of?

A

Choriocarcinoma and invasive mole

41
Q

A Partial Molar Hydatiform Mole derives its genetic material from?

A

BOTH parents

= 69XXX or 69XXY

42
Q

How will a Partial Molar Hydatiform Mole look and is there fetal parts?

A

Enlarged/abnormal villi mixed with normal villi

YES FETAL PARTS

43
Q

What stain can differentiate a Partial Molar from a Complete Molar Hydatiform Mole?

A

(+) P57

– maternally expressed so will be positive with a Partial Molar

44
Q

What stain can differentiate a Partial Molar from a Complete Molar Hydatiform Mole?

A

(+) P57

– maternally expressed so will be positive with a partial molar

45
Q

What is a Gestational Choriocarcinoma?

A

Malignant trophoblastic tumor

46
Q

Malignant trophoblastic tumor

A

Gestational Choriocarcinoma

47
Q

What is the risk factor for a Gestational Choriocarcinoma?

A

Complete mole!

malignant trophoblastic tumor

48
Q

What is often present at the time of diagnosis with a Gestational Choriocarcinoma and what will be VERY elevated in the serum?

A

Widespread metastases

– Elevated B-HCG

49
Q

What is a Placental Site Trophoblastic Tumor?

A

Malignant tumor of intermediate trophoblasts

50
Q

Malignant tumor of intermediate trophoblasts

A

Placental Site Trophoblastic tumor

51
Q

When does a Placental Site Trophoblastic Tumor occur and what will be mildly elevated in the serum?

A

Follows a miscarriage or normal pregnancy

- Mild elevated of B-HCG

52
Q

Symptoms of a Placental Site Trophoblastic Tumor?

A

Uterine mass with bleeding or amenorrhea

53
Q

Uterine mass with bleeding or amenorrhea is likely which gestational trophoblastic disease?

A

Placental Site Trophoblastic Tumor

ENRP (45 decks)

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