Pathology of the Placenta

Question 1

This trophoblastic disease is positive for hCG and keratin, but lacks the presence of villi.

Answer 1

Choriocarcinoma

Question 2

How can a partial and complete molar pregnancy be differentiated using lab testing?

Answer 2

Partial moles are positive for p57, while complete moles lack p57

Question 3

This is when the placenta implants on the lower uterus or segment and may cause fatal hemorrhage.

Answer 3

Placenta previa

Question 4

This disorder is characterized by chronic inflammation of the placenta due to the persistent presence of inflammatory cells.

Answer 4

Chronic villitis

Question 5

Choriocarcinoma is the most aggressive trophoblastic disease. From where do they most often originate?

Answer 5

Complete molar pregnancy

Question 6

These diseases are most associated with chronic villitis.

Answer 6

TORCH - toxoplasmosis, others (syphilis, Tb, listeria), rubella, CMV, herpes

Question 7

What is the pathophysiologic cause of molar pregnancies and choriocarcinoma?

Answer 7

Proliferation of the trophoblast

Question 8

In this type of molar pregnancy, sperm fertilizes an empty ovum. This results in duplication of sperm genes and eventual death of the embryo.

Answer 8

Complete molar pregnancy - no fetus develops

Question 9

True/False. Preeclampsia is associated with a higher risk of placental infarcts.

Answer 9

True

Question 10

This placental pathology occurs with the vili adhere directly to the superficial layer of the myometrium.

Answer 10

Placenta accreta

Question 12

A woman presents to the clinic suspecting she may be pregnant. Lab testing reveals continued rise in hCG levels and the uterus appears larger than expected for this stage of the pregnancy. No embryo can be discerned. What is the diagnosis?

Answer 12

Complete mole

Question 13

This disorder is characterized by inflammation of the umbilical cord due to a fetal inflammatory response.

Answer 13

Acute funisitis

Question 14

What is abruptio placenta?

Answer 14

Premature separation of the placenta from the uterine wall - this usually presents with fetal distress

Question 15

This type of molar pregnancy invades the myometrium and may perforate the uterus.

Answer 15

Invasive mole (often complete mole in origin)

Question 16

This placental pathology occurs with the vili invade deep into the myometrium.

Answer 16

Placenta increta

Question 17

What is the clinical presentation of placenta accreta, increta, and percreta?

Answer 17

Difficulty in separation of the placenta from the uterine wall that may cause severe hemorrhage

Question 18

This type of molar pregnancy is describes as having a “bunch of grapes” appearance.

Answer 18

Complete molar pregnancy

Question 19

What is the genetic cause of a partial molar pregnancy?

Answer 19

Two or more sperm fertilize a single ovum, producing an extra set of chromosomes. The embryo survives, leading to the development of a fetus that is eventually aborted.

Question 20

This is a common cause of third trimester vaginal bleeding.

Answer 20

Placenta previa - implantation in the lower uterus or cervix

Question 21

What is placenta percreta?

Answer 21

Placental pathology when the villi penetrate the full thickness of the uterine wall