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REPRO II Exam 1 > Placental Pathology I > Flashcards

Placental Pathology I Flashcards

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1
Q

placental delivery

A

third stage of delivery

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2
Q

looking at placenta during delivery

A

child surface
maternal surface

all placental vessels - are childs

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3
Q

trapped placenta

A

cannot deliver

dislodged from wall - but abnormal contraction of lower uterus stops expulsion

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4
Q

placental delivery steps

A

uterus contract - except what is connected to placenta
uterus relaxation - except connected to placenta - dislodge with shear force
global contraction - expels placenta

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5
Q

important to look at with cord

A

count vessels**

if 2 - structural and chromosomal abnormalities - 35% of time

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6
Q

progesterone

A

following ovulation increase

-prepares endometrium for implantation - secretory and blood vessel rich

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7
Q

placental implantation

A

week 1-2

produce HCG - prevents loss of CL

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8
Q

trophoectoderm

A

2 layers - of chorionic villi
-synctiotrophoblast
cytotrophoblast

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9
Q

spiral arteries

A

from endometrium - go up into placental tissue

smooth muscle cells invaded by cytotrophoblasts

  • high pressure system to low resistance system
  • allows pooling of blood

abnormalities - lead to preeclampsia

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10
Q

eclampsia pathology

A

placental factors to the mother

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11
Q

neutrophils on amniotic membrane

A

always abnormal

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12
Q

first trimester chorionic villi

A 
have syncytiotrophoblast (outer)
 and cytotrophoblasts (inner)
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13
Q

50% of fertilizations

A

spontaneous abortion

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14
Q

metabolic transfer in chorionic villi

A

most syncytiotrophiblast

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15
Q

third trimester chorionic villi

A

stroma with dense network of dilated capillaries surrounding thinned syncytiotrophoblasts and cytotrophoblasts

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16
Q

pregnancy lost <20 weeks

A

spontaneous abortion

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17
Q

1st trimester abortion

A

chromosomal problem

50% of spontaneous abortions

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18
Q

2nd trimester abortion

A

mechanical problem

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19
Q

3rd trimester abortion

A

fetoplacental unit problem

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20
Q

risk factors for spontaneous abortion

A

increased age
history of prior
maternal smoking

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21
Q

ectopic pregnancy location

A

90% fallopian tubes

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22
Q

predispose to ectopic

A

PID - 35-50%

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23
Q

diagnosis of ectopic

A

beta-HCG
ultrasound
laparoscopy

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24
Q

most important predisposing condition for ectopic?

A

hx of PID

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25
highest relative risk for ectopic?
smoking
26
dichorionic
fraternal twins
27
monochorionic
identical twins
28
twins get unequal blood supply
monochorionic placenta disproportionate circulation AV shunt can cuse death of both twin twin transfusion syndrome
29
two chorions between amnion
dichorion | -fraternal twins
30
one chorion between amnion
monochorion | -identical twins
31
implantation of placenta in lower uterus
placenta previa
32
retroplacental hemorrhage
abruptio placenta
33
placenta into myometrum
placenta accreta due to lack of intervening decidua
34
painful vaginal bleeding
abruptio placenta painful**
35
fetal death
with abruptio placenta of 1-3 or more of placenta
36
painless vaginal bleeding in 3rd trimester
placenta previa
37
most common cause of antepartum bleeding
placenta previa
38
tx for placenta previa
C-section
39
loss of decidual basalis
with placenta accreta
40
uterine rupture
15% of placenta accreta
41
depth of placent accreta
accreta - little invasion increta - partway though percreta - through to outside
42
cause of placenta accreta
endometrial scarring | -previous C section**
43
tx of placenta accreta
hysterectomy
44
placental infection
ascending - from vagina hematogenous - TORCH
45
TORCH
``` toxoplasmosis other rubella CMV HSV ```
46
ascending infection
group B strep
47
acute chorioamnionitis
placenta - greenish membrane - pus and or meconium baby stressed in uteru vaginal flora ASCENDS through cervix - after loss of mucous plug** neutros in membrane
48
villitis
inflammation of chorionic villi | -typical of TORCH organisms - from maternal infection
49
proteinuria and edema
preeclampsia | -HTN in pregnancy
50
path of preeclampsia
maternal endothelial dysfunction underperfusion of placenta - abnormal adaptation of spiral arteries
51
maternal complications of eclampsia
hypercoagulable DIC kidney damage
52
preeclampsia vs. eclampsia
eclampsia - is final condition
53
seizure, hyperreflex
complication of severe preeclampsia
54
hemolysis, elevated liver enzymes, low platelets
HELLP associated with severe preeclampsia
55
atherosis
can occur in preeclampsia
56
hydatidiform mole
Hydatidiform mole is a rare mass or growth that forms inside the womb (uterus) at the beginning of a pregnancy. complete and partial all elaborate HCG
57
invasive mole
perforates uterine wall
58
partial mole
fetus parts present** triploid - ovum and two sperm
59
complete mole
no fetus** diploid - empty ovum
60
high risk of choriocarcinoma
complete mole
61
low risk of choriocarcinoma
partial mole
62
edematous villi with diffuse trophoblastic proliferation
complete mole
63
non-edematous villi with slight trophoblastic proliferation
partial mole
64
uterus too large for date and no fetal heart sounds
gestational trophoblastic disease - moles also see painless vaginal bleeding during 4th month
65
grape like clusters
partial mole
66
snowstorm appearance on US
partial mole
67
choriocarcinoma
markedly elevated beta-hCG lack villous structures mets to lungs (cannon ball), vagina, brain, liver
68
bloody brown vaginal spotting
choriocarcinoma
69
tx of choriocarcinoma
chemotherapy - 100% cure or remossion DOC - methotrexate

REPRO II Exam 1 (14 decks)

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