Placental Pathology I Flashcards Preview

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Flashcards in Placental Pathology I Deck (69):
1

placental delivery

third stage of delivery

2

looking at placenta during delivery

child surface
maternal surface

all placental vessels - are childs

3

trapped placenta

cannot deliver

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

4

placental delivery steps

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

5

important to look at with cord

count vessels**

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

6

progesterone

following ovulation increase
-prepares endometrium for implantation - secretory and blood vessel rich

7

placental implantation

week 1-2

produce HCG - prevents loss of CL

8

trophoectoderm

2 layers - of chorionic villi
-synctiotrophoblast
cytotrophoblast

9

spiral arteries

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

10

eclampsia pathology

placental factors to the mother

11

neutrophils on amniotic membrane

always abnormal

12

first trimester chorionic villi

have syncytiotrophoblast (outer)
and cytotrophoblasts (inner)

13

50% of fertilizations

spontaneous abortion

14

metabolic transfer in chorionic villi

most syncytiotrophiblast

15

third trimester chorionic villi

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

16

pregnancy lost <20 weeks

spontaneous abortion

17

1st trimester abortion

chromosomal problem

50% of spontaneous abortions

18

2nd trimester abortion

mechanical problem

19

3rd trimester abortion

fetoplacental unit problem

20

risk factors for spontaneous abortion

increased age
history of prior
maternal smoking

21

ectopic pregnancy location

90% fallopian tubes

22

predispose to ectopic

PID - 35-50%

23

diagnosis of ectopic

beta-HCG
ultrasound
laparoscopy

24

most important predisposing condition for ectopic?

hx of PID

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