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7 Cards in this Set
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name 4 types of abnormal placental implantation
what is placenta accreta? what causes it? what are some consequences of it? what is placenta increta? what is placenta percreta? |
placenta accreta, increta, percreta, and pre-eclampsia
trophoblast invades deep and implants on myometrium w/o decidua caused by low implantation site/placenta previa or scar/myoma consequences include failure to separate and placental polyps placenta increta is when villous tissue invades into myometrium placenta percreta is when villous tissue invades the entire uterine wall and causes rupture |
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what is the pathophysiology of pre-eclampsia?
what are the primary clinical findings in pre-eclampsia? what are some vascular changes seen in pre-eclampsia? when does pre-eclampsia usually occur? in what kind of mothers does pre-eclampsia usually occur? |
trophoblast doesn't invade deep enough > not enough blood supply > becomes hypoxic > release PGI2 (hypercoagulable DIC state) and antiangiogenic factors (hypertension and proteinuria in mom and defective vascular growth in baby)
clinical findings: hypertension, proteinuria, edema vascular changes in pre-eclampsia include lack of BV conversion, atherosis, thrombosis, necrosis usually occurs at 34 weeks gestation usually in first, multiple, molar, and young mothers |
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name 2 types of gestational trophoblastic disease
what is a molar pregnancy? at what ages are molar pregnancies common? |
gestational trophoblastic diseases include hydatidifrom moles and malignant neoplasms like choriocarcinomas
molar pregnancy is when you have abn fertilization w/ too much paternal genes common at extremes of childbearing age |
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what are the symptoms of a complete hydatidiform mole?
how does CHM look grossly? histo? what is the genetic composition of a CHM? how do you treat CHM? if have persistent disease CHM, what can you get? |
symptoms include: enlarging uterus, vomiting, hypertension, hyperthyroidism, elevated HCG
CHM gross: grape-like vesicles/hydropic villi CHM histo: hydropic villi, trophoblastic hyperplasia, no fetus CHM genetics: 2 copies of 1 sperm (usually) or 2 sperm (dispermic fertilization) + 1 anucleate egg treat CHM by following HCG levels and if rises, treat w/ chemo if persisent CHM, can get residual tissue in uterus, invasive mole, or choriocarinoma |
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what are the presenting symptoms of a partial hydatidiform mole?
what does PHM look like gross? what does PHM look like histologically? what is the genetic composition of PHM? what is the prognosis of PHM? treatment? how do you differentiate PHM from CHM? |
spontaneous or missed abortion WITHOUT HCG increase
gross: normal or hydropic villi, can have fetus histo: scalloped borders, pseudoinclusions, less trophoblastic proliferation PHM genetics: fertilize normal egg w/ 2 sperm of 2 copies of 1 sperm (diandric triploidy) PHM prognosis is good, rarely malignant. treatment same as CHM PHM stains for P57 (maternal and paternal genes), while CHM does not OR ploidy analysis |
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what is the pathophysiology of an invasive mole?
how do you detect an invasive mole? how do you treat an invasive mole? |
invasive mole will invade myometrium and blood vessels. can perforate uterus or embolize
detect after prior diagnosis of mole by rising HCG treat by chemo |
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what does a choriocarcinoma usually follow?
what does a choriocarcinoma look like grossly? histologically? what is the clinical presentation of choriocarinoma? what is the prognosis for choriocarcinoma? treatment? |
usually follows a molar gestation
gross: hemorrhagic, necrotic, infiltrative histo: sheets of cyto and syncytio that infiltrate the myometrium and vasculature, no villi! clinical: abnormal bleeding and hemorrhagic from metastases good prognosis, chemo |
