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23 Cards in this Set

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Compare Placenta accreta vs Placent Previa:
Placenta accreta: attachment of the placenta directly to the myometrium causing villi to invade the myometrium because of absence of the decidua.

Placenta previa: an attachment of the placenta to the lower uterine segment partially or completely covering the cervical os.
Two predisposing factors to an ectopic pregnancy:
Inflammation and scarring
4 causes of hematogenous infections of plactena (or fetus):
TORCH:
Toxoplasmosis, Rubella, Clamydia, Herpes.
What is diamnoitic?
2 amniotic sacs
What is monochorionic?
One choronic plate
Between two twins, if you see a thin, transparent membrane =
Monochorionic and diamnotic
Between two twins, if you see a thick membrane =
Dichorionic and diamniotic (2 separate sacs)
Describe toxemia of pregnancy:
This disorder is characterized by severe HT that most often occurs in 3rd trimester and effects the kidneys, liver, and CNS (hemorrhage and thrombi)
What are some pathological findings of a placenta from a mom what was toxemic?
There are often infarcts, ischemia of villi, hematomas, and necrosis (inflammation).
What is Preeclampsia?
A milder form of toxemia that is composed of hypertension, proteinuria (albuminuria), and edema. (VIP)
What is eclampsia?
Eclamsia: a severe form of toxemia characterized by convulsions and DIC that causes rapid termination of the pregnancy (can be fatal).
General description of gestational trophoblastic disease: (types?)
Gestational trophoblastic disease: disorders characterized by degeneration or neoplastic changes of trophoblastic tissue.

Types: Hydatidiform mole (complete and partial) & Gestational Choriocarcinoma.
What is a complete hydatidoiform mole?
A complete mole:
1. no embryo present
2. 46, xx karotype, diploid
3. of paternal derivation (androgenesis)
4. 2% are choriocarcinoma
What is a partial hydatidoiform mole?
Partial mole:
1. embryo present
2. 69, XXY or XXX (triploidy and can be tetraploid
3. one egg and one sperm
4. fetus abnormal
5. choriocarcinoma is rare
VIP
Describe the clinical characterisitcs of a hydatidiform mole:
Hydatidiform mole:
1. presence of enlarged, edematous placental villi (resembling a bunch of grapes)
2. see an increase in HCG
3. presents as abnormal uterine bleeding
4. use ultrasound to diagnose
5. 10% are invasive moles
Which mole, complete or partial, has:
1. highest HCG elevation
2. atypia
3. trophoblast proliferation
4. villous edema
1. Complete mole has the highest HCG elevation
2. Atypia: only seen in complete moles
3. Trophoblast prolif: Complete-diffuse, Partial-focal, slight.
4. Villous edema: Complete-all villi; Partial-some villi.
Describe an invasive mole:
Invasive moles:
1. penetrates the uterine wall (+/- perforation)
2. villi and trophoblast invade the myometrium
3. get into parametrium and blood vessels
4. cause embolisms to lungs and brain
5. they Do NOT grow in other organs.
6. Vaginal bleeding and uterine enlargement
7. persistant HCG elevation
8. respond to chemotherapy
9. beign biologically
10. can cause rupture of uterus and hemorrhage.
VIP

What is gestational choriocarinoma?
Gestational choriocarcinoma:

It is an aggressive malignant neoplasm of trophoblastic cells. It is rapidly invasive and widely metastasizing tumor. It shows an increase in hCG.
Predisposing factors include = moles, abortions, nL pregancy, ectopic pregancy.
Gross and microscopic appearance of Gestational Choriocarcinoma:
Gross: soft, fleshy, yellow-white tumor

Microscopic: cytotrophoblast and syncytiotrophoblastic proliferation and anaplasia. No chorionic villi.
In to what does Gestational Choriocarcinoma invade into?
Myometrium
(involving also the blood vessels and lymphatics)
Where does Gestational Choriocarcinoma metastases to?
Lungs, brain, bone marrow, liver, kidney.
What is the cure rate of Gestational Choriocarcinoma if treated with surgery and/or chemotherapy?
100% cure
Describe the placental site trophoblastic tumor:
A proliferation of intermediate trophoblasts that produces human placental lactogen but does not produce hCG.