Pathological Disorders of the Placenta
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Questions and Answers

What is the fetal mortality rate associated with placental abruption?

  • 20–40% (correct)
  • 60–80%
  • 40–60%
  • 0–10%

Which of the following infections are known to cause villous inflammation (villitis)?

  • Cytomegalovirus and Toxoplasma (correct)
  • Group B Streptococcus and E. coli
  • Herpes virus and Varicella
  • Chlamydia and Gonorrhea

At what age range is hydatidiform complete mole most commonly observed?

  • Only in women over 30 years
  • Under 18 years and over 40 years (correct)
  • Under 15 years and over 35 years
  • 15 to 25 years and 30 to 40 years

What is a characteristic feature of hydatidiform mole?

<p>Avascular, large placental villi (B)</p> Signup and view all the answers

Which complication is most associated with placental abruption?

<p>Maternal mortality (D)</p> Signup and view all the answers

What chromosomal constitution is typical for a complete hydatidiform mole?

<p>46XX (D)</p> Signup and view all the answers

Hydatidiform mole leads to a risk of which serious condition?

<p>Choriocarcinoma (A)</p> Signup and view all the answers

Which symptom is commonly associated with a hydatidiform mole during early pregnancy?

<p>Bleeding (C)</p> Signup and view all the answers

What is the potential consequence of placenta accreta during childbirth?

<p>Severe post partum hemorrhage (A)</p> Signup and view all the answers

Which type of placenta previa completely covers the cervical opening?

<p>Complete (C)</p> Signup and view all the answers

What best describes placenta percreta?

<p>The placenta grows through the wall of the uterus (C)</p> Signup and view all the answers

What defines placental abruption (abruptio placentae)?

<p>Separation of the placental lining from the uterus (B)</p> Signup and view all the answers

What is a common procedure needed due to placenta accreta?

<p>Surgical removal of the placenta (D)</p> Signup and view all the answers

Which type of placenta previa is characterized by the placenta being adjacent to, but not covering, the cervical opening?

<p>Marginal (B)</p> Signup and view all the answers

How often does placenta accreta occur in pregnancies?

<p>1 in 2,500 (D)</p> Signup and view all the answers

What complication is associated with placenta previa during pregnancy?

<p>Antepartum hemorrhage (B)</p> Signup and view all the answers

What is the primary characteristic that distinguishes a partial mole from a complete mole?

<p>Presence of grossly abnormal fetal parts (A)</p> Signup and view all the answers

In what percentage of cases does choriocarcinoma commonly follow a hydatidiform mole?

<p>50% (D)</p> Signup and view all the answers

Which type of abnormality is associated with a partial mole?

<p>Triploidy (B)</p> Signup and view all the answers

What is the typical origin of choriocarcinoma?

<p>Fetal tissues (A)</p> Signup and view all the answers

Which tumor marker is secreted by both hydatidiform mole and choriocarcinoma?

<p>Human chorionic gonadotrophin (HCG) (C)</p> Signup and view all the answers

What is a common feature observed microscopically in choriocarcinoma?

<p>Mononuclear cytotrophoblast (C)</p> Signup and view all the answers

What is the typical treatment response rate for choriocarcinoma?

<p>80% response rate (A)</p> Signup and view all the answers

Which of the following is NOT a typical progression scenario leading to choriocarcinoma?

<p>Ruptured ovarian cyst (B)</p> Signup and view all the answers

Flashcards

What is the placenta?

An organ that connects the developing fetus to the uterine wall, enabling nutrient intake, waste elimination, and gas exchange via the mother's blood supply.

What is Placenta Accreta?

A rare disorder where the placenta is abnormally attached to the uterine wall, making removal difficult and causing potential complications.

What is Placenta Accreta?

The placenta grows into the lining of the uterus.

What is Placenta Increta?

The placenta grows into the wall of the uterus.

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What is Placenta Percreta?

The placenta grows through the wall of the uterus, potentially reaching nearby organs like the bladder or colon.

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What is Placenta Previa?

A complication of pregnancy where the placenta is positioned near or covering the cervix, leading to potential bleeding before birth.

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What is Marginal Placenta Previa?

The placenta is situated next to the cervix but does not cover the opening.

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What is Partial Placenta Previa?

The placenta partially covers the cervical opening.

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What is Complete Placenta Previa?

The placenta completely covers the cervical opening.

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What is Placental Abruption?

A serious pregnancy complication where the placental lining detaches from the uterus, causing bleeding before birth.

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Placental Abruption

A serious condition where the placenta detaches from the uterine wall before delivery, causing bleeding and potentially endangering both the mother and fetus.

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Chorioamnionitis

Inflammation of the membranes surrounding the fetus, often caused by ascending infection from the birth canal.

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Umbilical Cord Vasculitis

Inflammation of the blood vessels in the umbilical cord, often caused by ascending infection from the birth canal.

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Hydatidiform Mole

An abnormal pregnancy characterized by the absence of an embryo and the presence of enlarged, fluid-filled placental villi, often associated with chromosomal disorders.

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Villous Hyperplasia

The abnormal growth of placental villi, often associated with hydatidiform mole and sometimes leading to invasive behavior.

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Invasive Mole

An invasive form of hydatidiform mole that potentially burrows into the uterine wall, representing a more serious condition.

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Choriocarcinoma

A rare but serious cancer that can develop after a molar pregnancy, often associated with high levels of HCG.

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Complete Hydatidiform Mole

A type of hydatidiform mole where the embryo is completely absent, all placental villi are enlarged, and the condition is associated with chromosomal abnormality, leading to inevitable abortion.

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Invasive Hydatidiform Mole

A benign condition where abnormal villi penetrate the uterine wall, but don't form a tumor.

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Partial Mole

An abnormal placenta with some hydatidiform features, but with the presence of fetal parts. This is less likely to develop into choriocarcinoma.

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Triploidy in Partial Mole

A triploid chromosomal abnormality where the fetus has one maternal and two paternal sets of chromosomes (69XXY, 69XXX, or 69XYY).

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Human Chorionic Gonadotropin (hCG)

The hormone produced by the placenta which is elevated in hydatidiform moles and choriocarcinoma.

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Pleomorphism

The presence of different-looking cells within a tissue, which can be a sign of malignancy.

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Metastasis

The process of spreading cancer to distant sites.

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Study Notes

Pathological Disorders of the Placenta

  • The placenta is an organ connecting the developing fetus to the uterine wall. Its role is nutrient uptake, waste elimination, and gas exchange via the mother's blood supply.

Introduction

  • Pathology of the placenta involves two main issues: disorders during pregnancy and choriocarcinoma development.

Placental Disorders During Pregnancy

  • Placenta accreta: A rare condition where chorionic villi attach deeply to the myometrium (uterine muscle). It can penetrate the myometrium varying degrees. The placenta detaches with difficulty, potentially leading to postpartum hemorrhage. Risk factors may include previous uterine surgery.

    • Forms: Accreta, increta, percreta, distinguished by depth of penetration. Accreta is attachment to the endometrium, increta to the myometrium, and percreta through the myometrium into adjacent structures like bladder/colon.
  • Placenta previa: An obstetric disorder where the placenta attaches close to or over the cervix.

    • Hemorrhage is common during later stages of pregnancy (second or third trimester).
    • Types: Marginal (placenta next to but not covering cervix), partial (placenta covers part of the cervical opening), complete (placenta covers the entire cervical opening)
  • Placental abruption (Abruptio placentae): The premature separation of the placenta from the uterine wall. This causes late antepartum hemorrhage.

    • Significant cause of late pregnancy bleeding, a fetal mortality rate of 20-40% widely occurring in a 1% of pregnancy rate worldwide.
    • Degree of separation determines severity.
    • Maternal mortality is impacted

Inflammation

  • Inflammation of the placenta is usually related to infection.
    • Ascending infections from the birth canal (e.g., chorioamnionitis, umbilical cord vasculitis).
    • Hematogenous infections spreading from maternal septicemia (e.g., villous inflammation, or villitis).
    • Infections involve organisms: streptococci, toxoplasma, rubella, syphilis, cytomegalovirus, and herpes virus.
    • Fetal infection and abortion are common complications. Maternal conditions like septicemia, pelvic sepsis, and DIC (disseminated intravascular coagulation) also are complications

Hydatidiform Mole

  • Complete mole: Abnormal pregnancy characterized by missing embryo, avascular placental villi enlarged due to fluid distention, and chromosomal abnormality (46XX, typically).

    • Usually ends in abortion.
    • High levels of human chorionic gonadotropin (hCG) hormone
    • Often occurs in women under 18 or over 40; sometimes associated with pregnancy loss / abortion
    • 10% of complete moles lead to invasive features, even into surrounding uterine wall
  • Partial mole: Abnormal pregnancy with some villi showing hydatidiform changes and abnormal fetal development, leading typically to fetal chromosomal abnormalities (69 chromosomes);. Associated with the fertilization of an egg by one normal sperm and one abnormal sperm. This typically leads to molar pregnancy, followed by abortion.

Choriocarcinoma

  • A rare, highly malignant placenta tumor arising from trophoblastic tissues. Often directly related to prior molar pregnancy or spontaneous abortion..
    • Etiology (cause) is not fully understood
    • High hCG levels
    • Frequently invades uterine vessels and spreads to other areas like lungs, liver, brain, and vagina.
    • Treatable with chemotherapy; high cure rate in most people.

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Description

Explore the pathological disorders related to the placenta, focusing on conditions like placenta accreta and placenta previa. Understand their implications during pregnancy and potential complications associated with these disorders. This quiz provides insights into the classifications and risk factors of placental conditions.

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