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Questions and Answers
What is the fetal mortality rate associated with placental abruption?
What is the fetal mortality rate associated with placental abruption?
Which of the following infections are known to cause villous inflammation (villitis)?
Which of the following infections are known to cause villous inflammation (villitis)?
At what age range is hydatidiform complete mole most commonly observed?
At what age range is hydatidiform complete mole most commonly observed?
What is a characteristic feature of hydatidiform mole?
What is a characteristic feature of hydatidiform mole?
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Which complication is most associated with placental abruption?
Which complication is most associated with placental abruption?
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What chromosomal constitution is typical for a complete hydatidiform mole?
What chromosomal constitution is typical for a complete hydatidiform mole?
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Hydatidiform mole leads to a risk of which serious condition?
Hydatidiform mole leads to a risk of which serious condition?
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Which symptom is commonly associated with a hydatidiform mole during early pregnancy?
Which symptom is commonly associated with a hydatidiform mole during early pregnancy?
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What is the potential consequence of placenta accreta during childbirth?
What is the potential consequence of placenta accreta during childbirth?
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Which type of placenta previa completely covers the cervical opening?
Which type of placenta previa completely covers the cervical opening?
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What best describes placenta percreta?
What best describes placenta percreta?
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What defines placental abruption (abruptio placentae)?
What defines placental abruption (abruptio placentae)?
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What is a common procedure needed due to placenta accreta?
What is a common procedure needed due to placenta accreta?
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Which type of placenta previa is characterized by the placenta being adjacent to, but not covering, the cervical opening?
Which type of placenta previa is characterized by the placenta being adjacent to, but not covering, the cervical opening?
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How often does placenta accreta occur in pregnancies?
How often does placenta accreta occur in pregnancies?
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What complication is associated with placenta previa during pregnancy?
What complication is associated with placenta previa during pregnancy?
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What is the primary characteristic that distinguishes a partial mole from a complete mole?
What is the primary characteristic that distinguishes a partial mole from a complete mole?
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In what percentage of cases does choriocarcinoma commonly follow a hydatidiform mole?
In what percentage of cases does choriocarcinoma commonly follow a hydatidiform mole?
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Which type of abnormality is associated with a partial mole?
Which type of abnormality is associated with a partial mole?
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What is the typical origin of choriocarcinoma?
What is the typical origin of choriocarcinoma?
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Which tumor marker is secreted by both hydatidiform mole and choriocarcinoma?
Which tumor marker is secreted by both hydatidiform mole and choriocarcinoma?
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What is a common feature observed microscopically in choriocarcinoma?
What is a common feature observed microscopically in choriocarcinoma?
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What is the typical treatment response rate for choriocarcinoma?
What is the typical treatment response rate for choriocarcinoma?
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Which of the following is NOT a typical progression scenario leading to choriocarcinoma?
Which of the following is NOT a typical progression scenario leading to choriocarcinoma?
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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
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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.
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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)
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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
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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
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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.
