Premature separation of placenta. Hemorrhage into decidual basalis. Risk: htn; trauma; cocaine; smoking; PROM; previous abruption. Vaginal bleeding and uterine tenderness.
Trophoblastic diseases
hydatidiform mole; invasive mole; choriocarcinoma; placental site trophoblastic tumor (PSTT)
gross description hydatidaform mole.
cystic swelling of chorionic villi; trophoblastic proliferation
T/F Hydatidiform mole precede choriocarcinoma
TRUE
Symptoms of hydatidiform mole
vaginal bleeding; larger than expected growth; elevated B-HCG
Pathogenisis and characteristics of complete mole
no embryonic develpment; no fetal parts. all villi are diordered and dilated. Paternal genetic material only. progresses to choriocarcinoma
Pathogenesis and characteristics of partial mole
fetal parts present. vilous hydrops only a portion of villi. triploid/tetraploidy from double amount of paternal dna
Invasive mole
mole that penetrate/perforate uterine wall. SIgns similar to regular mole (vaginal bleeding and irregular uterine enlargement with elevated HCG). Response well to chemo.
choriocarcinoma etiology; groos and micro description. clincal course.
Trophoblastic cells are precursors. soft/fleshy/yellow tumor with area of necrosis. anaplastic cells; no villi. blood with B-HCG elevation.
Etiology of placental site trophoblastic tumor
trophoblasts at residual placental site following pregnancy. cought early good prognosis
common site of ectopic pregnancy
fallopian tubes
Risk factors for ectopic pregnancy
PID; chronic salphingitis; peritubal adhesions; endometriosis; leiomyomas; surgery