Pathology of Gestational Diseases

8/10/2019 Pathology of Gestational Diseases

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Dr. Soekimin, SpPA ; dr. Jessy Chrestella, SpPA

Dept. Patologi Anatomi Fakultas Kedokteran

Universitas Sumatera UtaraMedan 2010

PATOLOGI SISTEMREPRODUKSI WANITA

Penyakit gestasional


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PLACENTAABORTION

INFECTION PUERPERALINFECTION

HYDATID MOLECHORIO CARCINOMA

TOXEMIAGRAVIDARUM

ECTOPIC PREGNANCY


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Succenturiate placenta Circumvallate placenta

Battledore placenta Vilamentous insert. of cord Placenta previa (marginal, partial, total) Abruptio placentae (external and internal

bleeding).


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Cervical Interstitial

Isthmic Ampulla Infundibular Ovarial Abdominal


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is a spectrum of disorders with abnormal

trophoblast proliferation and maturation,

as well as neoplasms derived fromtrophoblast.


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Spectrum of disorders with abnormaltrophoblast proliferation and maturation, as

well as neoplasms derived from trophoblast.

Incomplete mole

fetal parts present,no carcinoma.

Complete moleno fetal parts, 2%chance of carcinoma.

Invasive / Aggressive mole.

Choriocarcinoma.

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Risk Factors :

Girls younger than 15 years of age

Increases progressively for women over 40 years of age.

Women older than 50 years of age have 200 times the risk

Higher in Asian women than among white women. Women who had a rior h datidi orm mole

HYDATIDIFORM MOLE


8/258Hydatidiform Mole (Image: ACT Pathology description)


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A. Entire uterine cavity is filled with swollenvilli.

B. The villi are each 1 to 3 mm in diameter and

appear grape-like.C. Individual molar villi, many of which have

cavitated central cisterns, exhibitconsiderable trophoblastic hyperplasia andatypia. The blood vessels of the villi haveatrophied and disappeared.


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All villi cystic No fetal parts

Diffuse trophoblastichyperplasia 46xx of sperm Choriocarcinoma

common.

Partially cystic Fetal parts may be

Focal hyperplasia oftrophoblasts 69xxy or 92xxxy (ovum & sperm) Rare carcinoma

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Trophoblast Hyperplasia

NoBV in villi


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NoBV in villi


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Atypia


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Myometrium

Invading chorionic villi


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Gestational choriocarcinoma is a malignant tumor derived fromtrophoblast.

Incidence related to abnormalities of pregnancy :

occurs in 1 of 160,000 normal gestations,

1 of 15,000 spontaneous abortions,

1 of 5,000 ectopic pregnancies, and

1 of 40 complete molar pregnancies. Clinical : abnormal uterine bleeding. Histological:the tumor contains a dimorphic population of

cytotrophoblast and syncytiotrophoblast, with varying degrees ofintermediate trophoblast.

It metastasizes widely by the hematogenous route, especially to lungs

(more than 90%), brain, gastrointestinal tract, liver, and vagina.


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Hypertension of pregnancy. Path: unknown/genetic/immune Common with First / molar pregnancy ?

Trophoblasts Seizures & Cerebral edema. Reduced placental blood flow. Spiral arteries of the uteroplacental beddo not

respond or dilate. Extensive placental infarction or retroplacental

hemorrhage in 1/3 patients with severepreeclampsia.

chorionic villi show underperfusion,cytotrophoblast hyperplasia, thickening ofbasement membrane.

Kidneys always show glomerular changes.

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Terima kasih


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Placental anatomy. (Reproduced, with permission, from Copenhaver WM, Kelly DE, Wood RL: Bailey's Textbook ofHi l h d Willi & Wilki 8 )

Pathology of Gestational Diseases

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