Obstetrics and Gynecology Board Review Pearls of Wisdom

(Elliott) #1

••• Chapter 19^ The Placenta and Umbilical Cord^203


❍ What is the recurrence risk of placental abruption?
5% to 16%; 25% if preceded by two consecutive abruptions.


❍ What is the sensitivity, specificity, and positive and negative predictive value of abruption via ultrasound?
25%, 96%, 88%, and 53%.


❍ What laboratory studies are useful in the management of abruption?
Hemoglobin and hematocrit, platelets, coagulation studies (PT, PTT, fibrinogen, and FSP).


❍ Abruptions account for what percentage of perinatal deaths?
15%.


❍ What proportion of abruptions result in fetal death?
4 in 1000 abruptions.


❍ What is the term used to describe abruption that leads to extravasation into and through the myometrium
to the serosal surface of the uterus?
Couvelaire uterus.


❍ What is the most common metastatic tumor of the placenta?
Malignant melanoma.


❍ What are the most common benign tumors of the placenta?
Chorioangiomas.


❍ What are placental site trophoblastic tumors?
Very rare trophoblastic neoplasms characterized by absence of chorionic villi and proliferation of intermediate
cytotrophoblast cells; they secrete beta hCG in amounts small in relation to tumor volume.


❍ Are placental site trophoblastic tumors sensitive to chemotherapy?
No.


❍ What is the treatment of choice for placental site trophoblastic tumors?
Hysterectomy, although D&C alone has cured some patients.

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