Products of conception: Difference between revisions
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*Chorionic villus sampling (10-12 weeks???). | *Chorionic villus sampling (10-12 weeks???). | ||
*Amniocentesis (15-16 weeks+). | *Amniocentesis (15-16 weeks+). | ||
==Gross== | |||
Fetal parts absent: | |||
*Minimum of five cassettes.<ref>URL: [https://voices.uchicago.edu/grosspathology/peds-perinatal/products-of-conception/ https://voices.uchicago.edu/grosspathology/peds-perinatal/products-of-conception/]. Accessed on: 2023 April 3.</ref> | |||
==Microscopic== | ==Microscopic== | ||
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*Abdominal pain in woman of childbearing age. | *Abdominal pain in woman of childbearing age. | ||
**''Every woman of childbearing age should be assumed pregnant until proven otherwise!''<ref name=pmid23210111>{{Cite journal | last1 = Doust | first1 = J. | title = A is for aphorism - a woman is pregnant until proven otherwise. | journal = Aust Fam Physician | volume = 41 | issue = 10 | pages = 827 | month = Oct | year = 2012 | doi = | PMID = 23210111 |url = http://www.racgp.org.au/afp/2012/october/a-is-for-aphorism/ }}</ref> | **''Every woman of childbearing age should be assumed pregnant until proven otherwise!''<ref name=pmid23210111>{{Cite journal | last1 = Doust | first1 = J. | title = A is for aphorism - a woman is pregnant until proven otherwise. | journal = Aust Fam Physician | volume = 41 | issue = 10 | pages = 827 | month = Oct | year = 2012 | doi = | PMID = 23210111 |url = http://www.racgp.org.au/afp/2012/october/a-is-for-aphorism/ }}</ref> | ||
*Typical gestational age (GA) for a tubal pregnancy ~ 5-9 weeks.<ref name=pmid9207811/> | *Typical gestational age (GA) for a tubal pregnancy ~ 5-9 weeks.<ref name=pmid9207811/> | ||
**Beta-hCG elevated but may be relatively low (<100 IU/L) even in the context of (uterine tube) rupture.<ref name=pmid9207811>{{Cite journal | last1 = Saxon | first1 = D. | last2 = Falcone | first2 = T. | last3 = Mascha | first3 = EJ. | last4 = Marino | first4 = T. | last5 = Yao | first5 = M. | last6 = Tulandi | first6 = T. | title = A study of ruptured tubal ectopic pregnancy. | journal = Obstet Gynecol | volume = 90 | issue = 1 | pages = 46-9 | month = Jul | year = 1997 | doi = 10.1016/S0029-7844(97)00180-4 | PMID = 9207811 }}</ref> | |||
===Microscopic=== | ===Microscopic=== | ||
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===Sign out=== | ===Sign out=== | ||
<pre> | |||
Fallopian Tube, Right Salpingectomy: | |||
- Fallopian tube with chorionic villi (tubal pregnancy). | |||
</pre> | |||
<pre> | |||
Submitted as "Left Fallopian Tube and Ectopic Pregnancy", Excision: | |||
- Tubal pregnancy; Fallopian tube with chorionic villi and fetal parts. | |||
</pre> | |||
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<pre> | <pre> | ||
FALLOPIAN TUBE, RIGHT, SALPINGECTOMY: | FALLOPIAN TUBE, RIGHT, SALPINGECTOMY: | ||
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*The above is considered a [[critical diagnosis]]. | *The above is considered a [[critical diagnosis]]. | ||
*It should be communicated to the on call gynecologist and this communication should be documented. | *It should be communicated to the on call gynecologist and this communication should be documented. | ||
<pre> | |||
Submitted as "Products of Conception": | |||
- Decidualized endometrium with necro-inflammatory changes/degeneration, | |||
blood and fibrin. | |||
- NEGATIVE for chorionic villi, see comment. | |||
Comment: | |||
The tissue was submitted in total. | |||
The ultrasound impression (intrauterine gestational sac present) is noted. The decrease in serum beta-hCG is noted. | |||
The lack of chorionic villi on pathology is a discordance with the clinical findings. | |||
A non-exhaustive list of possible explanations includes: non-removal/retention and prior spontaneous passing. Clinical correlation is required. | |||
</pre> | |||
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