Products of conception
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Products of conception, abbreviated POC, is stuff formed from the union of egg and sperm.
History
- Therapeutic abortions - may be abbreviated "MVC" (manual vacuum aspiration)[1]
Microscopic
Features:
- Chorionic villi are need to call POC - key feature.
- Cytotrophoblast.
- Centre of villi often have fetal red blood cells (which have nuclei) -- not required for diagnosis of POC.
- Should have decidual reaction of endometrium.
- Decidual changes -- mnemonic NEW:
- Nucleus central.
- Eosinophilic cytoplasm.
- Well-defined cell borders.
- Decidual changes -- mnemonic NEW:
- Embryo or fetus - a bonus.
ASIDE:
- Embryo = conceptus before 8 weeks.
- Fetus = conceptus 8th weeks 'til birth.
Beta-hCG
Calculator: http://www.countdowntopregnancy.com/tools/beta_doubling_calculator.php
Ectopic pregnancy
- Chorionic villi have to be identified (in some location, e.g. Fallopian tube) to Dx a pregnancy.
- Endometrium: decidual reaction, as seen in any pregnancy.
Arias-Stellas reaction
- Large nuclei - to the novice... it looks really scary.
- NC ratio is preserved.
- May see nuclear clearing.[2]
Screening tests
First trimester screen
- PAPP-A.
- Nuchal translucency.
- beta-hCG.
Maternal serum screen
- Alpha-fetoprotein.
- Beta-hCG.
- Estriol.
Diagnostic tests
- Chorionic villus sampling (10-12 weeks???)
- Amniocentesis (15-16 weeks+)
References
- ↑ Edelman A, Nichols MD, Jensen J (June 2001). "Comparison of pain and time of procedures with two first-trimester abortion techniques performed by residents and faculty". Am. J. Obstet. Gynecol. 184 (7): 1564-7. PMID 11408881. http://linkinghub.elsevier.com/retrieve/pii/S0002937801372241.
- ↑ Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 236 (bottom). ISBN 978-0470519035. .