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OB Ultrasound > Maternal Complications > Flashcards

Maternal Complications Flashcards

1
Q

The rate of ______ in a diabetic is 3-5%

A

fetal mortality

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2
Q

The risk of major fetal anomaly is _______.

A

6-12%

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3
Q

_________ plays a major role of monitoring in a pregnant diabetic.

A

Ultrasound

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4
Q

Diabetes is usually a ______ occurrence, __% of the time.

A

spontaneous, 90

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5
Q

The other 10% are caused by related _______,______, and _______.

A

pancreatic disease, hormone imbalance, drug reactions.

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6
Q

What are the two types of diabetes mellitus?

A

Type 1-juvenile onset, (insulin dependent)

Type 2-adult onset, (non-insulin dependent)

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7
Q

Serum marker for how well a diabetic is controlled in pregnancy, a poorly controlled diabetic is most frequently associated with fetal anatomic anomalies.

A

Hemoglobin A1C

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8
Q

Glucose intolerance of pregnancy

A

Gestational diabetes

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9
Q

Gestational diabetes usu. occurs in ____, and ____, trimesters. Is usu. associated with ______ ______.

A

2nd, 3rd, fetal macrosomia

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10
Q

What congenital anomalies arise due to the increased risk associated with diabetes mellitus?

A 
Caudal regression
neural tube defects
Cardiovascular malformations
Genitourinary anomalies
Single umbilical artery
Gastrointestinal anomalies
skeletal anomalies
IUGR
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11
Q

What are the fetal complications affected by DM?

A

Respiratory distress syndrome

Hypoglycemia.

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12
Q

What is associated with Gestational Diabetes

A 
Fetal macrosomia
hydrops
Polyhydramnios
still birth trauma
dystocia
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13
Q

What is fetal macrosomia?

A

Fetal weight greater than 4000 g or greater than 90 percentile for gestational age.

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14
Q

Define dystocia

A

Difficult delivery

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15
Q

Fetuses of gestational diabetic mother can have which other two conditions

A

hypocalcemic, hypoglycemia

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16
Q

What is involved with Hypertension in mothers.

A

Systolic pressure gradient and 140 mmHg
Increase in systolic pressure greater than 130 mmHg over the pregnancy
Diastolic pressure greater than 90 mmHg
Increase in diastolic pressure greater than 15 mmHg over prepregnancy state

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17
Q

Describe essential hypertension

A

pre-existing hypertension not related to the pregnancy. ( Also called chronic hypertension)

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18
Q

Hypertension that occurs during pregnancy without signs of preeclampsia

A

Pregnancy induced hypertension/gestational hypertension PIH

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19
Q

A disorder of pregnancy which is characterized by proteinuria and neurologic symptoms.

A

GEPH–Gestational edema proteinuria hypertensive syndrome–otherwise called (Toxemia of pregnancy)

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20
Q

GEPH or toxemia of pregnancy is most common in ________, _______, and _______.

A

1st time mothers (most common)
multiple gestations
patients with a family history

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21
Q

What are the two classifications of toxemia of pregnancy

A

Preeclampsia

Eclampsia

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22
Q

Symptoms associated with Preeclampsia

A

hypertension
generalized edema
Proteinuria
Rapid weight gain which is secondary to Edema

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23
Q

Symtoms associated with Eclampsia

A

Same as seen in preeclampsia but with seizures

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24
Q

List what Pathology of GEPH leads to:

A 
hypoxia, 
necrosis of tissue
premature placental aging
renal cellular damage
disseminated intravascular coagulopathy DIC
Portal hemorrhagic  necrosis in the liver
cerebral edema
pulmonary edema
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25
Q

What are the Sono findings of GEPH

A

IUGR
Increase of abruptio placentae
Oligohydramnios
Fetal demise

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26
Q

______ is used to track fetal growth and monitor the pregnancy

A

Ultrasound

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27
Q

______ _____ is a complication of preeclampsia.

A

HELLP syndrome

28
Q

What does HELLP stand for

A

hemolysis-H
Elevated liver enzymes-EL
Low platelets-LP

29
Q

List 3 complications associated with severe maternal infection.

A

Spontaneous abortion
Fetal death
Premature labor and delivery

30
Q

Name the most common significant utero infections.

A

TORCH infections

31
Q

What does TORCH stand for.

A 
Toxoplasmosis
Other/syphilis and parvovirus
Rubella
Cytomegalovirus/CMV
Herpes/genital type
32
Q

This protozoan is found in cat feces and undercooked meat, name it.

A

Toxoplasmosis—**Maternal infection crossed the placental barrier and results in fetal infection.

33
Q

Name 8 results of Toxoplasmosis

A 
Intracranial calcifications
Micro opthalmia
IUGR
Microcephaly
Hydrocephalus
Thick placenta
Thromboctyopenia
Jaundice
34
Q

An extremely teratogenic infection for the fetus, name this.

A

Rubella or German Measles

35
Q

Defects of Rubella are:

A

Cataracts
Congenital heart disease
Deafness
Mental retardation

36
Q

The most common infection in pregnancy.

A

Cytomegalovirus/CMV

37
Q

CMV may cause _____ _____ if exposure occurs in 1st trimester. Other findings are:(6)

A 
embryonic demise
Spontaneous abruption of placenta
IUGR
Fetal ascites
Cranial anomalies
Chest anomalies
Fetal death
38
Q

______ can be transmitted to the fetus during vaginal delivery.

A

Herpes

39
Q

Herpes can cause a woman to have ___ _____.

A

Cesarean section

40
Q

Women with Herpes may also cause (3)

A

CNS, eye, visceral involvement
Generalized multiple organ involvement
Death

41
Q

Common respiratory viral infection

A

Parvovirus

42
Q

Parvovirus can lead to the following (2)

A

Pancytopenia/anemia which can lead to fetal hydrops

Percutaneous umbilical cord sampling or fetal transfusion may become necessary

43
Q

Refers to premature dilation and efacement of uterine cervix

A

Incompetent cervix

**May be congenital or acquired and is mc related to prior cx trauma i.e. cervical surgery for cervical carcinoma.

44
Q

What happens with an incompetent cervix?

A

Cervix unable to prevent premature expulsion of pregnancy

45
Q

How is imcompetent cervix prevented?

A

Cerclage– stitch to keep the cx closed.

46
Q

Name the cerclage procedure.

A

McDonald or Shirodkar procedure

47
Q

Features of incompetent Cx. (3)

A

shortened cervix, < 2.5 cm
Dilation of the cervix greater than 2cm in 2nd Trimester–(Most reliable sign)
Bulging membranes into the dilated cervix–hourglass sign.(Poor prognostic indicator)

48
Q

The stages of incompetent cervix–TYVU- which stands for

A 
Trust Your Vaginal Ultrasound
T-Normal
Y-internal os slightly dilated
V-funneling
U-extremely short, thin cx
49
Q

Maternal anemias

The need for increased perfusion to a highly vascularized placenta results in a __% increase in blood volume.

A

40%

50
Q

Because increased plasma volume accounts for much of the increase, _____ and ______ values are much lower during pregnancy than in the nonpregnant state.

A

hemoglobin, hematocrit

51
Q

Clinical signs of anemia

A

Hemoglobin less than 10 g per 100 ML’s

Hematocrit less than 30%

52
Q

Types of anemia

A 
Iron deficiency (95%)
Folic acied deficiency
Aplastic anemia
Drug-induced hemolytic anemia
Thalassemia and Sickle Cell Anemia
53
Q

This is a rare and catastrophic cause of maternal death

A

Uterine rupture

54
Q

Name the clinical signs of Uterine rupture

A

Horrific pain

Sudden increase in fetal station

55
Q

Define preterm labor

A

The onset of labor prior to 37 weeks gestation

56
Q

What can cause preterm labor

A 
Previous uterine surgery
Uterine anomaly
Maternal stress
Multiple gestation
Heavy cigarette smoking
Polyhydramnios
Percentile previous or abruption,source of bleeding
Systemic infection 
Idiopathic
Premature rupture of membranes
Uterine masses
57
Q

What is found on Ultrasound when membranes rupture prematurely?

A

Oligohydramnios

58
Q

Most common mass of uterus

A

Myeloma or leiomyoma

59
Q

______ and ______ types of masses will be prone to torsion

A

Submucosal and surserosal types

60
Q

_______ may cause obstruction of vaginal delivery.

A

Leiomyomas

61
Q

They are also known to cause _____ ______

A

Fetal malpresentation

62
Q

What are the Ultrasound findings of Leiomyomas

A

solid, hypoechoic uterine mass which distorts with uterine contour

63
Q

How to differentiate between focal myometrial contraction and leiomyoma?

A

Focal myometrial contraction will change with time, a leiomyoma will not.

64
Q

What type cyst often found during pregnancy.

A

Ovarian

65
Q

Name the most common cyst.

A

Corpus luteum

66
Q

Name the cyst that occurs with gestational trophoblastic disease

A

Theca lutein which are lg and multi-septated

OB Ultrasound (24 decks)

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