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DMS 400 OB/GYN > Class 20: Maternal Disease > Flashcards

Class 20: Maternal Disease Flashcards

1
Q

what can cross the placental barrier than can cause abnormalities in the fetus? (3)

A

infection, antibodies, drugs

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2
Q

what 3 factors of maternal infections affect the fetus?

A
  1. virulence
  2. transmission route
  3. gestational age at time of infection
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3
Q

when is the fetus most susceptible to infections?

A

during the 1st tri

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4
Q

what are 5 viral infections that can affect the fetus?

A
  1. cytomegalovirus
  2. herpes simplex
  3. varicella zoster
  4. rubella
  5. HIV
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5
Q

what is the most common cause of congenital infections?

A

cytomegalovirus (CMV)

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6
Q

CMV is a type of __

A

herpes

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7
Q

how can CMV be transmitted?

A

transplacental & upward through cervix

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8
Q

S&S of CMV include __, __, __

A

fever, fatigue, tiredness

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9
Q

what antiviral meds can help reduce transmission of CMV?

A

cytovene

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10
Q

if herpes simplex is transmitted to the fetus at ___ weeks, it can lead to stillbirth or spontaneous abortion

A

20 weeks

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11
Q

when is a C-section indicated with herpes simplex?

A

if it is present in the genital tract at the time of delivery

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12
Q

varicella is a danger to the fetus if exposed between ___ to ___ weeks

A

8-12 weeks

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13
Q

another name for rubella

A

german measles

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14
Q

the following are associated with which viral infection?
blindness, deafness, heart defects, microcephaly, hydrocephaly, cephalocele

A

german measles

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15
Q

when does transmission of HIV occur?

A

near time of birth

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16
Q

3 factors relating to transmission of HIV

A
  1. placental barrier effectiveness
  2. immunologic factors
  3. # of HIV particles present
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17
Q

3 types of bacterial infections that can spread to the fetus

A
  1. syphilis
  2. gonorrhea
  3. UTI
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18
Q

2 types of parasitic infections that can spread to the fetus

A
  1. toxoplasmosis
  2. malaria
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19
Q

what parasite spreads toxoplasmosis?

A

toxoplasma gondii

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20
Q

how can one contract toxoplasmosis? (2)

A
  1. eating raw meat
  2. cat feces
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21
Q

when is toxoplasmosis more transmittable?

A

3rd tri

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22
Q

consequence of toxoplasmosis?

A

repeated miscarriage

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23
Q

treatment for toxoplasmosis?

A

antibiotics

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24
Q

what type of mosquito spreads malaria?

A

female anophales mosquitos

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25
Q

what are the effects on the placenta with malaria?

A

placental insufficiency

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26
Q

5 types of endocrine & metabolic maternal diseases

A
  1. diabetes mellitus
  2. gestational diabetes
  3. hyperthyroidism
  4. hypothyroidism
  5. hyperparathyroidism
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27
Q

which type of diabetes is known as juvenile onset?

A

type 1

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28
Q

which type of diabetes is insulin dependent?

A

type 1

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29
Q

which type of diabetes is the more common type of diabetes mellitus?

A

type 2

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30
Q

faulty ____ metabolism is related to decreased insulin

A

carbohydrate

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31
Q

frequency of abnormalities with diabetic mothers

A

3-6%

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32
Q

why is there such a broad spectrum of associated fetal effects with mothers with diabetes mellitus?

A

diabetes mellitus affects organogenesis

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33
Q

diabetes mellitus is associated with macrosomia. T/F?

A

true

34
Q

what is a macrosomic baby?

A

> 4000 g (90th percentile at birth)

35
Q

most common trisomy associated with diabetes mellitus?

A

trisomy 21

36
Q

what can happen to the placenta with a mother with diabetes mellitus?

A

thickened placenta (>6cm)

37
Q

how many pregnancies are affected by gestational diabetes?

A

25/1000 (4%)

38
Q

gestational diabetes is early onset. T/F?

A

false – late onset

39
Q

what is the most common type of hyperthyroidism?

A

grave’s disease

40
Q

lab values for hyperthyroidism?

A

elevated thyroxine

41
Q

what does increased thyroxine lead to?

A

abnormal cell development –> FGR

42
Q

hydatidiform mole can lead to hypothyroidism. T/F?

A

false – hyperthyroidism

43
Q

hypothyroidism can lead to decreased fertility. T/F?

A

true

44
Q

what can cause hyperparathyroidism?

A

parathyroid adenoma

45
Q

3 types of maternal hematologic disorders?

A
  1. sickle cell anemia
  2. thalessemia
  3. toxemia of pregnancy
46
Q

what happens to RBCs in patients with sickle cell anemia?

A

RBC’s are abnormally shaped & can get stuck in blood vessels –> slows down blood flow –> anemia

47
Q

which population is affected by sickle cell anemia?

A

black population

48
Q

which population is affected by thalassemia?

A

mediterranean descent

49
Q

what is thalassemia?

A

form of anemia with decreased RBC production

50
Q

what is the cause of toxemia of pregnancy?

A

unclear

51
Q

2 stages of toxemia of pregnancy?

A
  1. preeclampsia
  2. eclampsia
52
Q

toxemia of pregnancy can lead to increased placental volume & decreased placental maturation. T/F?

A

false – DECREASED placental volume & INCREASED placental maturation

53
Q

what is fetal alcohol syndrome?

A

when alcohol crosses placental barrier, leading to cell death or inhibiting fetal growth

54
Q

diagnosis criteria of FAS depends on ___

A

severity

55
Q

what is fetal growth restriction?

A

when fetus is less than 10% of the predicted fetal weight for its gestational age

56
Q

how many infants born <2500 g (5lb 8oz) have true IUGR?

A

1/3

57
Q

what types of metabolic conditions can IUGR infants have later in life? (2)

A
  1. abdominal obesity
  2. type 2 DM
58
Q

the cause of IUGR is ___ 50% of the time

A

idiopathic

59
Q

2 fetal factors that can lead to FGR?

A
  1. genetic/chromosomal ABNL
  2. chronic fetal infx
60
Q

6 maternal factors that can lead to IUGR?

A
  1. drug use
  2. poor nutrition
  3. poor pregnancy weight
  4. multiple gestation
  5. maternal disease
  6. placental insufficiency
61
Q

2 environmental factors that can lead to IUGR?

A
  1. irradiation
  2. high altitude
62
Q

2 types of IUGR?

A
  1. symmetric
  2. asymmetric/head sparing
63
Q

most common type of IUGR?

A

head sparing

64
Q

which trimester is affected with the fetus with symmetric IUGR

A

1st tri

65
Q

what is asymmetric IUGR?

A

head & long bones are normal measurements but abdomen & organs are small

66
Q

which trimester is affected with the fetus with head sparing IUGR?

A

2nd tri

67
Q

the HC/AC ratio will be ___ in a fetus with head sparing IUGR

A

increased

68
Q

why is the brain not spared with symmetric FGR?

A

because it occurs in early pregnancy (long duration)

69
Q

symmetric IUGR leads to a ___ in cell number & size

A

decreased

70
Q

symmetric IUGR is caused by __ & ___ factors

A

fetal & environmental

71
Q

asymmetric IUGR is caused by ___ factors

A

maternal

72
Q

head sparing IUGR occurs in the last ___ to ___ weeks of pregnancy

A

8-10 weeks

73
Q

there is normal cell numbers in head sparing IUGR. T/F?

A

true

74
Q

there is normal cell size in head sparing IUGR. T/F?

A

false – decreased cell size

75
Q

pulse wave of which arteries may help diagnose FGR?

A

UTA & umbilical artery

76
Q

normally, in early pregnancy, flow in UTA & UA is ___ resistance

A

higher

77
Q

normally, as pregnancy progresses, flow in UTA & UA is ___ resistance

A

lower

78
Q

as pregnancy progresses, the systolic/diastolic ratio ___

A

decreases

79
Q

in 80% of cases with FGR, the systolic/diastolic ratio ___ & the UTA & UA exhibit ___ resistance

A

increases; higher

80
Q

if a grade __ placenta is seen <35-36 weeks with an EFW of less than ___ grams, this can indicated FGR

A

grade 3; 2700 (5lb 14 oz)

DMS 400 OB/GYN (21 decks)

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