Fetal & Maternal Complications Flashcards

1
Q

When is a fetus considered to be IUGR?

A

< 10% percentile for GA

pg. E 192

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2
Q

What are the maternal causes for IUGR?

A
poor nutritional status
smoking
multiple gestation
drug/alcohol abuse
anemia
chronic renal disease
diabetes
Rh sensitization
asthma
under 17
over 35
heart disease
high altitude
pg. E 192
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3
Q

What are the placental causes for IUGR?

A
placental infarcts
small placenta
single umbilical artery
abruptio placenta
placental insufficiency
pg. E 192
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4
Q

What are the fetal causes for IUGR?

A

genetic or chromosomal defects
intrauterine infection
pg. E 192

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5
Q

What is a symmetric IUGR?

A

growth restrictions affecting entire fetus
begins in first tri
pg. E 193

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6
Q

What is asymmetric IUGR?

A

HC/AC > 2 SD
occuring later in pregnancy
pg. E 193

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7
Q

What would the umbilical systolic/diastolic ratio be for a fetus with IUGR?

A

> 3.0 after 30 weeks

pg. E 193

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8
Q

What is erythroblastosis fetalis?

A

destruction of RBCs by antibodies typically from Rh incompatibility
pg. E 195

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9
Q

What is hydrops fetalis?

A

excessive accumulation of fluid in fetal tissues and body cavities
pg. E 195

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10
Q

What is immune hydrops?

A

hydrops due to Rh isoimmunization

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11
Q

What is non-immune hydrops?

A
hydrops from anything but Rh sensitization
cardiac anomalies
chromosomal abnormalities
etc
pg. E 197
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12
Q

What are the sonographic findings of hydrops fetalis?

A
pericardial effusion
ascites
fetal skin thickening (anasarca)
placental thickening
pleural effusion
hepatosplenomegaly
polyhydramnios
enlarges umbilical vein
pg. E 197
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13
Q

What is the songraphic appearance of fetal demise?

A
no cardiac activity
exaggerated fetal position
Robert's sign
Spaulding's sign
Deuel's (halo) sign
pg. E 198
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14
Q

What are the effects of diabetes mellitus on pregnancy?

A
caudal regression syndrome
neural tube defects
cardiovascular malformations
GU anomalies
single umbilical artery
GI anomalies
skeletal anomalies
pg. E 200
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15
Q

When a mother has diabetes that predates pregnancy, what can that cause fetal weight to be?

A

IUGR

pg. E 200

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16
Q

When a mother has gestational diabetes, what can that cause fetal weight to be?

A

macrosomia

pg. E 200

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17
Q

What is macrosomia?

A

birth weight > 4000 g

> 90th %

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18
Q

What are some maternal complications with diabetes?

A
polyhydramnios
pre-eclampsia
renal dysfunction
hypoglycemia
peripheral vascular disease
postpartum hemorrhage
pg. E 201
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19
Q

Why would a glucose intolerance test be taken?

A

patient with diabetes to help manage pregnancy

pg. E 201

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20
Q

What systolic pressure is considered hypertension?

A

> 140 mm Hg

pg. E 201

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21
Q

What is pre-eclampsia?

A
hypertension
edema
proteinuria
rapid weight gain
pg. E 201
22
Q

What is eclampsia?

A
pre-clampsia +
convulsions
coma
death (if not treated)
pg. E 202
23
Q

What are the TORCH infections?

A
infections that are most common in utero
Toxoplasmosis
Other (syphilis)
Rubella
Cytomegalovirus
Herpes
pg. E 202
24
Q

How does HTN affect a pregnancy?

A

IUGR
prematurely mature placenta
oligohydramnios
pg. E 204

25
Q

How does Type 1 diabetes affect a pregnancy?

A

IUGR
thin placenta
oligo or poly
pg E 204

26
Q

How does gestational diabetes affect a pregnancy?

A

Macrosomia
placentamegaly
polyhydramnios
pg. E 204

27
Q

How does infection (TORCH) affect a pregnancy?

A

IUGR
increase or decrease in placenta size
normal, increase, or decrease in fluid depending on anomaly
pg. E 204

28
Q

What is an incompetent cervix?

A

premature dilatation of cervix

pg. E 206

29
Q

What are the songraphic findings of an incompetent cervix?

A

shortened cervix <2.5 cm
dilatation > 2 cm
bulging membranes
pg. E 206

30
Q

What is considered preterm labor?

A

onset before 37 weeks

pg. E 208

31
Q

What is premature rupture of membranes (PROM)?

A

spontaneous rupture of membranes prior to labor

pg. E 208

32
Q

What is common to see in maternal abdomen during a pregnancy?

A

hydronephrosis (right side more common)

pg. E 209

33
Q

Why do fibroids enlarge through a pregnancy?

A

estrogen stimulation

pg. E 209

34
Q

What is the typical size of the postpartum UT?

A

14 x 7 x 7 cm

pg. E 218

35
Q

What is the period after giving birth when the body returns back to normal called? how long does it last?

A

puerperal period
4-6 weeks
pg. E 218

36
Q

What are the sonographic findings of a postpartum UT?

A

large hypoechoic
fluid in endo
cervical internal os may be open
pg. E 218

37
Q

What is the most lethal complication in the puerperal period?

A

postpartum hemorrhage

pg. E 219

38
Q

What is a postpartum hemorrhage?

A

blood loss greater than 500 mL following a vaginal delivery

pg. E 219

39
Q

What is associated with postpartum hemorrhage?

A
retained products of conception
UT atony
UT overdistention
UT manipulation
pg. E 219
40
Q

What are the clinical signs of postpartum infection?

A
elevated body temp
increased WBC's
tachycardia
UT tenderness
pg. E 220
41
Q

What is associated with infection?

A
poor nutrition and hygiene
anemia
vaginitis
invasive fetal monitoring
C-section
prolonged labor
pg. E 220
42
Q

What would an abscess appear as sonographically?

A

complex fluid collection w/ debris
acoustic shadowing/ring down
pg. E 221

43
Q

What is a hematoma?

A

result of failure to stop bleeding after closing the UT C-section incision
pg. E 221

44
Q

What are the sonographic findings of a hematoma?

A

complex fluid collection in anterior cul-de-sac
appears same as abscess
pg. E 221

45
Q

What might the umbilical artery flow be in a fetus with IUGR?

A

Increased resistance
Decreased diastolic flow
URR Exam

46
Q

In IVF where is the embryo placed?

A

Uterus

URR Exam

47
Q

When is a glucose screening performed?

A

24-28 weeks

48
Q

If maternal syphillis goes untreated, what change will be seen in the fetus?

A

Hepatomegaly

49
Q

Where does fetal anemia most likely cause increased flow?

A

Umbilical vein
Middle cerebral artery
Descending aorta

50
Q

What is asymmetric IUGR associated with?

A

Malnutrition
Uretoplacental insufficiency
Drug abuse