Abnormalities

Question 1

Sacrococcygeal teratoma

Answer 1

abnormal gastrulation from reminents of the primitive streak.

Most common tumor in new born: 1 in 37000

Pluripotent cells

Question 2

Caudal dysgensis

Answer 2

Abnormal gastrulation

a group of syndromes resulting from insufficient mesoderm formation in the caudal region

Question 3

Charchteristics of caudal dysgensis

Answer 3

• hypoplasia and fusion of the lower limbs
  -anamolies of lumbar and sacral vertebrae
  -agents is of kidney and urinary tract
  -agensis of internal genital organs
  Imporforate anus: from improper migration of caudal mesoderm to anal membrane

Question 4

Sirenommelia

Answer 4

causal dysgensis from abnormal gastrulation

Fusion of lower limbs during early development
Rare: 1 in 70000 births

Question 5

Rachischisis

Answer 5

NTD: entire neural tube fails to close

Don’t survive

Question 6

Anencephaly

Answer 6

NTD: neural tube fails to close in cranial region —> most newborns dont survive more than a few hours after birth

Question 7

Spina bifida

Answer 7

NTD: caudal part of neural tube fails to close

Question 8

Spina bifida occupation

Answer 8

Asymptomatic NTD

Question 9

spina bifida with meningiocele

Answer 9

NTD: only meninges protrude from vertebral canal forming a fluid filled sac/cele

Question 10

Spina bifida with meningiomyelocele

Answer 10

NTD: meninges and parts of the spinal cord in the cele (most severe)

Question 11

How to prevent NTDs?

Answer 11

70% Of NTDs prevented from folic acids daily starting 3 months before conception:

400microgram/day
If family history: 1000micrograms (1mg) /day

Question 12

Bladder extrophy

Answer 12

body wall defects (folding)

Question 13

Gastroschisis

Answer 13

body wall defects (folding)

Question 14

Risk of birth defects and organogenesis. when is the critical period?

Answer 14

embryonic period from week 3 to * is the clinical period and the most vulnerable period for induction of birth defects

Question 15

Placenta acreta

Answer 15

Placental abnormality: abnormal adherence of chorionic villi to myometrium

Question 16

Placenta increta

Answer 16

Placental abnormality: chorionic villi invades deeply in the myometrium

Question 17

Placenta percreta

Answer 17

Placental abnormality: chorionic villi penetrates the full thickness of the myometrium

Presentation: retained placenta and postpartum hemorrhage

Question 18

Placenta previa

Answer 18

Placental abnormality: the blastocysts implants close to or overlying the internal opening of the cervix partially or completely causing the need for a C-section

Presentation: late pregnancy bleeding

Question 19

Oligiohydraminos

Answer 19

too little amniotic fluid (about 400mL in late pregnancy)

• may indicate renal agensis

Question 20

Causes of oligiohydraminos

Answer 20

1) reduced fetal urine output: from renal abnormalities or kidney agensis

2) increased clearance (fluid is lost too quickly): premature rupture of the membrane or chromosomal abnormalities

Question 21

polyhydraminos

Answer 21

too much amniotic fluid (about 2000mL late pregnancy)

May indicate anencephaly, esophageal atresia, and is commonly associated with maternal diabetes

Question 22

Causes of polyhydraminos

Answer 22

1) reduced clearance: mainly due to obstructive anamolies of the GI tract (esophageal atresia), and reduced fetal swallowing (fetal CNS malformation, anencephaly)(decreased swallowing reflux)

2)increased production: multiple pregnancy, diabetes, and 50% idiopathic

Question 23

The points conjoined twins are united at

Answer 23

1) thorax (thoracopagus) : most common
2) sacral region (pygopagus)
3)head (craniopagus)

Question 24

Twin pregnancy has a high incidence of

Answer 24

-prenatal mortality
-preterm delivery
-small birth weight
-twin transfusion syndrome

Question 25

Twin transfusion syndrome

Answer 25

the twins must share the same placenta (in 5 to 15% of monozygotic twins) -both share placenta, but circulation is unbalanced