AN care TOGs

Question 1

% of preg with fetal arrhythmias

Answer 1

3%

Question 2

Maternal cause for fetal cardiac disorders

Answer 2

• SLE- Anti Ro/Anti La antibodies
• Crosses the placenta from 16w

Question 3

Mx of women w anti Ro/La

Answer 3

P0 or prev unaffected baby:
- Fetal echo at 20w
- FH w doppler every 2 weeks

Prev preg affected by heart block:

• Hydroxychloroquine from 10 weeks
  (does not work if no past hx)
• Fetal ECHO at 18w

Question 4

How to assess fetal arrthymias

Answer 4

• USS + doppler
• M mode- to see the heart
• Fetal ECG
• Extracardiac US

Question 5

Most common fetal arrthymia

Answer 5

Ectopic beats
Usually self resolve

Question 6

Treatment for tachyarrthymias

Answer 6

• Individualised- depends on gestation, cardiac US
• Can use digoxin, flecainide,sotalol

Question 7

Bradycardia mx

Answer 7

• Give mum steroids or immunoglobulins
• Ventricular rate of 60bpm wo hydrops is good

Question 8

% of neurological sequelae in CMV

Answer 8

10-25%

Question 9

Primary CMV- IU transmission rate

Answer 9

30-40%

Question 10

Secondary CMV IU transmission rate

Answer 10

1-2%

Question 11

When to perform amnio for CMV

Answer 11

• 7 weeks after infection or >21weeks

Question 12

Cervical length and PTB in twins

Answer 12

Scan at 20-24 weeks
- <25mm - 25% chance before 28w
- <20mm - 42% before 32w
- <20mm - 62% before 34w

Question 13

Xrays/CT at what gestation has the highest risk of FGR

Answer 13

5-10weeks

Question 14

Greatest risk of CNS changes and most teratogenic changes

Answer 14

• 10-17weeks

Question 15

Accepted dose of radiation in pregnancy

Answer 15

• 5rad

Question 16

% of gastro anomalies

Answer 16

10%

Question 17

Omphalocele vs Gastroschisis

Answer 17

Omphalocele:
- Central,ventral abdominal wall defect THROUGH the umbilicus with umbilical cord insertion at its apex.

Covered by sac

Gastroschisis:
- Paraumbilical defect in the anterior abdominal wall. The umbilical cord is normally inserted,with the defect commonly to the right.

Exposed gut

Question 18

% of immune hydrops fetalis (from maternal antibodies)

Answer 18

1%

Question 19

Causes of non-immune hydrops

Answer 19

• Parvovirus B19/
  Infections
• Cardiac causes
• Chromosomal causes

Question 20

Mosaicism in CVS sample

Answer 20

1-2%

Question 21

Incidence of spyphilis

Answer 21

1/700-1/7000

Question 22

Presentation

Answer 22

• Chancre- single papule, non purulent, painless

Then 2ndary infection 4-10 weeks after-
Generalised illness

Question 23

Mx of syphilis

Answer 23

Pen G or cefriaxone

Resistance now to erythromycin

Question 24

Jarisch–Herxheimer reaction

Answer 24

• Excessive release of cytokines in first 24h of treatment.