Board Questions Flashcards
Still birth eval
Still birth term cause
Still birth risk factors
- hp
- fetal autopsy (30%)
- placenta eval (30%)
- fetal karyotype (8%) through amnio prior del > umbilical cord seg
- Least helpful: KB, syphilis, cups anticoagulant, anticardiolipin antibodies, B2glycoporetin antibodya
- Don’t order: routine testing for inherited thrombophilias
- mostly unknown cause
- old, fat, poor, first pregnancy or many pregnancies before,
Risk of death and neurological injury for
1) dichorioinc
2) monochorionic twins
AFTER 14w
1) di: death 3% death other, 1% neurological do other
2) mono: 15% death other, 18% neurological do other
(First trimester vanishing twin di/di, almost no effects)
WArfarin effects in pregnancy
- readily crosses the placenta
- “warfarin embryopathy” = nasal and midline facial hypoplasia, stippling of the vertebral and femoral epiphyses (rings near epiphyseal plates on US)
Lithium effects pregnancy
Epstein anomaly, downward displacement of tricuspid valve
methamphetmaine effects pregnancy
FGR
Retinoic Acid exposure pregnancy
1st tri: spontaneous abortion and microtia and anotia (small/no ears)
alpha thal racial least asosciated with
- northern european
- Very much correlated with: African West Indian, mediterranean, southeast asian
- cannot be dx on eletrophoresis
- South Asian more likely to have hem BART (two gene deletions in CIS chromosome (hydrops fetalis)
Antibodies:
1) duffy
2) kell
3) kidd
4) Lewis
5) Lutheran
6) I
1) duffy = severe hemolytic anemia
2) kell = severe hemolyic anemia, TITER DOES NOT REP RISK
3) kidd = severe hemolytic anemia
4) Lewis = most recently encountered other then Rh, IgM, does not cross placenta, does not cause hemolytic anemia
5) Lutheran = mild hemolytic anemia
6) I = also most common non-Rh, IgM, doesn’t cross, doesn’t cause problems.
Most effective way to dx CPD
interspinous diameter
LMWH vs UFH
1) both:
- don’t cross the placenta
1) LMWH better than UFH
- lower risk of HITT
- more predictable response
- fewer bleeding episodes
- longer half life (less administrations)
- less bone mineral density loss
- can’t reverse well
2) UFH better than LMWH
- shorter half life (good for delivery)
- can assess with PTT
typical dose of 3rd trimester Rhogam __, protects against __ transfer of blood
300 mcg
30 mg
risk NTD
1) baseline
2) sibling with it
3) two siblings with it
1) 0.04%
2) 3%
3) 10%
2nd degree tear break down with infection
- treat with abs
- 1st and 2nd degree allow to heal by secondary intention (on own)
neonatal lupus
- transfer of maternal antibodies across placenta
- specifically anti SSA/Ro, anti SSB/La.
- or to moms with SLE, Sjorens
= cuteanous rash+ cardiac findings: heart block - need regular fetal echocardiograms (weekly, or every other week)
fetal-maternal hemorrhage most likely to occur during:
- vaginal delivery (reasons everyone gets Rhogam)
- give up to 72h pp, but also up to 28d pp
- 300 mcg covers 30mL whole blood, 15mL PRBC
syphilis chart of phases
see chart attached
sphyilis rash
Target lesions hands/feet
Coagulation cascade and anticlotting drugs to memorize
Memorize
When to do each type of genetic fetal screen
The rates of detecting downs syndrome with it
fetal circulation
