Chapter 32 Fetal Environment And Maternal Complications Flashcards
(118 cards)
1
Q
What would increase the likelihood of developing placenta previa?
A
Previous C-section
2
Q
_______is described as the situation in which the placenta edge extends into the lower uterine segment but ends more than 2cm away from internal os
A
Low-lying placenta
3
Q
Mothers with gestational diabetes run the risk of having fetuses that are considered:
A
Macrosomic
4
Q
Doppler assessment of the middle cerebral artery can evaluate the fetus for:
A
Hypoxia
5
Q
The measurement that should be carefully scrutinized in cases of IUGR is the:
A
AC
6
Q
The abnormal insertion of the umbilical cord into the membranes beyond the placental edge is termed:
A
Velamentous insertion
7
Q
The cervix should measure at least _____ in length
A
3cm
8
Q
IUGR is evident when the EFW is:
A
Below the 10th percentile
9
Q
What is associated with polyhydramnios:
A
- Omphalocele
- Gastroschisis
- Esophageal atresia
10
Q
Evidence of polyhydramnios should warrant a careful investigation of the fetal:
A
Gastrointestinal system
11
Q
Fetal TORCH is frequently associated with:
A
Intracranial calcifications
12
Q
Normally, the S/D ratio:
A
Decreases with advancing gestation
13
Q
The normal umbilical cord insertion point into the placenta is:
A
Central
14
Q
A velamentous cord insertion is associated with:
A
Vasa previa
15
Q
Increased S/D ratio is associated with:
A
*IUGR
*Placental insufficiency
*Perinatal mortality
16
Q
Nonimmune hydrops is associated with:
A
- Pleural effusion
- Turner syndrome
- Fetal infections
17
Q
The maternal contribution to the placenta is the:
A
Decidua vera
18
Q
A succenturiate lobe of the placenta refers to a:
A
Accessory lobe
19
Q
The fetal contribution of the placental is the:
A
Chorion frondosum
20
Q
_______would be least likely associated with immune hydrops:
A
Leiomyoma
21
Q
The placenta is considered too thick when it measures:
A
> 4cm
22
Q
What is associated with a thin placenta (3):
A
- Preeclampsia
- IUGR
- Long-standing diabetes
23
Q
What would be most likely confused for a uterine leiomyoma?
A
Myometrial contration
24
Q
What is associated with a thick placenta:
A
- Fetal infections
- Rh isoimmunization
- Multiple gestations
25
Placenta accrete denotes:
The placenta adheres to the myometrium
26
Clinical features of placental abruption:
* Vaginal bleeding
* Uterine tenderness
* Abdominal pain
27
The most common placental tumor is the:
Choriangioma
28
What is associated with oligohydramnios:
*Bilateral renal agenesis
*Infantile polycystic kidney disease
*Premature rupture of membranes
29
The normal umbilical cord has:
Two arteries and one vein
30
The placenta releases ______ to maintain the corpus luteum
hCG
31
An anechoic mass is noted within the umbilical cord during a routine sonographic exam, what is the diagnosis?
Allantoic cyst
32
With Rh isoimmunization, the maternal antibodies cross the placenta and destroy the fetal:
RBC
33
Mothers with presentational diabetes as opposed to gestational diabetes, have an increase risk of a fetus with:
Neural tube defect
34
Pools of maternal blood noted within the placental substance are referred to as:
Maternal lakes
35
When the placenta completely covers the internal os, it is referred to as:
Total previa
36
One of the most common causes of painless vaginal bleeding in the second and third trimester is:
Placenta previa
37
Doppler sonography reveals vascular structures coursing over the internal os of the cervix. this is indicative:
Vasa previa
38
Penetration of the placenta beyond the uterine wall would be referred to as:
Placenta percreta
39
Pregnancy-induced maternal high blood pressure and excess protein in the urine after 20 weeks is termed:
Preeclampsia
40
Insertion of the umbilical cord at the edge of the placenta is referred to as:
Marginal cord insertion
41
Placental thickness should not exceed _____
4cm
42
______is an abnormally shaped placenta caused by the membranes inserting inwards from the edge of the placenta producing a curled-up plecental
Circumvallate placenta
43
________ are pools of maternal blood within the placental substance
Venous lakes
44
Abnormal cord insertion sites are described as:
Marginal or velamentous
45
The umbilical cord may be seen encircling the fetal neck, this is called:
Nuchal cord
46
______are linear bands of scar tissue within the uterus
Uterine synechiae (amniotic sheets)
47
Uterine synechaie are the result of:
Intrauterine adhesions
48
Those with an increased risk of preeclamsia include:
*Advanced maternal age
*Diabetic patients
*Gestational trophoblastic disease
49
_______is a common benign smooth muscle uterine tumor
Leiomyoma (Fibroid)
50
With _______ diabetes, the mother already has a history of diabetes
Pregestational
51
Retained products of conception is typically treated with:
Dilation and curettage
52
Incompatibility between the fetal and maternal RBC, a condition known as:
Erythroblastosis fetalis
53
The treatment of an incompetent cervix is a:
Cerclage
54
TORCH is an acronym that stands for:
* Toxoplasmosis
* Other infections
* Rubella
* Cystomegalovirus
* Herpes
55
Echogenic debris in the amniotic fluid may be:
Vernix or Meconium
56
Normally, the S/D ratio will ______ with advancing gestation
Decrease
57
The cord develops from the fusion of the:
Yolk stalk and vitelline duct (omphalomesenteric duct)
58
Marginal cord insertion is at the:
Edge of the placenta
59
_______ are the most common placental tumor
Chorioangioma
60
The most common location of a chorioangioma is:
Adjacent to the umbilical cord insertion site at the placenta
61
_______often results in only a few centimeters of placental separation
Partial abruption
62
The ______is the element of the placenta closest to the fetus
Chorionic plate
63
The ______is the area adjacent to the uterus
Basal layer
64
_______denotes the insertion of the umbilical cord into the membranes beyond the placental edge
Velamentous cord insertion
65
An ________is a mass that may be noted in the umbilical cord adjacent to the umbilical vessels
Allantoic cyst
66
_______is essentially the focal dilation of the abdominal portion of the umbilical vein
Umbilical vein varix
67
_______is the painless dilation of the cervix in the second or early third trimester
Cervical incompetence
68
______is a result of the premature opening of the internal os and the subsequent bulging of the membranes into the dilated cervix
Funneling of the cervix
69
_______is defined as the presence of pregnancy induced hypertension accompained by proteinuria
Preeclampsia
70
_______diabetes, which is the most common type of diabetes during pregnancy, is pregnancy induced
Gestational
71
The major risk for the fetus of a mother with gestational diabetes is:
Macrosomia
72
The normal postpartum uterus returns to its normal nongravid size ______ after delivery
6 to 8 weeks
73
______ occurs when the mother has RH- negative blood and the fetus has Rh positive blood
Maternal Rh sensitization
74
_______is caused by the absence of a detectable circulating fetal antibody against the RBC in the mother
Immune hydrops
75
________occurs when there is an accumulation of fluid within at least two fetal body cavities
Fetal hydrops (hydrops fetalis)
76
The ______is defined as a fetus that has an EFW of greater than the 90th percentile
Obese fetus
77
________is a rare disorder in which the mother suffer from edema and fluid buildup similar to hydropic fetus
Maternal mirror syndrome
78
The prevention of immune hydrops caused by Rh sensitization is the administration of:
RhoGAM (Rh immune globulin)
79
________is defined as an estimated fetal weight (EFW) that is below the 10th percentile at a given gestational age
IUGR
80
In the neonatal period ________ is technically defined as the neonate that measure more than 4,500g in nondiabetic mothers and 4,000g in diabetic mothers
Macrosomia
81
The two most commonly performed cerclage techniques are the:
*Shirodkar
*The McDonald
82
The right and left middle cerebral arteries are branches of the anterior portion of the:
Circle of Willis
83
The measurement that should be scrutinized closely in fetuses that are at risk for growth abnormalities is the:
Abdominal circumference (AC)
84
The most widely accepted means of evaluating the volume of amniotic fluid is the:
Amniotic fluid index (AFI)
85
The _______assesses the vascular resistance in the placenta by taking a sample of the umbilical artery
S/D ratio
86
The umbilical vessels are surrounded by a gelationous material called ________ which is covered by a single layer of amnion
Wharton jelly
87
_______often results in the development of a retroplacental hematoma, which is located between the placenta and the myometrium
Complete abruption
88
______is defined as the abnormal adherence of the placenta to the myometrium in an area where the decidual is either absent or minimal
Placenta Accreta
89
______is the premature separation of the placenta from the uterine wall before the birth of the fetus
Placental abruption
90
______ lies at the edge of the placenta and the most common placental hemorrhage identified with sonography
Marginal abruption
91
The complication of fetal vessels resting over the internal os of the cervix is called:
Vasa previa
92
Implantation of the placenta may occur within the lower uterine segment which leads to the placenta covers the internal os is called
Placenta previa
93
The placenta normally weighs between _____ and has a diameter of ______
*450 and 550g
*16 to 20cm
94
The placenta consists of approximately ________ cotyledons, which are groups or lobes of chorionic villi
10 to 30
95
The ________contains the functional parts of the placenta and is located between the chorionic plate and the basal layer
Placental substance
96
Sonographic findings of retained products of conception
1. Echogenic intracavitary mass that may contain some calcifications
2. Color doppler signals within the retained placental tissue
97
Sonographic findings of bladder flap hematoma
1. Anechoic or complex mass located between the lower uterine segment and the posterior bladder wall
98
Sonographic findings of cervical incompetence
1. Cervical length of less than 3cm
2. Funneling of the cervix (can produce a "U" or "'V" shape)
99
Sonographic findings of hemangiomas of the umbilical cord
1. Solid hyperechoic mass within the umbilical cord
2. Most often noted close to the insertion into the placenta
100
Sonographic findings of allantoic cysts
1. Cystic mass within the umbilical cord
2. Most often noted closed to the fetal abdomen
101
Sonographic findings of uterine synechia(e)
1. Linear, echogenic band of tissue traversing the uterine cavity
2. The band does not involve fetal parts and the normal fetus appears to move freely
102
Sonographic findings of a chorioangioma
1. Solid hypoechoic or hyperechoic mass within the placenta
103
Sonographic findings of placenta accreta, increta and percreta
1. Placenta previa
2. Loss of the normal hypoechoic interface between the placenta and the myometrium
104
Sonographic findings of placental abruption
1. Hematoma located either at the edge of the placenta or between the placenta and the myometrium
105
Sonographic findings of vasa previa
1. Identification of vessels over the internal os of the cervix with the use of color doppler
2. Velamentous cord insertion
106
Sonographic findings of preeclampsia and eclampsia (5):
1. Oligohydramnios
2. IUGR
3. Gestational trophoblastic disease
4. Placental abruption
5. Elevated S/D ratio
107
Sonographic findings of fetal hydrops (4):
1. Fluid accumulation within at least two fetal body cavities
2. Fetal hepatosplenomegaly
3. Polyhydramnios
4. Thickened placenta
108
Sonographic findings of fetal alcohol syndrome
1. Microcephaly
2. Dysgenesis of the corpus callosum
3. Long round philtrum
4. Malformed ears
5. Microphthalmia
6. Cleft palate
7. Heart defect such as ventricular septal defects
109
Sonographic findings of TORCH (5):
1. Intracranial calcifications
2. Microcephaly
3. Microphthalmia
4. Ventriculomegaly
5. Hepatosplenomegaly
110
Clinical findings of retained products of conception
1. Postpartum vaginal bleeding
111
Clinical findings of bladder flap hematoma
1. Recent C-section
112
Clinical findings of eclampsia
1. Long-standing, uncontrolled preeclampsia
2. Headaches
3. Seizures
113
Clinical findings of preeclampsia
1. Maternal hypertension
2. Maternal edema
3. Maternal proteinuria
114
Clinical findings of cervical incompetence (3):
1. Painless dilation of the cervix
2. Premature rupture of membranes
3. Vaginal bleeding
115
Clinical findings of a chorioangioma
1. Possible elevation in maternal serum alpha-fetoprotein (MSAP)
116
Clinical findings of placenta previa
1. Previous c-section or uterine surgery
2. Painless vaginal bleeding
3. Possibly asymptomatic
117
Clinical findings of placenta accreta, incretam and percreta
1. Previous c-section or uterine surgery
2. Painless vaginal bleeding if placenta previa is present
3. Possibly asymptomatic
118
Clinical findings of placental abruption
1. Abdominal pain
2. Possible vaginal bleeding
3. Uterine contractions
4. Uterine tenderness
