Fetal & Maternal Complications

Question 1

When is a fetus considered to be IUGR?

Answer 1

< 10% percentile for GA

pg. E 192

Question 2

What are the maternal causes for IUGR?

Answer 2

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

Question 3

What are the placental causes for IUGR?

Answer 3

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

Question 4

What are the fetal causes for IUGR?

Answer 4

genetic or chromosomal defects
intrauterine infection
pg. E 192

Question 5

What is a symmetric IUGR?

Answer 5

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

Question 6

What is asymmetric IUGR?

Answer 6

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

Question 7

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

Answer 7

> 3.0 after 30 weeks

pg. E 193

Question 8

What is erythroblastosis fetalis?

Answer 8

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

Question 9

What is hydrops fetalis?

Answer 9

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

Question 10

What is immune hydrops?

Answer 10

hydrops due to Rh isoimmunization

Question 11

What is non-immune hydrops?

Answer 11

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

Question 12

What are the sonographic findings of hydrops fetalis?

Answer 12

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

Question 13

What is the songraphic appearance of fetal demise?

Answer 13

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

Question 14

What are the effects of diabetes mellitus on pregnancy?

Answer 14

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

Question 15

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

Answer 15

IUGR

pg. E 200

Question 16

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

Answer 16

macrosomia

pg. E 200

Question 17

What is macrosomia?

Answer 17

birth weight > 4000 g

> 90th %

Question 18

What are some maternal complications with diabetes?

Answer 18

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

Question 19

Why would a glucose intolerance test be taken?

Answer 19

patient with diabetes to help manage pregnancy

pg. E 201

Question 20

What systolic pressure is considered hypertension?

Answer 20

> 140 mm Hg

pg. E 201

Question 21

What is pre-eclampsia?

Answer 21

hypertension
edema
proteinuria
rapid weight gain
pg. E 201

Question 22

What is eclampsia?

Answer 22

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

Question 23

What are the TORCH infections?

Answer 23

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

Question 24

How does HTN affect a pregnancy?

Answer 24

IUGR
prematurely mature placenta
oligohydramnios
pg. E 204

Question 25

How does Type 1 diabetes affect a pregnancy?

Answer 25

IUGR thin placenta oligo or poly pg E 204

Question 26

How does gestational diabetes affect a pregnancy?

Answer 26

Macrosomia placentamegaly polyhydramnios pg. E 204

Question 27

How does infection (TORCH) affect a pregnancy?

Answer 27

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

Question 28

What is an incompetent cervix?

Answer 28

premature dilatation of cervix | pg. E 206

Question 29

What are the songraphic findings of an incompetent cervix?

Answer 29

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

Question 30

What is considered preterm labor?

Answer 30

onset before 37 weeks | pg. E 208

Question 31

What is premature rupture of membranes (PROM)?

Answer 31

spontaneous rupture of membranes prior to labor | pg. E 208

Question 32

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

Answer 32

hydronephrosis (right side more common) | pg. E 209

Question 33

Why do fibroids enlarge through a pregnancy?

Answer 33

estrogen stimulation | pg. E 209

Question 34

What is the typical size of the postpartum UT?

Answer 34

14 x 7 x 7 cm | pg. E 218

Question 35

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

Answer 35

puerperal period 4-6 weeks pg. E 218

Question 36

What are the sonographic findings of a postpartum UT?

Answer 36

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

Question 37

What is the most lethal complication in the puerperal period?

Answer 37

postpartum hemorrhage | pg. E 219

Question 38

What is a postpartum hemorrhage?

Answer 38

blood loss greater than 500 mL following a vaginal delivery | pg. E 219

Question 39

What is associated with postpartum hemorrhage?

Answer 39

``` retained products of conception UT atony UT overdistention UT manipulation pg. E 219 ```

Question 40

What are the clinical signs of postpartum infection?

Answer 40

``` elevated body temp increased WBC's tachycardia UT tenderness pg. E 220 ```

Question 41

What is associated with infection?

Answer 41

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

Question 42

What would an abscess appear as sonographically?

Answer 42

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

Question 43

What is a hematoma?

Answer 43

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

Question 44

What are the sonographic findings of a hematoma?

Answer 44

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

Question 45

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

Answer 45

Increased resistance Decreased diastolic flow URR Exam

Question 46

In IVF where is the embryo placed?

Answer 46

Uterus | URR Exam

Question 47

When is a glucose screening performed?

Answer 47

24-28 weeks

Question 48

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

Answer 48

Hepatomegaly

Question 49

Where does fetal anemia most likely cause increased flow?

Answer 49

Umbilical vein Middle cerebral artery Descending aorta

Question 50

What is asymmetric IUGR associated with?

Answer 50

Malnutrition Uretoplacental insufficiency Drug abuse