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Registry Review OB/GYN > First trimester Abnormalities > Flashcards

First trimester Abnormalities Flashcards

1
Q

___: bleeding into uterine wall and chorion

A

subchorionic hemorrhage

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2
Q

subchorionic hemorrhage can lead to what

A

spontaneous abortion

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3
Q

S/A subchorionic hemorrhage

A
  • hypoechoic structure between chorion and uterine wall

- usually crescent shaped

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4
Q

what are some risk factors of ectopic pregnancy

A
  • history of PID
  • history of fertility treatment
  • history of tubal surgery or trauma
  • history of previous ectopic
  • IUD
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5
Q

what is the number 1 risk for an ectopic pregnancy

A

history of tubal surgery or trauma

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6
Q

list the most common to least common locations for ectopics to occur

A
  • ampulla
  • isthmus
  • interstitial
  • c section scar
  • ovary
  • abdomen
  • retroperitoneal
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7
Q

___: an ectopic pregnancy that implants at the upper lateral corner of the endometrial cavity near the opening of the Fallopian tube

A

angular pregnancy or corneal pregnancy

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8
Q

an ectopic pregnancy usually occurs on which side

A

the same side as the corpus luteal cyst

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9
Q

where is the most dangerous place for an ectopic to occur

A

interstitial portion of Fallopian tube

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10
Q

what is the classic triad of symptoms for ectopic pregnancy

A
  • pain
  • vaginal bleeding
  • fever
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11
Q

what happens to the HCG levels with an ectopic pregnancy

A

will not increase as fast as in normal intrauterine pregnancy

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12
Q

___: ectopic and IUP coexisting with each other

A

heterotypic pregnancy

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13
Q

what is the drug that is used to treat early enraptured ectopics

A

methotrexate

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14
Q

S/A ectopic pregnancy

A
  • free fluid in cul de sac or adnexa
  • empty gestational sac
  • single decidual layer
  • complex adnexal mass
  • adnexal tubal ring or bagel/donut sign
  • ring of fire sign (increased vascularity)
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15
Q

___: hyperplasia and overgrowth of the trophoblastic material

A

hydatidiform mole or gestational trophoblastic disease

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16
Q

what causes gestational trophoblastic disease

A

two sperm fertilize a single egg

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17
Q

hydatidiform more is associated with what kind of ovarian cyst

A

theca lutein cyst

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18
Q

S/S hydatidiform mole

A
  • excessively high levels of bHCG

- acute onset of maternal systemic HTN in the first trimester

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19
Q

what are the two forms of hydatidiform mole

A

complete and incomplete

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20
Q

which form of hydatidiform mole is the most common

A

complete

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21
Q

which type of hydatidiform mole does not involve a fetus

A

complete

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22
Q

S/A hydatidiform mole

A
  • may be seen with theca lutein cyst
  • enlarged uterus with heterogeneous endometrial cavity (snowstorm appearance)
  • hydropic villi appear as multiple cystic structures within the uterine cavity
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23
Q

which form of hydatidiform mole includes a fetus and a molar pregnancy

A

partial mole

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24
Q

___: invasive malignant molar pregnancy that moves int the myometrium uterine wall and peritoneum

A

chorioadenoma destruens

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25
___: malignant molar pregnancy that metastasizes usually to the liver
choriocarcinoma
26
S/A choriocarcinoma
- can see theca lutein cyst due to elevated bHCG levels - may see masses in the cervix and vagina - highly vascular complex mass
27
what is the most common solid mass found in pregnancy
fibroid
28
which type of fibroid has the highest rate for early pregnancy complications
submucosal
29
which type of fibroid has the highest risk for delivery complications
cervical fibroids
30
if surgical removal of a fibroid is required during pregnancy when should the procedure be preformed
between 16-20 weeks
31
what are some major anomalies seen in the 1st trimester
- acrania - anecncephaly - alobar holoprosencephaly - body stalk anomaly - ectopia cordis - megacystitis - omphalocele - gastroschesis
32
at what gestational age should the NT be done
11-14 weeks
33
the optimal view for the NT includes what things
- echogenic tip of nose - rectangualr palate - translucent diencephalon - nt
34
how is the NT measured
inner to inner
35
what mmt is considered abnormal for an NT
>3mm
36
at what gestational age is the nuchal skin fold measured
15-21 weeks
37
what mmt is considered abnormal for the nuchal skin fold
>6mm
38
S/A acrania
- no calvarium - abnormal brain tissue - Mickey Mouse sign
39
S/A anencephaly
- no calvarium - absent brain tissue above orbits - frog eyes
40
S/A lobar holoprosencephaly
- single ventricle - fused thalami - absent corpus collosum
41
what is the only type of holoprosencephaly that can be detected in the first trimester
alobar
42
S/A cephalocele
-bony defect with intracranial contents protruding
43
S/A ventriculomegaly
-dialted lateral ventricles with dangling choroid plexus
44
S/A open spina bifida
- small or absent IT space - obliterated cisterna magna - thickened brain stem - skin defect
45
S/A dandy walker malformation
- enlarged intracranial translucency space - compressed brainstem - large posterior fossa
46
what are some of the major cranial anomalies seen in the 1st trimester
- acrania - anencephaly - alobar holoprosencephaly - cephalocele - ventriculomeglay - open spina bifida - dandy walker malformation.
47
what are some of the major abdominal anomalies seen in the 1st trimester
- omphalocele - gastroschesis - pentalogy of Cantrell - ectopia cordis - limb body wall complex - bladder extrophy
48
S/A omphalocele
- midline wall defect | - covered by a membrane
49
S/A gastroschesis
- wall defect adjacent to cord insertion - herniated bowel - not covered by membrane
50
S/A pentalogy of cantrell
- midline supra umbilical wall defect - diaphragmatic defect - defect in pericardium - intracardiac defect/ ectopia cordis
51
S/A ectopia cordis
-sternal defect with hear protruding out of chest
52
S/A limb body wall complex
- large wall defect | - short or no umbilical cord with fetus fixed to the placenta
53
S/A bladder exstrophy
- wall defect below the cord insertion | - bladder protrudes outside the body
54
what are the major chest/thorax anomalies seen in the first trimester
- malposition of the heart - abnormal cardiac axis - diaphragmatic hernia - lung agenesis
55
S/A malposition if the heart
-heart in mid or right of chest
56
S/A abnormal cardiac axis
-rotation from axis
57
S/A diaphragmatic hernia
stomach and or liver in the chest cavity
58
S/A lung agenesis or hypoplasia
- absence of echogenic lung tissue surrounding the heart - small thoracic circumference - cardiac malpositon
59
what are the major first trimester skeletal dysplasia findings
- increased NT - short, broken, bowed, absent long bones - asymmetric extremities - shortened ribs, narrow thorax
60
what are the most common neural tube defects
anencephaly and spina bifida
61
___: cephalic end of the neural tube fails to close
anencephaly
62
if cerebral tissue is present but the cranial vault is absent it is considered ___
acrania or exencephaly
63
anencephaly can be see with what other spinal defects
- exophthalmos - macroglossia - polyhydramnios
64
___: lack of cranial bone formation
acrania
65
what is the Mickey Mouse sign that is associated with acrania
-brain tissue droops to the side
66
what are the signs that are associated with spina bifida that are not usually seen in the 1st trimester
banana and lemon sign
67
what are some sonographic markers for trisomy 21
- hypoplasia/absence of nasal bone - AV septal defect - tricuspid regurgitation - echogenic cardiac foci - retrograde A wave on the ductus venosus
68
what are some sonographic findings associated with trisomy 13
- alobar holprosencephaly - midline facial anomalies - megacystitis - severe hydrops - tricuspid regurgitation - retrograde A wave on ductus venous
69
which aneuploidy usually has the largest NT measurement
trisomy 18
70
what are some sonographic findings associated with trisomy 18
- dilated 4th ventricle - choroid plexus cyst - spina bifida - omphalocele - diaphragmatic hernia - severe hydrops - tricuspid regurgitation - retrograde A wave on ductus venous
71
what are some sonographic findings associated with Turner syndrome
- normal nasal bone - tachycardia - hypoplastic left heart - hydrops - renal anomalies - tricuspid regurgitation - retrograde A wave on ductus venous
72
___: complete extra set of chromosomes
triploidy
73
what is the term for an extra paternal chromosome
diandric triploidy
74
what is the term for an extra maternal chromosome
dysgenic triploidy
75
with diandric triploidy: - ___ NT thickness - bhCG ___ - PAPP-A ____ - CRL ____
- increased NT - HCG normal - PAPP-A decreased - normal or short CRL
76
with dysgenic triploidy - ___ NT - bhCG ____ - PAPP-A ___ - CRL ___
- normal NT - bhCG decreased - PAPP-A decreased - severe growth restriction
77
what are some sonographic findings of dysgenic triploidy
- large head with small abdomen - compressed posterior fossa - small placenta - cardiac anomalies - echogenic bowel - spina bifida

Registry Review OB/GYN (31 decks)

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