Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fall 2014 - OB II > High Risk Pregnancy ✔️ > Flashcards

High Risk Pregnancy ✔️ Flashcards

0
Q

describe 1st trimester testing

A

looks for pattern of biochemical markers associated with plasma protein A (PAPP-A)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

maternal high risk factors

A 
advanced maternal age - AMA
abn maternal lab values
vaginal bleeding
insulin dependent diabetes mellitus
HTN
preeclampsia
maternal systemic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe 2nd trimester screening

A

performed with maternal serum quad screen lab value and targeted US exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

quad screen looks at following serum markers:

A

AFP
HCG
uE3
inhibin-A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

define hydrops fetalis

A

condition in which excessive fluid accumulates within fetal body cavities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

2 classifications of fetal hydrops

A

immune hydrops

non-immune hydrops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is hydrops fetalis associated with

A 
anasarca - massive edema
ascites
pericardial effusion
pleural effusion
placental edema
polyhydramnios
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe immune hydrops

A

results from fetomaternal blood group incompatibility

blood group isoimmunization

Rh isoimmunization

indicated by presence of maternal serum antibody acting again fetal RBC antigen - sensitization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

immune hydrops (IHF) Rh sensitization:

A

Rh- mom

Rh+ fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe Rh sensitization

A

antibodies attack RBC’s
fetal hemolysis
hemolytic anemia
cardiac output > eventually leads to hydrops & erythroblastosis fetalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what may be needed if Rh sensitization is present

A

blood transfusion in utero

O- blood transfusedd into umbilical vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

immune hydrops - perinatal death rate for Rh-sensitized pregnancies is _____% to _____% before intrauterine transfusions performed

A

25-35

**perinatal death rate has decreased significantly with modern treatment and care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

an Rh ______ father and an Rh ______ mother my conceive an Rh positive baby

A

positive father

negative mother

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

immune hydrops sonographically

A 
scalp edema
pleural effusion
pericardial effusion
ascites
polyhydramnios
thickened placental > 5 cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what does the indirect coomb’s test check for

A

maternal Rh antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

immune hydrops - potential of fetal anemia can be determined by

A

US surveillance - doppler of MCA

amniocentesis

cordocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

immune hydrops is rare today dut to ______

A

RhoGam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe alloimmune thrombocytopenia

A

rare

mother may develop immune response to fetal platelets in manner similar to that of RBC’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

describe nonimmune hydrops

A

not a result of fetomaternal blood group incompatibility

disorders - cardio, chromo, hematologic, urinary, pulmonary, twin pregnancies, infectious diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

to make a diagnosis of NIH (nonimmune hydrops), isoimmunization ruled out with _______ _______

A

antibody screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

nonimmune hydrops statistics

A

1 in 1500 to 1 in 3800 pregnancies

accounts for 90% of all hydrops cases

accounts for 3% of fetal mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

nonimmune hydrops sonographically

A 
scalp edema
pleural effusion
percardial effusion
ascites
cardiac abn's
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

bleeding in the 2nd and 3rd trimesters can be associated with what placental anomalies

A

placenta previa

placenta abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

_______ _______ is the main cause for 3rd trimester bleeding

A

placenta previa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

describe placenta previa

A

placenta covers internal cervical os and prohibits vaginal delivery of fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

______ ______ is a rare condition in which umbilical cord is presenting part

A

vasa previa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

_______ ________ is used to evaluate any structures in front of the cervical os to see if vascular

A

color doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

________ ________ may cause vaginal bleeding during pregnancy

A

placental abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

describe placental abruption

A

hypoechoic and 1-2 cm thick

thicker than 1-2 cm may be due to abruption or contraction

contraction should resolve within 20-30 minutes - use color doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

retroplacental area will look __________ due to large number of blood vessels present

A

hydoechoic

**blood clots from abruption will not ehibit color flow

30
Q

when sweeping with color doppler retroplacentally looking for flow void, if flow void is ________, be suspicious of abruption

A

present

31
Q

2 categories of maternal diabetes

A

overt

gestational

32
Q

describe overt diabetes

A

prior to pregnancy (IDDM or NIDDM)

33
Q

describe gestational diabetes

A

manifests during pregnancy (GDM)

34
Q

anomalies in IDM’s (infants of diabetic moms)

A

**CARDIAC - most common in occurance - transposition of great vessels and VSD

single umbilical artery

polyhydramnios

IUGR - due to UPI secondary to vasc insufficiency

thin placenta

**Caudal Regression Syndrome - most exclusive anomaly of a diabetic mother

35
Q

describe caudal regression syndrome

A 
broad spectrum of findings:
   sacral agenesis**
   bowel
   renal
   bladder
   msk
36
Q

gestational diabetes sono findings

A

macrosomia - > 4,000 g (> 9 lbs)

increased plcental thickness - > 5 cm

polyhydramnios

37
Q

3 stages of hypertension

A

PIH - pregnancy induced HTN - younder moms

chronic HTN (essential) HTN - older moms

chronic HTN aggrevated by pregnancy

38
Q

hypertension is associated with

A

small placentas

preeclampsia - high HTN, proteinuria, edema
severe preeclampsia - deliver immediately
eclampsia - preeclampsia + seizures/coma = death

39
Q

PIH (pregnancy induced hypertension) involves what 3 things…

A

preeclampsia

severe preeclampsia

eclampsia

40
Q

describe supine hypotension syndrome

A

IVC is compressed > hypotension > mother feels nausated, dizzy, sweaty

41
Q

describe systemic lupus erythematosus

A

chronic autoimmune disorder
inflammatory responses in the placental vessels
> incidence of spontaneous abortion & fetal death
monitor fetus to r/o congential heart block & pericardial effusion
incidence of spontaneous abortion and fetal death is 22%-49%

42
Q

describe HELLP syndrome

A

Hemolysis
Elevated Liver Enzymes
Low Platelets
Pre-eclampsia findings

multisystemic ideopathic disorder > may lead to serious fetal compromise

43
Q

describe hyperemesis gravidarum

A

vomiting - dehydration and electrolyte imbalance

hospitalization with IV

associated with H-mole and twin pregnancy

44
Q

name 2 urinary tract diseases

A

pyelonephritis with flank pain

hydronephrosis

45
Q

example of an adnexal cysts

A

physiologic ovarian cysts

46
Q

uterine fibroids can cause _______ and _______ _______

A

pain and premature labor

47
Q

premature labor can be caused by

A 
maternal illness
epidemiologic factors
class
age
weight/height
smoking
cervial injury
coitus
bleeding
PROM
infections
multiple pregnancy
48
Q

US assessment of preterm labor patient should include

A 
amniotic fluid assesssment
cervical assessment
fetal number
placental assessment
targeted US
49
Q

intrauterine fetal death accounts for roughtly ______ of all perinatal mortality

A

1/2

50
Q

US findings associated with fetal death are

A

absent heart beat
absent fetal movement
overlap of skull bones (spalding’s sign)
exaggerated curvature of fetal spine; gas in fetal abd

51
Q

multiple gestation pregnancy basics

A

fetus closest to internal os is A
in 1st tri, if side by side, position may change
document membrane separating the fetus - diamniotic
gender is important
cord doppler

52
Q

what should be documented during an exam for multiple gestations

A 
number of sacs
number and location of placenta
gender of fetuses
biometry
presence of anomalies
53
Q

increased incidence and risk of multifetal pregnancy

A

incidence:
due to older age of childbearing
assisted reproductive technologies

risk:
IUGR, incompetent cx, premature delivery

54
Q

clincal findings of multiple gestations

A 
LGA
abn quad screen
2 heart beats
palpate 2 heads
unsuspected
55
Q

multiple gestation growth measurements

A

predictors of discordant growth

EFW difference > 20%
BPD difference of 6 mm
AC difference of 20 mm
FL difference of 5 mm

56
Q

2 types of twinning

A

**dizygotic - 2 ova fertilized

monozygotic - 1 ovum fertilized

57
Q

describe dizygotic twins (fraternal)

A 
2 separately fertilized ova
each ovum implants separately
2 placentas - may be fused
2 chorion/2 amnion
NOT genetically identical
diamniotic, dichorionic
58
Q

describe monozygotic twins

A

single fertilized ovum divides

genetically identical fetuses - game gender

59
Q

early division monozygotic twins

A

0-4 days

2 chorion and 2 amnion (DC/DA)

60
Q

divison of monozygotic twins days 4-8

A

MOST COMMON

1 chorion and 2 amnion (MC/DA)

61
Q

division of monozygotic twins after 8 days

A

1 chorion and 1 amnion (MC/MA)

62
Q

division of monozygotic twins after 13 days

A

incomplete - conjoined twins (MC/MA)

63
Q

2 placentas are called

A

dichorionic

64
Q

1 placentas is called

A

monochorionic

65
Q

Chorionicity/Amnionicity in relation to:

twin peak sign or lambda
thick membrane
thinner membrane
absence of membrane

A

twin peak sign or lambda - DC/DA
thick membrane - DC/DA
thinner membrane - MC/DA
absence of membrane - MC/MA

66
Q

describe twin to twin transfusion (TTS)

A

typically MC/DA

due to A-V communication within the placenta

67
Q

twin to twin transfusion donor and recipient

A

donor:
severe IUGR
oligohydramnios
“stuck twin”

recipient:
polyhydramnios
hydrops fetalis

68
Q

describe poly-oli sequence (stuck twin)

A

poly in one sac (recipient) and oligo in the other sace (donor)

16-26 weeks gestation

MC/DA

69
Q

describe conjoined twins

A

incomplete division of the embryo after 13 days

70
Q

types of conjoined twins

A 
thoracopagus - thoras
omphalopagus - anterior wall
craniopagus - cranium
pygopagus - ischial
ischiopagus - buttocks
71
Q

describe twin reversed arterial perfusion (trap)

A

must be monochorionic pregnancy
vein to vein and artery to artery anastamosis
one twin is acardiac and nonviable
other twin normally formed twin is “pump” twin

72
Q

describe fetus papyraceous

A

a fetus which dies in the 2nd trimester of pregnancy and becomes compressed and parchment-like

Fall 2014 - OB II (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions