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Structures: Part Deux > LEC49: Late Fetal Period & Twins > Flashcards

LEC49: Late Fetal Period & Twins Flashcards

(66 cards)

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1
Q

fragment of time OBGYNs measure trimesters by

A

weeks, not months

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2
Q

1st trimester time pd

A

weeks 1-13

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3
Q

2nd trimester time pd

A

weeks 14-27

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4
Q

3rd trimester time pd

A

weeks 28-40

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5
Q

what occurs during 1st trimester

A

major organ systems form

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6
Q

what occurs during 2nd trimester

A

fetal growth, differentiation- organ systems develop ability to take on roles, fxns as they should in a born baby

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7
Q

ultrasound fxn

A

allows to visualize fetus, see anomalies

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8
Q

when is fetus viable

A

24 weeks from LMP, end of 2nd trimester

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9
Q

when is fetus peri-viable?

A

23 weeks

may survive

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10
Q

what occurs during 3rd trimester

A

continued growth, maturation, development of embryo

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11
Q

why is it important to accurate date pregnancy?

A

many things occur at very specific times during pregnancy so must know accurately how old fetus is

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12
Q

when can visualize fetal heart beat on U/S?

A

6 weeks from LMP, 4 weeks since conception

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13
Q

what are carnegie stages?

A

why to visualize embryonic pd of fetal development - til 8 weeks, 10 weeks from LMP
visualize by morpholgy, not just by age

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14
Q

CRL

A

crown-rump length: measure from crown of head to rump- accurate for dating fetus within 3-5 days

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15
Q

when can use CRL?

A

7-13 weeks

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16
Q

weeks 9-12 features

A

1) head = 1/2 CRL of fetus
2) eyes fused
3) ears low
4) see some ossification cts appear in skeleton

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17
Q

when do primary ossification cts appear?

A

end of 12th week

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18
Q

weeks 13-16 highlights

A

1) coordinated limb movements
2) ossification of skeleton active
3) scalp hair patterning determined
4) genetalia recognizable
5) eyes anterior

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19
Q

17-20 week highlights

A

1) mother feels movement
2) skin covered w/ vernix
3) fine lanugo hair present
4) brown fat forms- heat production
5) anatomy US routinely performed

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20
Q

what is vernix

A

waxy white protection over skin

appears weeks 17-20

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21
Q

why might baby at 24 weeks have trouble w/ heat production

A

brown fat hasn’t formed

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22
Q

when is uterus at level of umbilicus/bellybutton?

A

20 weeks since LMP

1 cm from pubic symphysis=1 week

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23
Q

21-24 weeks features

A

1) skin wrinkled, translucent
2) beginning of surfactant production
3) viability est

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24
Q

26-29 weeks features

A

1) lungs more developed
2) CNS can control rhythmic breathing, body temp
3) eyelids open at 26 weeks
4) subcutaneous fat

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25
30-34 weeks features
1) skin pink, smooth 2) 32 weeks decreased risk of bleed in brain 3) majority survive
26
when do eyelids open
26 weeks
27
when is preterm
< 27 weeks
28
when is early term
37-38+6 weeks
29
when is full term
39-40+6 weeks
30
when is post term
42+ weeks
31
biggest risk factor for having a preterm birth?
if mom has prior hx of having preterm birth
32
all risk factors for preterm birth?
1) prior preterm birth 2) uterine anomaly 3) multiple gestation 4) excess amniotic fluid 5) cigarettes/drug use 6) intrauterine infection
33
how to treat woman who has had prior preterm birth?
progesterone-like injections
34
diabetes effect on fetal growth?
if mom has diabetes, excess sugar stimulates fetus to create growth factor; can get fetus that's TOO BIG or too SMALL
35
what factors might restrict fetal growth?
1) vascular disease 2) hypertension 3) cigarettes 4) genetic disorders 5) anti-phospholipid antibody syndrome
36
possible post-term issues?
1) increase in mortality 2) dry parchment-like skin, long nails, decreased vernix 3) meconium aspiration
37
spontaneous incidence of multiple gestations in US?
twins: 1/80 triplets: 1/8,000
38
why increase in multiple births nationwide?
use of ART, increase in maternal age
39
what are dizygotic twins
twins from 2 diff eggs; each forms own amnion, chorion
40
which type of twinning is familiar
dizygotic
41
percentage of twins that're dizygotic
2/3 twins
42
is dizogytic twins maternal or paternal inheritance
maternal
43
what is monozygotic twins
1 embryo that splits if 4-8 day split, 1 placenta w/ 2 sacs if 8-13 day split, 1 sac - risk for fetal death
44
when do conjoined twins occur
after day 13, monozygotic twins
45
is monozygotic twins inherited
no
46
which has better outcome- dizogytic or or monozogytic twins
dizogytic twins
47
hw might monozygotic twins present
2 separate amnions; 1 placenta w/ 2 diff sacs OR if split before day 4, 2 placentas w/ 2 sacs
48
day 3-5 twin type
di/di
49
day 5-8 twin type
mc/di
50
day 8-13 twin type
mc/ma
51
day 13+ twin type
conjoined twins
52
what are monochorionic twins risk for?
1) fetal growth restriction 2) twin-twin transfusion syndrome 3) congenital anomalies 4) miscarriage 5) preterm birth
53
degree of risk, least to greatest, re: twin type?
dizygotic di and mono mono mono
54
complications of multiple births for baby?
1) preterm brith 2) low birth weight 3) neonatal morbidity and morality 4) congenital anomalies 5) chromosomal abnormalities 6) spontaneous fetal loss
55
complications of multiple births for mom?
1) gestational diabetes 2) preeclampsia 3) cesarean delivery 4) maternal hemorrhage 5) acute fatty liver 6) placenta previa
56
when did rate of twins peak in USA
1998
57
when do singletons deliver
39-40 weeks
58
when do twins deliver
35-36 weeks
59
when do triplets deliver
33 weeks
60
when do quads deliver
30 weeks
61
what delivers earlier- multiple births or singleton?
multiple births
62
complications of prematurity
1) hypothermia 2) patent ductus arteriosus 3) intracranial hemorrhage 4) hypoglycemia 5) respiratory abnormalities 6) necrotizing enterocolitis 7) infection 8) retinopathy of prematurity 9) learning disabilities, developmental delays, cerebral palsy
63
risk of CP in multiple birth?
twins: 5x increased risk triplets: 17x increased risk
64
what factors increase perinatal morbidity, mortality?
fetal growth restriction and discordant growth
65
why do dizygotic twins have great risk of chromosomal anomalies?
each twin has independent risk, whereas monozygotic twins have genetically identical risk so 2x age related risk for dz twins
66
what about ART might increase risk of chromosomal abnormalities?
sperm from subfertile men/women may increase risk of chromosomal and gene abnormalities w/ ART

Structures: Part Deux (36 decks)

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