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Flashcards in Maternal Complications Deck (66):
1

The rate of ______ in a diabetic is 3-5%

fetal mortality

2

The risk of major fetal anomaly is _______.

6-12%

3

_________ plays a major role of monitoring in a pregnant diabetic.

Ultrasound

4

Diabetes is usually a ______ occurrence, __% of the time.

spontaneous, 90

5

The other 10% are caused by related _______,______, and _______.

pancreatic disease, hormone imbalance, drug reactions.

6

What are the two types of diabetes mellitus?

Type 1-juvenile onset, (insulin dependent)
Type 2-adult onset, (non-insulin dependent)

7

Serum marker for how well a diabetic is controlled in pregnancy, a poorly controlled diabetic is most frequently associated with fetal anatomic anomalies.

Hemoglobin A1C

8

Glucose intolerance of pregnancy

Gestational diabetes

9

Gestational diabetes usu. occurs in ____, and ____, trimesters. Is usu. associated with ______ ______.

2nd, 3rd, fetal macrosomia

10

What congenital anomalies arise due to the increased risk associated with diabetes mellitus?

Caudal regression
neural tube defects
Cardiovascular malformations
Genitourinary anomalies
Single umbilical artery
Gastrointestinal anomalies
skeletal anomalies
IUGR

11

What are the fetal complications affected by DM?

Respiratory distress syndrome
Hypoglycemia.

12

What is associated with Gestational Diabetes

Fetal macrosomia
hydrops
Polyhydramnios
still birth trauma
dystocia

13

What is fetal macrosomia?

Fetal weight greater than 4000 g or greater than 90 percentile for gestational age.

14

Define dystocia

Difficult delivery

15

Fetuses of gestational diabetic mother can have which other two conditions

hypocalcemic, hypoglycemia

16

What is involved with Hypertension in mothers.

Systolic pressure gradient and 140 mmHg
Increase in systolic pressure greater than 130 mmHg over the pregnancy
Diastolic pressure greater than 90 mmHg
Increase in diastolic pressure greater than 15 mmHg over prepregnancy state

17

Describe essential hypertension

pre-existing hypertension not related to the pregnancy. ( Also called chronic hypertension)

18

Hypertension that occurs during pregnancy without signs of preeclampsia

Pregnancy induced hypertension/gestational hypertension PIH

19

A disorder of pregnancy which is characterized by proteinuria and neurologic symptoms.

GEPH--Gestational edema proteinuria hypertensive syndrome--otherwise called (Toxemia of pregnancy)

20

GEPH or toxemia of pregnancy is most common in ________, _______, and _______.

1st time mothers (most common)
multiple gestations
patients with a family history

21

What are the two classifications of toxemia of pregnancy

Preeclampsia
Eclampsia

22

Symptoms associated with Preeclampsia

hypertension
generalized edema
Proteinuria
Rapid weight gain which is secondary to Edema

23

Symtoms associated with Eclampsia

Same as seen in preeclampsia but with seizures

24

List what Pathology of GEPH leads to:

hypoxia,
necrosis of tissue
premature placental aging
renal cellular damage
disseminated intravascular coagulopathy DIC
Portal hemorrhagic necrosis in the liver
cerebral edema
pulmonary edema

25

What are the Sono findings of GEPH

IUGR
Increase of abruptio placentae
Oligohydramnios
Fetal demise

26

______ is used to track fetal growth and monitor the pregnancy

Ultrasound

27

______ _____ is a complication of preeclampsia.

HELLP syndrome

28

What does HELLP stand for

hemolysis-H
Elevated liver enzymes-EL
Low platelets-LP

29

List 3 complications associated with severe maternal infection.

Spontaneous abortion
Fetal death
Premature labor and delivery

30

Name the most common significant utero infections.

TORCH infections

31

What does TORCH stand for.

Toxoplasmosis
Other/syphilis and parvovirus
Rubella
Cytomegalovirus/CMV
Herpes/genital type

32

This protozoan is found in cat feces and undercooked meat, name it.

Toxoplasmosis---****Maternal infection crossed the placental barrier and results in fetal infection.

33

Name 8 results of Toxoplasmosis

Intracranial calcifications
Micro opthalmia
IUGR
Microcephaly
Hydrocephalus
Thick placenta
Thromboctyopenia
Jaundice

34

An extremely teratogenic infection for the fetus, name this.

Rubella or German Measles

35

Defects of Rubella are:

Cataracts
Congenital heart disease
Deafness
Mental retardation

36

The most common infection in pregnancy.

Cytomegalovirus/CMV

37

CMV may cause _____ _____ if exposure occurs in 1st trimester. Other findings are:(6)

embryonic demise
Spontaneous abruption of placenta
IUGR
Fetal ascites
Cranial anomalies
Chest anomalies
Fetal death

38

______ can be transmitted to the fetus during vaginal delivery.

Herpes

39

Herpes can cause a woman to have ___ _____.

Cesarean section

40

Women with Herpes may also cause (3)

CNS, eye, visceral involvement
Generalized multiple organ involvement
Death

41

Common respiratory viral infection

Parvovirus

42

Parvovirus can lead to the following (2)

Pancytopenia/anemia which can lead to fetal hydrops
Percutaneous umbilical cord sampling or fetal transfusion may become necessary

43

Refers to premature dilation and efacement of uterine cervix

Incompetent cervix
****May be congenital or acquired and is mc related to prior cx trauma i.e. cervical surgery for cervical carcinoma.

44

What happens with an incompetent cervix?

Cervix unable to prevent premature expulsion of pregnancy

45

How is imcompetent cervix prevented?

Cerclage-- stitch to keep the cx closed.

46

Name the cerclage procedure.

McDonald or Shirodkar procedure

47

Features of incompetent Cx. (3)

shortened cervix, < 2.5 cm
Dilation of the cervix greater than 2cm in 2nd Trimester--(Most reliable sign)
Bulging membranes into the dilated cervix--hourglass sign.(Poor prognostic indicator)

48

The stages of incompetent cervix--TYVU- which stands for

Trust Your Vaginal Ultrasound
T-Normal
Y-internal os slightly dilated
V-funneling
U-extremely short, thin cx

49

Maternal anemias
The need for increased perfusion to a highly vascularized placenta results in a __% increase in blood volume.

40%

50

Because increased plasma volume accounts for much of the increase, _____ and ______ values are much lower during pregnancy than in the nonpregnant state.

hemoglobin, hematocrit

51

Clinical signs of anemia

Hemoglobin less than 10 g per 100 ML's
Hematocrit less than 30%

52

Types of anemia

Iron deficiency (95%)
Folic acied deficiency
Aplastic anemia
Drug-induced hemolytic anemia
Thalassemia and Sickle Cell Anemia

53

This is a rare and catastrophic cause of maternal death

Uterine rupture

54

Name the clinical signs of Uterine rupture

Horrific pain
Sudden increase in fetal station

55

Define preterm labor

The onset of labor prior to 37 weeks gestation

56

What can cause preterm labor

Previous uterine surgery
Uterine anomaly
Maternal stress
Multiple gestation
Heavy cigarette smoking
Polyhydramnios
Percentile previous or abruption,source of bleeding
Systemic infection
Idiopathic
Premature rupture of membranes
Uterine masses

57

What is found on Ultrasound when membranes rupture prematurely?

Oligohydramnios

58

Most common mass of uterus

Myeloma or leiomyoma

59

______ and ______ types of masses will be prone to torsion

Submucosal and surserosal types

60

_______ may cause obstruction of vaginal delivery.

Leiomyomas

61

They are also known to cause _____ ______

Fetal malpresentation

62

What are the Ultrasound findings of Leiomyomas

solid, hypoechoic uterine mass which distorts with uterine contour

63

How to differentiate between focal myometrial contraction and leiomyoma?

Focal myometrial contraction will change with time, a leiomyoma will not.

64

What type cyst often found during pregnancy.

Ovarian

65

Name the most common cyst.

Corpus luteum

66

Name the cyst that occurs with gestational trophoblastic disease

Theca lutein which are lg and multi-septated