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Maternal Complications Flashcards

(66 cards)

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1
Q

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

A

fetal mortality

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2
Q

The risk of major fetal anomaly is _______.

A

6-12%

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3
Q

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

A

Ultrasound

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4
Q

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

A

spontaneous, 90

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5
Q

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

A

pancreatic disease, hormone imbalance, drug reactions.

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6
Q

What are the two types of diabetes mellitus?

A

Type 1-juvenile onset, (insulin dependent)

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

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7
Q

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

A

Hemoglobin A1C

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8
Q

Glucose intolerance of pregnancy

A

Gestational diabetes

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9
Q

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

A

2nd, 3rd, fetal macrosomia

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10
Q

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

A 
Caudal regression
neural tube defects
Cardiovascular malformations
Genitourinary anomalies
Single umbilical artery
Gastrointestinal anomalies
skeletal anomalies
IUGR
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11
Q

What are the fetal complications affected by DM?

A

Respiratory distress syndrome

Hypoglycemia.

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12
Q

What is associated with Gestational Diabetes

A 
Fetal macrosomia
hydrops
Polyhydramnios
still birth trauma
dystocia
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13
Q

What is fetal macrosomia?

A

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

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14
Q

Define dystocia

A

Difficult delivery

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15
Q

Fetuses of gestational diabetic mother can have which other two conditions

A

hypocalcemic, hypoglycemia

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16
Q

What is involved with Hypertension in mothers.

A

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

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17
Q

Describe essential hypertension

A

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

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18
Q

Hypertension that occurs during pregnancy without signs of preeclampsia

A

Pregnancy induced hypertension/gestational hypertension PIH

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19
Q

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

A

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

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20
Q

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

A

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

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21
Q

What are the two classifications of toxemia of pregnancy

A

Preeclampsia

Eclampsia

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22
Q

Symptoms associated with Preeclampsia

A

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

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23
Q

Symtoms associated with Eclampsia

A

Same as seen in preeclampsia but with seizures

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24
Q

List what Pathology of GEPH leads to:

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

OB Ultrasound (24 decks)

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