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Spring 2014 - OB TEST 9 - 1st TRIMESTER ✔️ > Normal 1st Trimester > Flashcards

Normal 1st Trimester Flashcards

0
Q

What is gestational age?

A

Used by clinicians & sonographers

Also called MENSTRUAL age

1st day of pregnancy is 1st day of LMP

Adds 2 weeks (14 days) to conceptual age

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1
Q

What is conceptual age?

A

Used by embryologists

Also called EMBRYOLOGIC age

1st day of pregnancy is conception

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2
Q

What is ovum?

A

Egg released from ruptured Graffian follicle

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3
Q

What is zygote?

A

Fertilized ovum

For 12 days after conception during implantation process

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4
Q

What is morula?

A

16 stage cell and greater

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5
Q

What is blastocyt?

A

Enters uterus at day 4-5 after fertilization

Implants into the endometrial lining begins 7-9 days after fertilization

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6
Q

What is embryo?

A

From implantation until end of 10th week

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7
Q

What is fetus?

A

After first 10 weeks

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8
Q

What is ovulation?

A

Day 14 of 28 day cycle

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9
Q

When and where does fertilization occur?

A

Within 1-2 days after ovulation (12-24 hrs)

In distal fallopian tube (ampulla)

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10
Q

A fertilized ovum becomes a _________.

A

Zygote

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11
Q

What forms around the zygote to prevent sperm from penetrating?

A

Zona pellucida

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12
Q

A ruptured _________ becomes a corpus luteum. _________ & _________ is secreted.

A

Graffian follicle

Estrogen and progesterone

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13
Q

A zygote or conceptus undergoes _________ & forms 16-18 cell _________.

A

Rapid cellular division

Morula

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14
Q

As pregnancy progresses, the morula continues _________ and becomes a _________.

A

Cellular proliferation

Blastocyst

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15
Q

What is a blastocyst?

A

Fluid-filled cavity

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16
Q

What does a blastocyst consist of?

A

Blastocyst

Trophoblast

In cell mass

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17
Q

Trophoblastic cells make up the _________, secrete _________, and cause the endometrium to convert the a _________, which forms _________ and _________.

A

Placenta

HCG

Decidua

Chorion and placenta

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18
Q

What does an inner cell mass consist of?

A

Embryo

Yolk sac

Amnion

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19
Q

Implantation is completed within _________ days post fertilization.

A

6-9

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20
Q

An inner mass cell enters the uterus _________ days after fertilization.

A

4-5

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21
Q

Implantation is completed by day _________ posy fertilization.

A

12

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22
Q

Enzymes produced by _________ create lacunae.

A

Trophoblast

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23
Q

What is lacunae?

A

Blood pools formed by eroded maternal capillaries

Nourishes trophoblastic cells

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24
Q

When implantation occurs a _________ network is formed between the mother and blastocyst.

A

Blood exchange

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25
Q

The blood exchange network will mature into _________ circulation.

A

Placental/maternal

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26
Q

When circulation is complete, the zygote will…

A

Bury in one wall of the uterus - may cause light vaginal bleeding

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27
Q

When a complete trophoblast forms, _________ will encircle the early gestational sac.

A

Primary villi

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28
Q

Trophoblastic cells produce _________.

A

HCG

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29
Q

Chorion are _________ cells and are located in the _________ membrane of the gestational sac.

A

Trophoblastic

Outer

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30
Q

_________ Is early chorionic villi which attach to the _________ and becomes _________ of the placenta.

A

Chorion frondosum

Endometrium

Fetal side

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31
Q

_________ Is not involved with implantation.

A

Chorion laeve

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32
Q

_________ Is the maternal component of placental attachment - turns into placenta.

A

Decidua basalis

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33
Q

_________ Is the layer of endo that heals over the implanted GS.

A

Decidua capsularis

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34
Q

_________ Is when the endo is not in direct contact with the GS.

A

Decidua vera parietalis

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35
Q

_________ Is adjacent to decidua capsularis. Creates the “double bubble” sign.

A

Decidua vera

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36
Q

Inner cell mass develops into _________ and _________.

A

Embryonic disc

Primary yolk sac

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37
Q

Approx day _________, the primary yolk sac “pinches off” and forms _________.

A

23

Secondary yolk sac

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38
Q

When is the secondary yolk sac seen sonographically and what is its function?

A

1st trimester

Transfers nutrients, forms blood cells/vessels, formation of digestive tract

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39
Q

What 2 cavities develop at the same time?

A

Amniotic & chorionic

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40
Q

What is gastrulation?

A

Creating 3 germ cell layer of digestion tract

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41
Q

When does cardiovascular formation occur?

A

Begins immediately after gastrulation and is complete 5-8 weeks

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42
Q

When is a fetal HR initially seen and what is the BPM?

A

5 wks & alive

120-150

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43
Q

What is neurulation?

A

Formation of neural tube

Complete closure by week 7

44
Q

What phase happens between weeks 6-10?

A

Embryonic phase

45
Q

What happens during weeks 6-10?

A

Organogenesis - main features

All major internal & external structures begin to develop - malformations will be seen

Embryo changes from flat disc like appearance to c-shaped structure

Limb buds form, brain growth, midgut herniation

CRL rapid development - 35 mm by 10th week

46
Q

During what weeks & phase are you most susceptible to teratogens?

A

Weeks 6-10

Embryonic phase

47
Q

Weeks 11 & 12 are considered…

A

The end of the first trimester

48
Q

What period begins during weeks 11 & 12?

A

Fetal period

49
Q

What happens during weeks 11 & 12?

A

Organs and structures continue to grow

Fetal head is large

Fetal anatomy fully develops in late 1st trimester

50
Q

Maternal biochemistry is a direct relationship between _________ and _________.

A

bHCG and sonographic findings

51
Q

Gestational sac visualized through _________ at 500-1000 mUI/ml.

A

TV

52
Q

Gestational sac visualized through _________ at 1800 mIU/ml.

A

TA

53
Q

HCG levels should double every _________ hrs in the first _________ wks.

A

48

6

54
Q

HCG levels plateau and then decline at _________ weeks.

A

9-10

55
Q

_________ Levels in abnormal pregnancies usually do not increase normally. Give examples.

A

HCG

Ectopic, trisomy 21

56
Q

What does PAPP-A stand for?

A

Pregnancy-associated plasma protein -A

57
Q

What 2 levels are used in combination in 1st trimester as marker for trisomy 21 (Down’s Syndrome)?

A

HCG and PAPP-A

58
Q

Why do TA’s during 1st trimester?

A

Overall view of pelvic structures/anatomic relationship/pelvic masses

59
Q

Why do TV’s during the 1st trimester?

A

More detail of anatomy/pathology

More detail of GS, contents, fetus

Different planes

60
Q

Why do transperineal during 1st trimester?

A

Visualize cervix

61
Q

What 2 sonographic techniques can be used but aren’t all the time for 1st trimester scan?

A

3D and pulsed Doppler

62
Q

1st trimester evaluation standards are outlined by?

A

ACR

AIUM

ACOG

63
Q

Major components that should be seen when scanning a 1st trimester patient?

A

Uterus & adnexa - presence of GS

Measurements of embryo &/or GS

Fetal heart activity

Fetal #

Cul de sac & ovaries assessed

64
Q

During the _________week of development a pregnancy can be identified.

A

5th

1-2 mm sac with echogenic ring - sonolucent center

65
Q

Sonolucent center is in what cavity?

A

Chorionic

66
Q

Describe the echogenic ring…

A

Trophoblastic tissue

Decidual reaction

67
Q

What forms a double decidual sac sign?

A

Decidua capsularis and decidua parietalis

68
Q

Describe the GS sonographically…

A

Round or oval

Fundal position

Eccentrically located

Smooth contours

Decidual wall thickness greater than 3 mm

69
Q

What may be associated with the GS implanted in the LUS?

A

Placenta accreta or placenta previa

70
Q

Yolk sac mean sac diameter is…

A

Greater than 12 mm at 5-5 1/2 weeks

71
Q

Embryo mean sac diameter is…

A

Greater than 18 mm

72
Q

GS grows _________ in early pregnancy.

A

1mm/day

73
Q

What 4 structures are seen at weeks 5 1/2-6 wks?

A

Amniotic cavity & membrane

Chorionic cavity

Yolk sac

Embryo

74
Q

When is a yolk sac usually seen?

A

From 5 weeks of gestation

75
Q

Yolk sac is initially attached to embryo via _________.

A

Yolk stalk

76
Q

When does amniotic expansion, the yolk sac, which lie between amniotic and chorionic membranes, detaches from yolk stalk?

A

Approx week 8

77
Q

What is the size of the yolk sac?

A

2-6 mm

78
Q

What does the yolk sac do and where is it located?

A

Nutrition to developing embryo

CHORIONIC CAVITY

79
Q

Yolk sac predicts _________ 90% of the time.

A

Viability

80
Q

Failure to see a _________, with minimum of 12 mm MSD, transvaginally is suspicious of abnormal pregnancy.

A

Yolk sac

81
Q

Transabdominally, yolk sac should be seen with MSD of _________ but definitely seen at _________.

A

10-15 mm

20 mm

82
Q

Yolk sac will reabsorb and disappear by week _________.

A

12

83
Q

Why initially does there appear to be no space between the yolk sac and the embryo?

A

Amniotic cavity is small

84
Q

_________ Cavity is initially the dumping ground for embryonic waste.

A

Chorionic

85
Q

What takes over waste removal later in pregnancy and why?

A

Placenta

Amniotic cavity expands and chorionic cavity decreases

86
Q

Fusion of membranes is called _________ and occurs at _________ weeks.

A

Chorioamniotic fusion

14-15

87
Q

What 3 structures are brought together to form the umbilical cord?

A

Yolk stalk

Connecting stalk

Allantois

88
Q

Spine forms at what week of gestation?

A

6th

89
Q

Week 7 what structures are distinguishable?

A

Head and trunk

Spine

Limb buds

90
Q

_________ Will appear as a cystic space in the POSTERIOR fetal brain during 8-11 weeks.

A

Rhombencephalon

91
Q

Midgut herniation may be apparent and is normal till before _________ weeks.

A

12

92
Q

What is apparent at week 9?

A

Limb movement

Midline flax, echogenic choroid plexus, lat vets

93
Q

What is apparent during week 10?

A

Cerebellum, medulla, medulla oblongata in rhomboid fossa

Extremities and spine flex and extend

Palate fusion

Embryonic face with no detail - maxilla & mandible echogenic

Bowel, cecum, colon

94
Q

After week 12, echogenic _________ is no longer visualized and echogenic _________ is seen within fetal ABD.

**DO NOT confuse with omphalcele or gastroschisis

A

Umbilical cord mass

Bowel

95
Q

Week 11 is termed _________ period.

A

Fetal

96
Q

What organ is the first to function?

A

The heart

97
Q

When does the heart obtain its adult configuration?

A

End of 8th week of GS

98
Q

CRL at 5 and alive should be _________ mm.

A

Greater than 4 mm

99
Q

Rates of _________ BPM at 6 weeks increase to rates of _________ BPM at 9 weeks.

A

90-115

140-160

100
Q

What approximate heart rate through remainder of late 1st and 2nd trimester?

A

140 BPM

101
Q

How do you know the difference between a fetal heartbeat and the maternal heartbeat?

A

Fetal is over 100 BPM

102
Q

What is the formula for MSD?

A

Length + width + height / 3

103
Q

When is nuchal translucency preformed?

A

Weeks 11-14

104
Q

What is the normal nuchal thickness?

A

Less than 3 mm

105
Q

Twin gestations have _________ times greater mortality rate than singletons do.

A

7-10

106
Q

Risk increases when twins are _________ and share _________ components.

A

Monozygotic

Membrane

107
Q

Differences in nuchal translucency between normal twins may be an early sign of _________ syndrome.

A

Twin-to-twin transfusion

Spring 2014 - OB TEST 9 - 1st TRIMESTER ✔️ (1 decks)

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