Outcome 4 Conception and Early Pregnancy Flashcards Preview

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Flashcards in Outcome 4 Conception and Early Pregnancy Deck (89):
1

Abnormal proliferation of placental tissue than can take on characteristics of malignancy

hydatidiform (hydatid) mole

2

Placenta has a ___ appearance on ultrasound or the diagnosis may come from evaluation after miscarriage/abortion

grape cluster

3

Hydatid mole is caused by ___ during fertilization where the placenta develops abnormally as a mass of clear grape like vessels

genetic anomaly

4

How are hydatid moles treated?

1. evacuation of the uterus by dilation
2. chemotherapy
3. hysterectomy

5

Pregnancy should be avoided for at least __ months after removal of a hydatid mole

6 months

6

Fertilized egg implants that grows outside of the endometrial canal, most often the fallopian tube

ectopic pregnancy

7

What medication is prescribed for early unruptured ectopic pregnancies?

methotrexate

8

Methotrexate causes the ___ to die and the products to be reabsorbed by the body

placenta

9

What surgeries treat ectopic pregnancy?

1. laparoscopic surgery
2. tubal conservation if unruptured

10

Severe state of morning sickness that doesn't respond to over the counter remedies, requires prescription medicine or hospitalization

hyperemesis gravidarum

11

Hyperemesis gravidarum is ssociated with weight loss of more than __ and metabolic disturbances and dehydration

10%

12

Hyperemesis gravidum is linked to elevated ___ and ___

estrogen and hCG

13

Which patients have a higher risk for hyperemesis gravidum?

patients with underlying emotional disturbances with abusive relationships

14

What is ruled out with hyperemesis gravidum

hyperthyroidism

15

How is hyperemesis gravidum treated?

1. patient hospitalized
2. electrolyte imbalance corrected with salts
3. antiemetics

16

Refer to number of times the patient has been pregnant

gravidity

17

Refer to number of past pregnancies that have gone to viability and have been delivered

para

18

Pregnant woman

gravida

19

Number of times the female delivered a baby

para

20

Woman who is not pregnant and has never been pregnant

nulligravida

21

Woman who has never delivered a child

nullipara

22

First pregnancy

primigravida

23

Female who has delivered a fetus that reached viability

primipara

24

Female that has been pregnant 2 or more times

multigravida

25

Female that has delivered more than one baby

multipara

26

Female who have just given birth up to 42 days following delivery

puerpera

27

Naturally occurring loss of a fetus before the 20th week of pregnancy. Also called “missed” or “incomplete”

spontaneous abortion or miscarriage

28

__% of all pregnancies end in spontaneous abortions.

10-15%

29

Spontaneous abortion results from ____.

abnormal chromosomes

30

What 4 factors are associated with increased risk of abortion?

1. infection
2. metabolic disturbances
3. maternal antibody production
4. lupus or clotting disorders

31

Spontaneous abortion with no severe bleeding is treated how?

Allowing the products of conception to pass on their own; given medication to expedite the passage of fetal and placental tissue

32

Spontaneous abortion with severe bleeding is treated how?

Dilation, other surgical interventions

33

What is checked in spontaneous abortion?

Rh factor of mother

34

Non-invasive test in pregnancy providing detailed information on the health of the fetus

18 week ultrasound

35

What 4 thingscan be detected at 18 week ultrasound?

1. heart abnormalities
2. developmental problems of genitoruinary system which are incompatible with life
3. nervous system disorders
4. dating

36

18-week ultrasound is completed at what gestational age?

16th-20th weeks

37

Needle sample of chorion guided by ultrasound

chorionic villus sampling (CVS)

38

What can be detected during a chorionic villus sampling?

early detection of abnormalities to ensure time to decide whether or not to proceed with the pregnancy

39

CVS is completed at what gestational age?

10-12 weeks

40

Maternal blood sample

Maternal Serum Screen (MSS)

41

What does the maternal serum screen measure?

1. bhCG
2. maternal alphaprotein
3. unconjugated estrogen

42

What is detected during MSS?

estimates risk of
1. spina bifida
2. trisomy 21 or down syndrome
3. trisomy 18 or edwards syndrome
4. open neural tube defects

43

MSS relies on accurate _____

gestational age

44

MSS is is completed at what gestational age?

16 weeks

45

Nuchal translucency screen (ultrasound measurement)

First Trimester Screen (FTS)

46

BhCG, pregnancy associated with ___, risk of ___ can be detected in FTS

plasma protein A, down syndrome

47

FTS is not useful in ____

multiple gestation

48

False positives in FTS should follow ___ or ___ to confirm

CVS, amniocentesis

49

FTS is completed at what gestational age?

11-14 weeks

50

Combines use of FTS and MSS

integrated prenatal screen

51

Integrated prenatal screen detects Down Syndrome in __% of pregnancies but should still be followed by _____ to confirm

85-90%, amniocentesis

52

Integrated prenatal screen is completed at what gestational age?

1st: 11-14 weeks
2nd: 15-20 weeks

53

Assessment of genetic karyotype allowing for accurate prenatal diagnosis of genetic abnormalities including down syndrome

amniocentesis

54

Which is more accurate: amniocentesis or CVS?

amniocentesis

55

Amniocentesis can reveal the maturity of the ___ and ___ defects

fetal lung, open neural tube defects

56

AMniocentesis provides information on ______ affected pregnancies

Rh isoimmunization

57

Amniocentesis is completed at what gestational age?

15-16 weeks

58

Amniocentesis takes ___ days for results

10-14 days

59

What days are the menstrual cycle?

Days 1-4

60

During the menstrual cycle, __ and __ are rising

FSH and LH

61

Proliferative phase days

5-14 but varies between women

62

Secretory phase days

15-28

63

Secretory phase is always __ days in length

14 days

64

How many trimesters in a pregnancy?

3

65

How long is the first trimester?

0-12 weeks

66

How long is the second trimester?

13-26 weeks

67

How long is the third trimester?

27+ weeks

68

What are the 2 phases of pregnancy?

1. embryonic
2. fetal

69

Pregnancy phase spanning the first two months

embryonic

70

Pregnancy phase spanning the third through ninth months?

fetal

71

Hydatidiform is also called a ___

molar pregnancy

72

T or F. Molar pregnancies can become cancerous.

T

73

What are 5 risk factors for ectopic pregnancies?

1. IUDs
2. pelvic adhesions due to previous pelvic infection or surgery
3. damaged fallopian tubes
4. progesterone contraception
5. previous tubal ligation

74

What are the 3 categories for risk factors?

1. past obstetrical history
2. medical history
3. problems in current pregnancy

75

What ages are risk factors in pregnancy?

35

76

What are the risks for having a baby past 35 years old?

down syndrome

77

How many kg overweight must a woman be to be considered a risk factor in pregnancy

>9kg

78

What are problems in current pregnancy that are risk factors?

1. membrane rupture before 37 weeks
2. PIH
3. gestational diabetes
4. post term pregnancy (>42 weeks)
5. absence of fetal movements
6. exposure to smoking and drugs

79

When is absence of fetal movements worrisome?

1. more than 24 hours after the 20th week
2. fewer than 10 movements per hour after the 28th week

80

GTPAL

gravidity
term deliveries
preterm deliveries
abortions (all types: elective or miscarriage)
live births

81

What are the 3 classifications of spontaneous abortions?

1. missed
2. incomplete
3. complete

82

What is a missed spontaneous abortion?

no tissue has passed

83

What is an incomplete spontaneous abortion

some tissue has passed

84

What is a complete spontaneous abortion?

all tissue has passed

85

In 18-week ultrasound, a ___ is done and provides a score out of 2 for a possible total of 10

biophysical profile (BPP)

86

What 5 things can a BPP indicate?

1. amniotic fluid volume
2. breathing movements
3. limb (body) movements
4. fetal tone (muscle)
5. heart rate/non-stress test

87

What is the difference between CVS and amniocentesis?

CVS can't detect neural tube defects, is less accurate

88

What is the main advantage of CVS over other screening tests?

more specificity, sensitivity

89

Which two tests detect Down syndrome

FTS & MSS, integrated