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Fall:OB/GYN > Test3:Review > Flashcards

Test3:Review Flashcards

1
Q

What structure carries oxygenated blood from the umbilical vein to the IVC?

A

the veins carry oxygenated blood

the arteries carry deoxygenated blood

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2
Q

what is the term that indicates the fetal head is towards the fundus of the uterus?

A

breech

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3
Q

what are the three vessels found in the umbilical cord?

A

one vein

two arteries

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4
Q

which vessel shunts the blood away from the fetal lungs?

A

ductus areteriosus

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5
Q

What is the 4 quadrant fluid assessment?

A

AFI

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6
Q

What is MVP?

A

maximum vertical pocket

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7
Q

What is the test to perform fetal well being?

A

biophysical

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8
Q

what is a normal AFI?

A

5-20cm

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9
Q

What are the numbers that indicate oligohydramnios and polyhydramnios?

A

MVP:

oligo- <2cm

poly- >8cm

AFI:

oligo- <2cm

poly- >24cm

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10
Q

what measurement do we use for cord Doppler?

A

25-29wks: 4.0

29-34wks: 3.3

34-40wks: 3.0

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11
Q

what is a false knot of the umbilical cord?

A

blood vessels are longer than the cord, folded on themselves

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12
Q

what is a true knot?

A

actual knot, may be single or multiple, may be formed when a loop of cord is slipped over the infant’s head or shoulders

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13
Q

what are fetal membranes comprised of?

A

chorion

amnion

allantois

yolk sac

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14
Q

chorion

A

originate from trophoblastic cells and remains in contact with trophoblasts throughout preg

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15
Q

amnion

A

develops at 28th menstrual day, is attached to margins of embryonic disk

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16
Q

allantois

A

tubular extension of the endoderm of the yolk sac, becomes umbilical vessels

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17
Q

yolk sac

A

circular structure seen between 4-10wks gest, supplies nutrition

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18
Q

what is the decidual basalis?

A

decidual reaction that occurs between the blastocyst and the myometrium

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19
Q

what is the decidua capsularis?

A

reaction occuring over blastocyst closest to endometrial cavity

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20
Q

what is the decidua vera (parietalis)?

A

reaction except for areas beneath and above implanted

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21
Q

what is the maternal side of the placenta? fetal side?

A

maternal-basal plate

fetal- chorionic plate

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22
Q

major functions of the placenta:

A

respiration

nutrition

excretion

protection

storage

hormonal production

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23
Q

respiration

A

transfer of oxygen from maternal blood across the placental membrane into fetal blood is by diffusion

the placenta acts as fetal lungs

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24
Q

nutrition

A

water, inorganic slats, carbohydrates, fats, proteins, and vitamins pass from maternal blood through the placental membrane into fetal blood

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25
Q

excretion

A

waste products cross membranes from fetal blood and enter maternal blood

excreted by mother’s kidneys

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26
Q

protection

A

some microorganisms cross the placental border

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27
Q

storage

A

carbohydrates, proteins, calcium, and iron are stored in placenta and released into fetal circulation

28
Q

hormonal production

A

produced by syncytiotrophoblast of placenta: human chorionic gondatropin (hcg), estrogens, progesterone

29
Q

what is a velamentous placenta?

A

umbilical cord insertion on the surface of the placenta in the membranes

30
Q

what is a battledore insertion?

A

the insertion of the umbilical cord at the margin of the placenta within 10mm of the edge

31
Q

what is a marginal or an accentric insertion of the placenta?

A

battledore insertion

32
Q

what is the primary cause of placentomegaly?

A

placentomegaly- placenta weighing more than 600g

primary cause-diabetes

33
Q

what are percreta, accrete, increta? which is worse?

A

placenta accrete- superficially to myometrium; mild

placenta increta- deep into myometrium; moderate

placenta percreta- through the myometrium; severe

34
Q

what is an accessory lobe of the placenta?

A

succenturiate placenta; occurs in 3-6% of pregnancies

35
Q

what is a low pressure bleed of the placenta?

A

marginal

36
Q

what is marginal?

A

most common type and is a sub chorionic bleed

(low pressure bleed)

37
Q

what is partial?

A

just about to cover the cervical os, but doesn’t cover it all the way

38
Q

what is a previa?

A

implantation of the placenta over the internal cervical os

39
Q

what maternal abnormalities demonstrate a small placenta?

A

intrauterine growth restriction

intrauterine infection

aneuploidy

40
Q

what maternal abnormalities demonstrate a large placenta?

A

maternal diabetes

maternal anemia

x-Thalassemia

Rh sensitivity

Fetomaternal hemorrhage

Chronic intrauterine infections

Twin-twin transfusion syndrome

congenital neoplasms

fetal malformations

41
Q

what is vasa previa?

A

placenta covering the cervix, cord insertion at cervix

42
Q

what is circumvallate placenta?

A

condition where the chorionic plate is smaller than the basal plate, the margin is raised with a rolled edge

43
Q

what is circummarginate placenta?

A

chorionic place of the placenta is smaller than the basal plate, with a flas interface between the fetal membrane and the placenta

44
Q

what is the chorion frondosum?

A

portion of chorion that develops into fetal portion of placenta; site where water exchanged freely between fetal blood and AF across amnion

45
Q

Amniotic Band Syndrome

A

associated with abnormality in fetal membranes; common, non-recurrent cause of various fetal malformations involving limbs, craniofacial region, trunk

46
Q

Amniotic sheets, shelves, or folds

A

identified as echogenic, nonfloating bands crossing through amniotic cavity, do not cause fetal malformations, most likely signify uterine synechiae

47
Q

what regulates the amount of amniotic fluid?

A

AF volume increases rapidly during 1rst trimester

fetus swallows fluid, reabsorbed by GI tract, recirculates through kidneys

increased AF production in 1rst trimester

by 20wks gest, AF volume increases by 10ml/day

fluid produced by fetal urination slightly exceeds amount removed by fetal swallowing

48
Q

conditions associated with polyhydramnios

A

central nervous system (CNS) disorders

gastrointestinal (GI) problems

CNS disorders cause depressed swallowing

GI abnormalities result in ineffective swallowing that are often caused by a blockage (atresia) of the esophagus, stomach, duodenum, or small bowel

49
Q

conditions associated with oligohydramnios

A

congenital anomalies

IUGR

post term preg

rupture of membranes (ROM)

iatrogenesis

hypertension

preeclampsia

chronic cardiac disease

connective tissue disorders

patients receiving indomethacin

50
Q

functions of the amniotic fluid

A

allows fetus to move freely within amniotic cavity

maintains intrauterine temperature

protects developing fetus from injury

51
Q

when is the amniotic fluid at its greatest?

A

18-20wks gest

52
Q

what is the cause of a patient having persistant polyhydramnios?

A

diabetes

53
Q

how do sonographers typically evaluate AF?

A

eyeball assessment

54
Q

what is the debris in the AF?

A

vernix caseosa particulate matter

intra-amniotic blood

intra uterine meconium passage

55
Q

oligohydramnios could be attributed to:

A

congenital abnormalities

IUGR

post term preg (42wks)

rupture of membranes (ROM or PROM)

chorionic villus sampling

Iatrogenesis

56
Q

polyhydramnios (hydramnios) volume

A

> 2,000 ml

57
Q

hydrops

A

disparity between amounts of serous fluid being produced and absorbed

58
Q

hydrops indications:

A

pleural effusions

ascites

cardiac effusion

skin edema

anasarca

59
Q

hydrops fetal findings:

A

enlarged umbilical cord

polyhydramnios

placental edema

enlarged liver and spleen

in many cases, highly associated with mortality

60
Q

Immune hydrops

A

associated with alloimmune hemolytic disease (erythroblastosis fetalis) or rhesus (Rh) isoimmunization

maternal blood sampling and history of previously affected fetus extremely important for preg management

61
Q

nonimmune hydrops

A

presence of abnormal accumulations of fluid in fetal body and/or skin

is associated with numerous conditions and causes

62
Q

nonimmune hydrops causes

A

may be sporadic condition or associated with numerous other causes

cardiac insufficiency one of the most common causes

cardiac insuffiency can result from cardiac anomalies (tumors) or arrhythmias (tachycardia)

63
Q

placenta infarcts

A

focal, discrete lesion caused by ischemic necrosis

common, about 25% of preg, usually small with no clinical significance

large infarcts may reflect underlying maternal vascular disease

acute, subacute, and chronic stages

majority hyperechoic in acute stage, ultrasound may be unable to distinguish them from intraplacental hemorrhages

calcification may occur over time

64
Q

placentomegaly-how many grams does placenta weigh?

A

600g

65
Q

ductus venosus

A

connects the umbilical vein to the IVC and allows oxygenated blood to bypass the liver and return directly to the heart

66
Q

ductus arteriosis

A

communicating structure that carries oxygenated blood from the pulmonary artery to the descending aorta, closes after birth

Fall:OB/GYN (5 decks)

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