1st trimester abn 2 Flashcards
what is subchorionic hemorrhage
blood collects between the uterine wall and the chorionic membrane and may leak through the cervical canal
out come of a fetus with subchorionic hemorrhage depends on (3)
Size of the hematoma,
Mother’s age,
Fetus’s gestational age.
1st trimester screening preformed when
9to 13W6D
first trimester serum screening suggests trisomy 21 if
higher concentration of BHCG and lower PAPP-A
second semester serum screening is analysing for
Down syndrome (trisomy 21) Edwards syndrome (trisomy 18) Neural tube defects (ex. spina bifidaor anencephaly)
When would AFP test be done by itself in 2nd trimester
whenfirst trimester Down syndrome screening has already been used to assess risk.
what weeks is second trimester test done
15 and 20th weeks
sonographic appearance of nuchal translucency
collection of fluid under the skin behind the fetal neck in the first trimester of pregnancy
Nuchal translucency increasing size associated with
Aneuploidy and structure defects
optimal NT measurement time
11 to 13W6
min and max CRL for NT measure
45-84mm
What size should heart rate be detected in fetal pole
7mm
Pregnancy failure
Crown-rump length (CRL) of____mm and no heart beat
> or = 7 mm and no heart beat
Pregnancy failure
Mean sac diameter (MSD) of_____ and no embryo
≥25mm
Pregnancy failure
Absence of embryo with heartbeat_______ after a scan that showed a gestational sac without a yolk sac
≥2 weeks
Pregnancy failure
Absence of embryo with heartbeat______ after a scan that showed a gestational sac with a yolk sac
≥11 days
When there are findings suspicious for pregnancy failure, follow-up ultrasonography at ____Days
7-10
Fetal demise is when there is no
no Fetal Heart Rate
_______ of all fertilized eggs die and are lost (aborted) spontaneously, usually before the woman knows she is pregnant.
about half
Among women who know they are pregnant, the miscarriage rate is about
15-20 %
Most miscarriages occur during the first _______ weeks of pregnancy.
7 weeks
what is threatened miscarriage
is a loose term referring to pain, bleeding or contractions during the first 20 weeks of gestation, with a closed cervical os.
what is Missed miscarriage/missed abortion/early fetal demise
situation when there is a non-viable fetuswithin the uterus, without the patient presenting with frank abortion-like features.
what is Spontaneous Abortion
refers to naturally occurring events, not to medical or surgical abortions.
what is inevitable abortion
refers to the presence of an open internal os in the presence of bleeding in the first trimester of pregnancy.
what is incomplete abortion
miscarriage where there are retained products of conception still within the uterus
what is septic abortion
lining of the womb (uterus) and any remaining products of conception become infected
WHAT is complete abortion
final stage of a miscarriagewhere all products of conception have passed out of the uterus
Shows an empty uterus with no fetal components or products of conception.
4 first trimester related complications
fibroids, synchiae, IUCD, cerclage
what are synechiae
idiopathic fibrous scars
what may synchiae mimic
amniotic band syndrome
what is ashermans syndrome
Intrauterine adhesions resulting from the uterine trauma or interventions
uterine synechiae aka (2)
amniotic sheets or amniotic folds
do uterine synechiae interfere with development of the fetus?
no
appearance of synchiae
thick banding across the uterine wall and colour doppler flow
classic history that raises the suspicion of cervical insufficiency
recurrent mid-trimester pregnancy losses.
5 causes of incompetent cervix
Malformed cervix or uterus from a birthdefect
Damage during a difficult birth
Previous surgery on the cervix such as LEEP procedure
Previous trauma to the cervix, such as aD&C (dilation and curettage) from a termination or amiscarriage
DES
what was DES linked to
linked to the occurrence of vaginal clear cell adenocarcinoma in female offspring
what does cerclage do and when is it performed
procedurethat sews the cervix closed to reinforce the weak cervix
12-14 weeks
Copper IUCD stops pregooos how
makes the uterus and fallopian tubes produce fluid that kills sperm and prevents implantation of the blastocyst.
(prostoglandulins)
