4. Introduction to Foetal Medicine

Question 1

Foetal medicine (perinatology)

Answer 1

Managing health concerns of the mother and foetus during pregnancy

Answer 2

• Screening and diagnosis of chromosomal abnormalities; foetal conditions or complications in multiples
• Prediction and prevention of pregnancy complications (pre-eclampsia, preterm delivery, growth restriction)

Question 3

1st trimester marker for foetal aneuploidies

Answer 3

Foetal Nuchal Translucency >3mm

Question 4

Patau syndrome cause:

Answer 4

Trisomy 13,

Meiotic non-disjunction

Question 5

Patau syndrome feautres:

Answer 5

Small head, no eyebrows, cleft lip/palate, malformed ears, undescended testes, CNS, facial, heart abnormalities

Question 6

Death rate in Patau Syndrome

Answer 6

> 80% will die in the 1st year of life

Question 7

Edwards syndrome

Answer 7

Trisomy 18

Question 8

Edward Syndrome features:

Answer 8

CNS, facial, heart, renal abnormalities; Flexed big toe, prominent heels, malformed ears, clenched fists, overlapping fingers, wide-set nipples, prominent back of the skull.

Question 9

When does FETO occur?

Answer 9

Foetal Endoscopic Tracheal Occlusion (FETO) in Congenital Diaphragmatic Hernia

Question 10

Foetal therapy

Answer 10

Prenatal surgical and medical intervention to decrease morbidity and improve neurodevelopmental outcomes of a child

Question 11

Chorionic villous sampling

Answer 11

Taking a small amount of placenta under US guidance. Safest <15 weeks

Question 12

Amniocentesis

Answer 12

Taking a small amount of amniotic fluid under ultrasound guidance. Safest >15 weeks

Question 13

Foetal arrhythmia treatment:

Answer 13

Hydrops: Flecainide, Sotalol

No hydrops: Digoxin, Sotalol

Question 14

What is hydrops

Answer 14

Large amounts of fluid build up in baby’s tissue and organs

Question 15

PET (pre-eclampsia)

Answer 15

New hypertension in pregnancy with onset >20 weeks with significant proteinura

Question 16

Incidence of Pre-eclampsia

Answer 16

5%

Question 17

High risk factors for pre-eclampsia

Answer 17

DM, SLE, Previous pre-eclampsia, CKD, chronic hypertension

Question 18

Moderate risk factors for pre-eclampsia

Answer 18

First pregnancy, age>40, BMI>35, interpregnancy interval >10 years, family history

Question 19

Aetiology of pre-eclampsia

Answer 19

Abnormal placentation with release of inflammatory mediators leading to inflammation and vasospasm

Question 20

Prediction of pre-eclampsia

Answer 20

Maternal history (priory risk) + Biophysical markers + Biochemical markers

Question 21

Pre-eclampsia prevention treatment

Answer 21

150mg of aspirin bedtime (12 to 36 weeks)