Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OBGYN > 7: Fetal complications > Flashcards

7: Fetal complications Flashcards

1
Q

if fundal height varies more than ? from gestational age, get US

A

3 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

conditions that lead to SGA infants

A

congenital: Down’s, trisomy 18, 13, Turner syndrome, OI, achondroplasia, NTDs, anencephaly, other AR diseases
IU infection: CMV, rubella
exposure to teratogens (etOH, cigarettes)
radiation exposure
small maternal stature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

maternal risk factors for IUGR

A

HTN, anemia, CKD, SLE, APA syndrome, malnutrition, severe DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

placental risk factors for IUGR

A

placenta previa, chronic abruption, placental infaction, multiple gestations, placental thrombosis, marginal cord insertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how to monitor infant at risk for IUGR

A

serial US scans every 2-3 wks

fetus with DGP will be consistently small, whereas IUGR will progressively fall off the growth curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

another test to ddx IUGR

A

doppler investigations of the umbilical artery
normally diastolic flow decreases to 50-80% of systolic, but if significantly decreased or even reversed/absent implies increased placental resistance (thrombosed/calcified placenta)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

fetal demise risk assessment of SGA fetuses that have fallen off growth curve

A

nonstress test (NST), oxytocin challenge test (OCT), biophysical profile (BPP), and umbilical Doppler velocimetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

definition of macrosomia

A

a birth weight greater than 4,500 g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

risks of macrosomia

A

low Apgar scores, hypoglycemia, polycythemia, hypocalcemia, and jaundice.
leukemia, Wilms tumor, and osteosarcoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

offer elective C section at what fetal weights?

A

estimated fetal weight of 5,000 gms or greater in women without gestational diabetes and 4,500 gms or greater in women with gestational diabetes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The amniotic fluid reaches its maximum volume of about ? at about ? weeks.

A

800 mL at about 28 weeks

volume maintained until close to term when it begins to fall to about 500 mL at week 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how is amniotic fluid index (AFI) calculated

A

by dividing the maternal abdomen into quadrants, measuring the largest vertical pocket of fluid in each quadrant in centimeters, and summing them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

oligohydramnios?

polyhydramnios?

A

AFI less than 5

AFI 20 or 25+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

oligohydramnios risks

A

umbilical cord compression, congenital anomalies (GU), IUGR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

causes of oligohydramnios

A

ROM is most common!
chronic uteroplacental insufficiency (UPI), Congenital abnormalities of the GU tracts, Potter syndrome (renal agenesis), PKD, obstruction of GU system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

polyhydramnios associations

A

Fetal structural and chromosomal abnormalities, maternal DM, NTDs, obstruction of fetal alimentary canal, hydrous, TE fistula, duodenal atresia, twin-twin transfusion

17
Q

Erythroblastosis fetalis, or fetal hydrops s/s

A

hyperdynamic state, heart failure, diffuse edema, ascites, and pericardial effusion, is the result of serious anemia. Fetal hydrops is defined as accumulation of fluid in the extracellular space in at least two body compartments.

18
Q

when should RhoGAM be given?

A

to Rh- mother at 28 weeks and postpartum if the neonate is Rh+
also if exposed to fetal blood: amniocentesis, miscarriage, vaginal bleeding, abruption, and delivery
0.3 mg of Rh IgG, will eradicate 15 mL of fetal RBCs

19
Q

if Rh Ab screen is +, check Ab titers. what is a worrisome titer? f/u with what?

A

> 1:16

-begin serial amniocentesis at 16-20 wks to determine fetal Rh status

20
Q

if fetus is Rh+ in sensitized mom with titers >1:16 check for ?

A

fetal anemia using fetal middle cerebral artery (MCA) Doppler measurements, will have greater PSV (peak systolic velocity) measurements

21
Q

beneficial procedures for fetal anemia

A

percutaneous umbilical blood sampling (PUBS) and intrauterine transfusion (IUT) next best: fetal intraperitoneal transfusion

22
Q

other RBC antigens

A

ABO blood type, antigens CDE in which D is the Rh antigen, Kell, Duffy, and Lewis

23
Q

a retained IUFD > 3 to 4 weeks can lead to

A

hypofibrinogenemia secondary to the release of thromboplastic substances from the decomposing fetus–>DIC

24
Q

treatment for early IUFD

A

evacuation with D/E or with mifepristone and misoprostol

25
Q

treatment for IUFD >20 wks

A

the pregnancy is usually terminated by induction of labor with prostaglandins or high-dose oxytocin

26
Q

screening tests to do after IUFD

A

screening for collagen vascular disease or hypercoagulable state, fetal karyotype, and often TORCH titers (i.e., toxoplasmosis, RPR, CMV, and HSV).
microarray studies of the fetal or placental genome to both look for aneuploidy, autopsy

27
Q

postterm pregnancy

fetal associations?

A

> 42 weeks
anencephaly, fetal adrenal hypoplasia, and absent fetal pituitary. All are notable for diminished levels of circulating estrogens.

28
Q

most clinicians offer induction after ? weeks

benefits?

A

> 41 wks
lower rates of cesarean delivery (even with an unfavorable cervix) as well as lower rates of meconium aspiration syndrome

29
Q

Recent evidence suggests that active labor does not begin until at least ?cm in induced labor.

A

6cm

30
Q

obstetric complications of multiple gestations

A

preterm labor, placenta previa, cord prolapse, postpartum hemorrhage, cervical incompetence, gestational diabetes, and preeclampsia

31
Q

multiple gestation fetus is at risk for

A

preterm delivery, congenital abnormalities, SGA, and malpresentation.

32
Q

Monochorionic (one placenta), diamnionic (two amniotic sacs) (Mo-Di) twins are at risk for ?

A

twin-to-twin transfusion syndrome (TTTS) as they often have placental vascular communications

33
Q

Monochorionic, monoamnionic (Mo-Mo) twins complications

A

an extremely high mortality rate (reported as high as 40% to 60%) secondary to cord accidents from entanglement.

34
Q

Di-Di twins if division before
Mo-Di twins if division btw
Mo-Mo twins if division btw

A 
day 3 
days 3-8
days 8-13
days 13-15
after will be single
35
Q

“twin peak” sign seen on US

A

in Di-Di twins: the fused chorionic and amniotic membranes

36
Q

Twin-to-Twin Transfusion Syndrome (TTTS) or Polyhydramnios-oligohydramnios (poly-oli) sequence results in

A

one fetus with hypervolemia, cardiomegaly, glomerulotubal hypertrophy, edema, and ascites, and the other with hypovolemia, growth restriction, and oligohydramnios.

37
Q

Vaginal delivery of ? presenting twins is preferred and is possible with ? twins under the right circumstances. ? presenting twins are delivered by cesarean section.

A

vertex/vertex
vertex/nonvertex
Nonvertex

OBGYN (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions