Advanced Prenatal Eval Flashcards

1
Q

benefits of ultrasound

A

noninvasive imaging of intrauterine contents

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2
Q

primary use of ultrasound

A
identify gestational age
diagnose intrauterine pregnancy
number of pregnancies (fetuses)
assess for malformations and abnormalities (can be a sign of genetic disorders)
fetal wellbeing
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3
Q

what is the degree of error for ultrasound identifying gestational age?

A

weeks equal to trimester it’s used

- 1st trimester = +/- 1wk, 3T = +/- 3wks

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4
Q

when is an ultrasound routinely performed

A

first trimester
second trimester - anatomy scan 18-22wks
labor and delivery - confirm cephalic lie or when BPP indicated

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5
Q

what is the umbilical artery doppler used for

A

monitoring growth-restricted babies

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6
Q

what is normal for umbilical arteries?

A

in normal babies, there’s high end diastolic flow in the umbilical arteries

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7
Q

what happens if resistance in the placenta increases?

A

end diastolic flow slows down and can be absent or reversed if severe

  • indicative of an increased risk of mortality
  • systolic/diastolic ratio is measured (increased is abnormal)
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8
Q

what is the MCA doppler used for?

A

assess for fetal anemia

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9
Q

what is seen on an MCA doppler

A

after 20wks, an increased flow by intracranial doppler is indicative of fetal anemia

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10
Q

when is an MCA doppler used

A

patients at risk for developing a fetal anemia, especially in the setting of alloimmunization

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11
Q

what is amniocentesis used for?

A

genetic diagnosis

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12
Q

when can amniocentesis be done?

A

as early as 15-20wks

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13
Q

what is amniocentesis

A

fluid taken from amniotic sac

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14
Q

when is amniocentesis reliable?

A

15wks

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15
Q

what are the risks of amniocentesis

A

pregnancy loss

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16
Q

what do you look at for amniocentesis

A

amniocytes

17
Q

when is chorionic villous sampling (CVS) used?

A

high risk or desire diagnosis early

  • advanced maternal age (>35)
  • those who have suffered from infants with birth defects, fetal demise, and intellectual disability
18
Q

why is CVS considered in AMA?

A

increased risk of:

  • trisomy 13 = patau
  • trisomy 18 = edwards
  • trisomy 21 = down’s
19
Q

when can CVS be done?

A

10-13wks

20
Q

risks of CVS

A

invasive

carries risk of fetal demise

21
Q

what is CVS

A

sampling of chorionic villous (made from pregnancy tissue) to directly test genes

22
Q

what is the advantage of CVS over amniocentesis

A

CVS can be performed earlier in pregnancy and has a faster turnaround time

23
Q

what are less invasive tests that can be used instead of CVS or amniocentesis?

A

cell-free fetal DNA

24
Q

what is percutaneous umbilical blood sampling (PUBS)/cordocentesis used for?

A

definitive means of diagnosing and treating fetal anemia

25
Q

when to use PUBS/cordocentesis?

A

MCA doppler positive (fetal anemia)

babe requires transfusion to survive

26
Q

when can PUBS/cordocentesis be performed?

A

20wks < x < 32wks