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OB-GYN Board Review > Assessment of the First Trimester > Flashcards

Assessment of the First Trimester Flashcards

1
Q

decidua parietalis / decidua vera

A

results from hormonal influence on the uninvolved endometrial tissue

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2
Q

gestational sac

A
  • Beta hCG of 1000 mIU/mL should demonstrate a GS transvaginally
  • transabdominal: 5mm mean sac diameter 5-6 weeks
  • transvaginal: 2-3mm about 4-5 weeks
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3
Q

sonographic findings of gestational trophoblastic neoplasm

A
  • moderately echogenic soft tissue uterine mass
  • cystic structures within mass
  • vascular flow
  • bilateral theca lutein cysts
  • possible adjacent fetus
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4
Q

chorion frondosum

A

the portion of the chorion that develops into the fetal portion of the placenta

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5
Q

abdominal wall

A
  • physiological herniation of the fetal bowel into the umbilical cord
  • bowel returns into abdomen, adn herniation resolves by the eleventh gestational week
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6
Q

What should be seen during the 6th week?

A
  • MSD 15-20mm
  • yolk sac visualized
  • c-shaped embryo approx 5mm
  • heart rate present
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7
Q

cornual ectopic

A
  • laterally placed gestational sac
  • myometrium incompletely surrounds the GS
  • highly vascular location
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8
Q

Nuchal Translucency

A
  • first trimester screening for chromosomal abnormalities
  • maximum thickness of the subcutaneous translucency betweem the skin and soft tissue overlying the cervical spine is measured
  • calipers are placed on the hyperechoic lines, not in the nuchal fluid, from inner-to-inner borders
  • exceeding 3 mm is abnormal
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9
Q

where does the zygote form?

A

in distal fallopian tube

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10
Q

What should be seen by the 5th week?

A
  • MSD 10mm
  • yolk sac seen transvaginally
  • may see embryonic disc and may wee cardiac activity
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11
Q

what are the risk factors for an ectopic?

A
  • pelvic infection
  • IUD
  • oviduct surgery
  • infertility treatment
  • endometriosis
  • previous ectopic
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12
Q

decidua basalis

A

portion of the endometrium on which the implanted conceptus rests

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13
Q

skeletal system

A
  • vertebral bodies and ribs are forming at 6 weeks
  • arms and legs are forming at 7 weeks
  • ossification of the vertebral bodies and rib cartilage at 9 weeks
  • long bones form during the 10 week
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14
Q

heterotopic pregnancy

A

one IUP and one extrauterine

differential: bicornuate uterus pregnancy in both horns, IUP with complex corpus luteal cyst

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15
Q

morula

A

solid mass of cells formed by cleavage of a fertilized ovum

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16
Q

The embryo unfolds and the midgut has herniated during what week?

A

8th week

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17
Q

What is demonstrated during 12th week?

A
  • midgut returned to abdominal cavity
  • skeletal body
  • fluid in stomach
  • yolk sac no longer seen
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18
Q

chorionic plate

A

the part of the chorionic membranethat covers the placenta

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19
Q

crown-rump length

A
  • measured until 12th gestational week
  • most accurate method of dating a pregnancy
  • sagittal measurement of the embryo or fetus from the top of the head to the bottom of the rump
  • lower extremities are not included in the measurement
  • length increases approximately 1 mm/day
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20
Q

What should be seen by the 4th week?

A

thickening of endometrium

MSD 2-3mm

21
Q

decidua capsularia

A

decidua that covers the surface of the implanted conceptus

22
Q

embryological age

A

length of time based from conception.

weeks 6-10

23
Q

decidua parietalia

A

decidua exclusive of the area occupied by the implanted conceptus; aka decidua vera

24
Q

embryo

A
  • embryonic period extends from the sixth through the tenth gestational weeks
  • transabdominal: usually detected within an MSD >25mm
  • transvaginal: usually detected in an MSD >16mm
25
Q

pseudocyesis

A
  • false pregnancy
  • psychological codition
  • normal nongravid uterus
  • normal adnexa
26
Q

The 10th week has what sonographic findings?

A
  • muscle movement has begun
  • hyperechoic choroid plexuses
  • rhombencephalon demonstrated
27
Q

mean sac diameter

A

establishes gestional age before visualization of an embryonic disc

MSD(mm)=length+height+width/3

28
Q

when is organogenesis generally completed?

A

by the 10th week

29
Q

decidua basalis

A

develops where the blastocyst implants

maternal contribution to placenta

30
Q

gestational trophoblastic neoplasm

A
  • abnormal proliferation of the trophoblast
  • hydatid swelling in a blighted ovum
  • trophoblastic changes in retained placental tissue
31
Q

what implants in the endometrium?

A

blastocyst

32
Q

anembryonic (blighted ovum)

A
  • zygote develops into a blastocyst but inner cell mass fails to develop
  • differential: missed abortion or pseudogestational sac
33
Q

complete abortion

A

miscarriage

differential: ectopic or early IUP

34
Q

clinical findings of pseudocuesis

A
  • nausea and vomiting
  • abdominal distention
  • amenorrhea
  • negative pregnancy test
  • differential: recent complete miscarriage
35
Q

differential of gestational trophoblastic neoplasm

A
  • incomplete abortion
  • degenerating fibroid
  • adenomyosis
36
Q

cranium

A
  • prosencephalon- forebrain
  • mesencephalon- midbrain
  • rhombencephalon- hindbrain
37
Q

fallopian tube ectopic

A
  • 95% are located in the fallopian tube
  • typically in ampulla
  • complex adnexal mass
  • cul-de-sac fluid
  • may display an extrauterine gestational sac with or without embryo
38
Q

decidua capsularis

A

closes over and surrounds the blastocyst

39
Q

clinical findings of gestational trophoblastic neoplasm

A
  • bleeding
  • hyperemesis
  • elevated beta hCG
  • large for dates
  • no heart tones
  • low maternal AFP
  • preeclampsia
40
Q

subchorionic hemorrhage

A
  • low pressure bleed from implant of blastocyst
  • becomes more anechoic with time
  • differential: nonviable twin, incomplete abortion, placenta abruption
41
Q

cardiovascular system

A
  • first system to function in the embryo
  • four heart chambers are formed by the eighth gestational week
  • cardiac motion as early as 5.5 weeks
42
Q

cardiac activity

A
  • first system to function in embryo
  • should be identified by 6 weeks, as early as 5.5 weeks
  • 110-115 bpm before 6 weeks
  • 120-160 bmp after 6 weeks
43
Q

Amnion

A
  • attaches to embryo at the umbilical cord insertion.
  • expands with accumulation of amniotic fluid and growth of the embryo
  • obliterates chorionic cavity by 16th week
44
Q

corpus lutem during pregnancy

A
  • secretes progestrone before placental circulation
  • usually measures
  • hypervascular periphery (ring of fire)
  • differential: ectopic or endometrium
45
Q

yolk sac

A
  • provides nutrition to the embryo
  • earliest structure visualized in the gestational sac
  • attached to the embryo by the vitelline duct
  • inner-to-inner border diameter should not exceed 6mm
  • transabdominal: evident within an MSD of 20mm
  • transvaginal: evident within an MSD of 8mm
46
Q

during what week do limb buds appear?

A

7th week

CRL 1 cm

47
Q

how long does it take fertilization to implant?

A

5 to 7 days

48
Q

incomplete abortion

A
  • retained products of conception
  • thick and complex endometrium
  • intact gestational sac with nonviable embryo
  • collapsed GS
  • differential: ectopic or endo dysplasia
49
Q

human chorionic gonadotropian

A
  • produced by the trophoblastic cells of the developing chorionic villi
  • normally doubles every 30 to 48 hours during the first 6 weeks of pregnancy
  • peaks at the tenth gestational week 100,00 mIU/mL
  • declines after tenth week and levels out at about 18 weeks 5000mIU/mL
  • gestaional sac should be identified transvaginally after the hCG levels reach 1000 mIU/mL and as early as 500 mIU/mL

OB-GYN Board Review (12 decks)

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