CH 50 WORKBOOK - 1st TRIMESTER COMPLICATIONS

Question 1

partial or complete absence of the cranium

Answer 1

acrania reported as early as 12 weeks predecessor to anencephaly

Question 2

gestational sac without an embryo

Answer 2

anembryonic pregnancy (blighted ovum)

Question 3

congenital absence of the brain and cranial vault with the cerebral hemispheres missing or reduced to small masses

Answer 3

anencephaly “frog face” seen at the end of the first trimester

Question 4

gestational sac without an embryo

Answer 4

blighted ovum (anembryonic pregnancy)

Question 5

during the first trimester, the bowel normally herniates outside the abdominal cavity between 8 and 12 weeks

Answer 5

bowel herniation

Question 6

protrusion of the brain from the cranial cavity

Answer 6

cephalocele midline cranial defect herniation of brain tissue and/or meninges (brain membranes)

Question 7

complete expulsion of all products of conception, including embryo and deciduas

Answer 7

complete abortion

Question 8

a physiologic cyst that develops within the ovary after ovulation, secretes progesterone, and prevents menses if fertilization occurs; may persist until the 16th to 18th week of pregnancy

Answer 8

corpus luteum cyst

Question 9

fluid-filled structure (often with septations) initially surrounding the neck; may extend upward to the head or laterally to the body

Answer 9

cystic hygroma one of the most common abnormalities seen in the 1st trimester most common: Turner’s Syndrome Trisomy 21, 18, and 13 If the hygroma resolves by week 18, the chromosomes are usually normal

Question 10

a pregnancy that implants in a location other than the center of the uterus

Answer 10

ectopic pregnancy

Question 11

congenital defective opening in the wall of the abdomen just to the right of the umbilical cord; bowel and other organs may protrude outside the abdomen from this opening

Answer 11

gastroschisis difficult to diagnose in the first trimester

Question 12

condition in which trophoblastic tissue overtakes the pregnancy and propagates throughout the uterine cavity; partial and complete

Answer 12

gestational trophoblastic disease –

Question 13

simultaneous intrauterine and extrauterine pregnancy

Answer 13

heterotopic pregnancy

Question 14

failure of forebrain to divide into two cerebral hemispheres, resulting in a single large ventricle with varying amounts of cerebral cortex; has been known to occur with trisomies 13, 15, and 18

Answer 14

holoprosencephaly should divide into cerebral hemispheres and lateral ventricles between week 4 and 8 3 types: Alobar (most serious), lobar, semilobar

Question 15

pregnancy loss with products of conception remaining in the uterus

Answer 15

incomplete spontaneous abortion

Question 16

a rare neural tube defect in which the brain tissue protrudes through a fissure in the occiput, so that the brain and the spinal cord occupy a single cavity

Answer 16

iniencephaly occupital defect involving the foramen magnum retroflexed spine fetus looks upward open spinal defects are present

Question 17

pregnancy occurring in the fallopian tube near the cornu of the uterus; also known as cornual pregnancy

Answer 17

interstitial pregnancy

Question 18

congenital defect of the abdominal wall with protrusion of abdominal contents into the base of the umbilical cord; the cord appears to enter the mass

Answer 18

omphalocele difficult to diagnose in the first trimester

Question 19

decidual reaction with fluid occurring within the uterus in a patient with an ectopic pregnancy

Answer 19

pseudogestational sac

Question 20

additional term for missed abortion or miscarriage

Answer 20

spontaneous pregnancy loss (SPL)

Question 21

a nonlethal genetic abnormality; chromosomal makeup is 45XO instead of the normal 46XX or 46XY. Cystic hygroma often is seen in affected fetuses in the first trimester. Survivors tend to be short in stature with low-set ears, webbing of the neck, a shield-shaped chest, and infertility as a result of an endocrine disorder caused by failure of the ovaries to respond to pituitary hormone

Answer 21

Turner’s syndrome

Question 22

dilation of the cerebral ventricles without enlargement of the cranium

Answer 22

ventriculomegaly

Question 23

results from a cystic dilation of the 4th ventricle with dysgenesis or complete agenesis of the cerebellar vermis and frequently hydrocephaly

Answer 23

Dandy Walker 6 to 7 week of gestation

Question 24

spinal irregularities with bulging within the contour of the spine

Answer 24

spina bifida can be detected late 1st trimester

Question 25

partial or complete absence of the cranium

Answer 25

Acrania

Question 26

gestational sac without an embryo

Answer 26

Anembryonic (blighted ovum)

Question 27

congenital absence of the brain and cranial vault with the cerebral hemispheres missing or reduced to small masses

Answer 27

Anencephaly

Question 28

during the first trimester, the bowel normally herniates outside the abdominal cavity between 8 and 12 weeks

Answer 28

bowel herniation

Question 29

complete expulsion of all products of conception, including embryo and deciduas

Answer 29

complete abortion

Question 30

a physiologic cyst that develops within the ovary after ovulation, secretes progesterone and prevents menses if fertilization occurs; may persist until the 16th week of pregnancy

Answer 30

corpus luteum cyst

Question 31

fluid-filled structure (often with sepatations) initially surrounding the neck; may extend upward to the head or laterally to the body

Answer 31

cystic hygroma

Question 32

a pregnancy that implants in a location other than the center of the uterus

Answer 32

ectopic pregnancy

Question 33

congenital defective opening in the wall of the abdomen just to the right of the umbilical cord; bowel and other organs may protrude outside the abdomen from this opening

Answer 33

gastroschisis

Question 34

condition in which trophoblastic tissue overtakes the pregnancy and propagates throughout the uterine cavity; partial and complete

Answer 34

gestational trophoblastic disease

Question 35

simultaneous intrauterine and extrauterine pregnancy

Answer 35

heterotopic pregnancy

Question 36

failure of forebrain to divide into cerebral hemispheres, resulting in a single large ventricle with varying amounts of cerebral cortex; has been known to occur with trisomies 13, 15 and 18

Answer 36

holoprosencephaly

Question 37

pregnancy loss with products of conception remaining in the uterus

Answer 37

incomplete abortion

Question 38

a rare neural tube defect in which the brain tissue protrudes through a fissure in the occiput, so that the brain and the spinal cord occupy a single cavity

Answer 38

iniencephaly

Question 39

pregnancy occurring in the fallopian tube near the cornu of the uterus; AKA cornual pregnancy

Answer 39

interstitial pregnancy

Question 40

congenital defect of the abdominal wall with protrusion of abdominal contents into the base of the umbilical cord; the cord appears to enter the mass

Answer 40

omphalocele

Question 41

additional term for missed abortion or miscarriage

Answer 41

spontaneous pregnancy loss (SPL)

Question 42

a nonlethal genetic abnormality; chromosomal makeup is 45XO instead of the normal 46XX or 46XY. Cystic hygroma often is seen in affected in the first trimester. Survivors tend to be short in stature with low-set ears, webbing of the neck, a shield-shape chest, and infertility as a result of an endocrine disorder caused by failure of the ovaries to respond to pituitary hormone

Answer 42

Turner's syndrome

Question 43

dilation of the cerebral ventricles without enlargement of the cranium

Answer 43

ventriculomegaly

Question 44

The dominant structure seen within the embryonic cranium within the first trimester is the:

Answer 44

choroid plexus

Question 45

\_\_\_\_\_\_\_\_\_\_\_ of the cranial vault is not complete in the first trimester; the resulting false cranial border definition may give rise to a false-negative diagnosis for cranial anomaly

Answer 45

ossification

Question 46

an abnormality that may be seen near the end of the first trimester when there is absence of the cranium superior to the orbits with preservation of the base of the skill and facial features with the brain projected from the open cranial vault

Answer 46

anencephaly

Question 47

in ____________ the choroid plexus is shown to be "dangling" in the dilated dependent lateral ventricle.

Answer 47

ventriculomegaly

Question 48

On U/S a large posterior fossa cyst that is continuous with the fourth ventricle an elevated tentorium, and dilation of the third and lateral ventricles may be seen in a fetus with _____________ \_\_\_\_\_\_\_\_.

Answer 48

Dandy-walker malformation

Question 49

The fetal urinary bladder becomes sonographically apparent at _______ weeks

Answer 49

12-Oct

Question 50

one of the most common abnormalities seen sonographically in the first trimester is ______ \_\_\_\_\_\_\_\_

Answer 50

cystic hygroma

Question 51

sonographically, placental hematomas may be difficult to distinguish from __________ hemorrhages

Answer 51

subchorionic

Question 52

by far the most common ovarian mass seen in the first trimester of pregnancy is a ______ \_\_\_\_\_\_ cyst

Answer 52

corpus luteum

Question 53

List associated risks factors for ectopic pregnancies

Answer 53

PID, IUD, Fallopian tube SX, infertility TX, HX of prior ectopics

Question 54

the most important finding in scanning for ectopic pregnancy is to determine if there is a normal intrauterine gestation or if the uterine cavity is ______ and an adnexal ____ is present

Answer 54

empty; mass

Question 55

as many as 20% of patients with ectopic pregnancy demonstrate an intrauterine saclike structure known as the _____________ \_\_\_\_

Answer 55

pseudogestational sac

Question 56

embyronic cardiac rates lower than __ BPM at any gestational age within the first trimester have been shown to be a poor prognosis

Answer 56

90

Question 57

cornual pregnancy, or \_\_\_\_\_\_\_\_\_, is potentially the most life-threatening of all ectopic pregnancies

Answer 57

interstitial

Question 58

the most common occurrence of bleeding in the first trimester results from ________ hemorrhages

Answer 58

subchorionic

Question 59

several sonographic findings may be shown with _________ abortion, ranging from an intact gestational sac with a nonliving embryo to a collapsed gestational sac that is grossly misshapen

Answer 59

incomplete

Question 60

a proliferative disease of the trophoblast after a pregnancy is ________ \_\_\_\_\_\_\_\_ disease

Answer 60

gestational trophoblastic

Question 61

in the above condition, serum levels of beta-hCG are dramatically _______ often to greater than 100,000 IU/mL

Answer 61

elevated

Question 62

the characteristic "\_\_\_\_\_ \_\_\_\_\_\_" appearance of hydatidiform mole, which includes a moderately echogenic soft tissue mass filling the uterine cavity and stubbed with small cystic representing hydropic chorionic villi, may be seen on U/S

Answer 62

snow storm

Question 63

bilateral ______ \_\_\_\_\_ cysts have been reported in as many as half of molar pregnancies.

Answer 63

theca-lutein

Question 64

a young female in her first trimester presented in the ER with elevated human chorionic gonadotropin levels, bleeding, and pelvic pain. what are the sonographic findings?

Answer 64

A) sagittal midline TV image shows uterus w/out an embryo B) coronal image of right adnexa show ectopic gestational sac

Question 65

sonogram of 1st trimester pregnancy demonstrates this condition:

Answer 65

cervical pregnancy: gestational sac w/ intrauterine contents can be seen in the cervical region of the uterus

Question 66

name the structure that the arrows are pointing to in this 13 week embryo

Answer 66

skull is absent from fetal forehead to the top of the cranium In this anacephalc fetus.

Question 67

The mother presented with an elevated maternal serum alpha fetoprotein level, larger than appropriate for dates and bleeding. Describe the sonographic findings in this fetus.

Answer 67

uterus is filled with tiny grapelike clusters of tissue, which represents **hydatidiform mole**

Question 68

this was an US on a 13.5 week fetus. describe the sonographic findings

Answer 68

* presets with marked ventriculomegaly very early in 2nd trimester * normally choroids fill the lateral ventricles at this gestational age