CH 50 WORKBOOK - 1st TRIMESTER COMPLICATIONS Flashcards
partial or complete absence of the cranium
acrania reported as early as 12 weeks predecessor to anencephaly
gestational sac without an embryo
anembryonic pregnancy (blighted ovum)
congenital absence of the brain and cranial vault with the cerebral hemispheres missing or reduced to small masses
anencephaly “frog face” seen at the end of the first trimester
gestational sac without an embryo
blighted ovum (anembryonic pregnancy)
during the first trimester, the bowel normally herniates outside the abdominal cavity between 8 and 12 weeks
bowel herniation
protrusion of the brain from the cranial cavity
cephalocele midline cranial defect herniation of brain tissue and/or meninges (brain membranes)
complete expulsion of all products of conception, including embryo and deciduas
complete abortion
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
corpus luteum cyst
fluid-filled structure (often with septations) initially surrounding the neck; may extend upward to the head or laterally to the body
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
a pregnancy that implants in a location other than the center of the uterus
ectopic pregnancy
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
gastroschisis difficult to diagnose in the first trimester
condition in which trophoblastic tissue overtakes the pregnancy and propagates throughout the uterine cavity; partial and complete
gestational trophoblastic disease –
simultaneous intrauterine and extrauterine pregnancy
heterotopic pregnancy
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
holoprosencephaly should divide into cerebral hemispheres and lateral ventricles between week 4 and 8 3 types: Alobar (most serious), lobar, semilobar
pregnancy loss with products of conception remaining in the uterus
incomplete spontaneous abortion
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
iniencephaly occupital defect involving the foramen magnum retroflexed spine fetus looks upward open spinal defects are present
pregnancy occurring in the fallopian tube near the cornu of the uterus; also known as cornual pregnancy
interstitial pregnancy
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
omphalocele difficult to diagnose in the first trimester
decidual reaction with fluid occurring within the uterus in a patient with an ectopic pregnancy
pseudogestational sac
additional term for missed abortion or miscarriage
spontaneous pregnancy loss (SPL)
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
Turner’s syndrome
dilation of the cerebral ventricles without enlargement of the cranium
ventriculomegaly
results from a cystic dilation of the 4th ventricle with dysgenesis or complete agenesis of the cerebellar vermis and frequently hydrocephaly
Dandy Walker 6 to 7 week of gestation
spinal irregularities with bulging within the contour of the spine
spina bifida can be detected late 1st trimester
partial or complete absence of the cranium
Acrania
gestational sac without an embryo
Anembryonic (blighted ovum)
congenital absence of the brain and cranial vault with the cerebral hemispheres missing or reduced to small masses
Anencephaly
during the first trimester, the bowel normally herniates outside the abdominal cavity between 8 and 12 weeks
bowel herniation
complete expulsion of all products of conception, including embryo and deciduas
complete abortion
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
corpus luteum cyst
fluid-filled structure (often with sepatations) initially surrounding the neck; may extend upward to the head or laterally to the body
cystic hygroma
a pregnancy that implants in a location other than the center of the uterus
ectopic pregnancy
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
gastroschisis
condition in which trophoblastic tissue overtakes the pregnancy and propagates throughout the uterine cavity; partial and complete
gestational trophoblastic disease
simultaneous intrauterine and extrauterine pregnancy
heterotopic pregnancy
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
holoprosencephaly
pregnancy loss with products of conception remaining in the uterus
incomplete abortion
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
iniencephaly
pregnancy occurring in the fallopian tube near the cornu of the uterus; AKA cornual pregnancy
interstitial pregnancy
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
omphalocele
additional term for missed abortion or miscarriage
spontaneous pregnancy loss (SPL)
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
Turner’s syndrome
dilation of the cerebral ventricles without enlargement of the cranium
ventriculomegaly
The dominant structure seen within the embryonic cranium within the first trimester is the:
choroid plexus
___________ 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
ossification
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
anencephaly
in ____________ the choroid plexus is shown to be “dangling” in the dilated dependent lateral ventricle.
ventriculomegaly
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 _____________ ________.
Dandy-walker malformation
The fetal urinary bladder becomes sonographically apparent at _______ weeks
12-Oct
one of the most common abnormalities seen sonographically in the first trimester is ______ ________
cystic hygroma
sonographically, placental hematomas may be difficult to distinguish from __________ hemorrhages
subchorionic
by far the most common ovarian mass seen in the first trimester of pregnancy is a ______ ______ cyst
corpus luteum
List associated risks factors for ectopic pregnancies
PID, IUD, Fallopian tube SX, infertility TX, HX of prior ectopics
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
empty; mass
as many as 20% of patients with ectopic pregnancy demonstrate an intrauterine saclike structure known as the _____________ ____
pseudogestational sac
embyronic cardiac rates lower than __ BPM at any gestational age within the first trimester have been shown to be a poor prognosis
90
cornual pregnancy, or _________, is potentially the most life-threatening of all ectopic pregnancies
interstitial
the most common occurrence of bleeding in the first trimester results from ________ hemorrhages
subchorionic
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
incomplete
a proliferative disease of the trophoblast after a pregnancy is ________ ________ disease
gestational trophoblastic
in the above condition, serum levels of beta-hCG are dramatically _______ often to greater than 100,000 IU/mL
elevated
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
snow storm
bilateral ______ _____ cysts have been reported in as many as half of molar pregnancies.
theca-lutein
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?
A) sagittal midline TV image shows uterus w/out an embryo
B) coronal image of right adnexa show ectopic gestational sac
sonogram of 1st trimester pregnancy demonstrates this condition:
cervical pregnancy: gestational sac w/ intrauterine contents can be seen in the cervical region of the uterus
name the structure that the arrows are pointing to in this 13 week embryo
skull is absent from fetal forehead to the top of the cranium In this anacephalc fetus.
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.
uterus is filled with tiny grapelike clusters of tissue, which represents hydatidiform mole
this was an US on a 13.5 week fetus. describe the sonographic findings
- presets with marked ventriculomegaly very early in 2nd trimester
- normally choroids fill the lateral ventricles at this gestational age
