Ch 54: High Risk Pregnancies

Question 1

What is anasarca?

Answer 1

Severe generalized massive edema often seen with fetal hydrops

Anasarca is characterized by widespread swelling due to excess fluid accumulation in the body.

Question 2

Define caudal regression syndrome.

Answer 2

Lack of development of the caudal spine and cord that may occur in the fetus of a diabetic mother

This syndrome is associated with maternal diabetes and can result in severe congenital malformations.

Question 3

What are conjoined twins?

Answer 3

Twins physically connected that arise from a single fertilized egg, which divides after 13 days of fertilization.

Conjoined twins share some parts of their bodies and may have various degrees of connection.

Question 4

What does dizygotic mean?

Answer 4

Twins that arise from two separately fertilized ova

Dizygotic twins are also known as fraternal twins and can be of different sexes.

Question 5

What is eclampsia?

Answer 5

Coma and seizures in the second- or third-trimester patient secondary to pregnancy-induced hypertension

Eclampsia is a serious condition that can pose significant risks to both mother and fetus.

Question 6

What is fetus papyraceus?

Answer 6

Fetal death that occurs after the fetus has reached a certain growth that is too large to resorb into the uterus

This condition typically occurs in multiple pregnancies where one twin dies and the other continues to develop.

Question 7

Define hydrops fetalis.

Answer 7

Fluid collection occurring in at least two areas: pleural effusion, pericardial effusion, ascites, or skin edema

Hydrops fetalis can be a sign of severe fetal distress or underlying conditions.

Question 8

What is hyperemesis gravidarum?

Answer 8

Excessive vomiting during pregnancy that leads to dehydration and electrolyte imbalance

This condition can result in significant maternal weight loss and may require medical intervention.

Question 9

What is maternal serum alpha-fetoprotein?

Answer 9

Antigen present in the fetus

This protein is often measured in maternal blood to assess fetal health and development.

Question 10

What does maternal serum quad screen test for?

Answer 10

Blood test conducted during the second trimester to identify pregnancies at higher risk for chromosomal anomalies and neural tube defects

The quad screen measures four specific markers in the mother’s blood.

Question 11

Define monozygotic twins.

Answer 11

Twins that arise from a single fertilized egg

Monozygotic twins are genetically identical and share the same genetic material.

Question 12

What is nonimmune hydrops?

Answer 12

Group of conditions in which hydrops is present in the fetus but not as a result of fetomaternal blood group incompatibility

Nonimmune hydrops can result from various underlying fetal or maternal conditions.

Question 13

What is polyhydramnios?

Answer 13

Too much amniotic fluid; fluid measures greater than 22 on the amniotic fluid index

Polyhydramnios can be associated with fetal anomalies or maternal diabetes.

Question 14

Define preeclampsia.

Answer 14

Complication of pregnancy characterized by increasing hypertension, proteinuria, and edema

Preeclampsia can progress to eclampsia if left untreated, posing risks to both mother and baby.

Question 15

What is pregnancy-induced hypertension?

Answer 15

Elevation of maternal blood pressure that may put fetus at risk

This condition can lead to complications if not monitored and managed properly.

Question 16

What is systemic lupus erythematosus?

Answer 16

Inflammatory disease involving multiple organ systems

This autoimmune condition can complicate pregnancy and affect maternal and fetal health.

Question 17

What is twin twin transfusion syndrome?

Answer 17

Monozygotic twin pregnancy with single placenta and arteriovenous shunt within the placenta

This condition can lead to unequal blood flow and growth discrepancies between twins.

Question 18

Fill in the blank: _______ occurs when division of the egg occurs after 13 days.

Answer 18

Conjoined twins

This timing of egg division is crucial for the development of conjoined twins.

Question 19

Fill in the blank: Leaking or breaking of the amniotic membranes causing loss of amniotic fluid is called _______.

Answer 19

Premature rupture of membranes

This can lead to premature delivery or infection.

Question 20

What is described as advanced maternal age?

Answer 20

A patient who will be 35 or older at the time of delivery.

Question 21

What biochemical markers are tested in the first trimester?

Answer 21

Plasma protein A (PAPP-A) and free BhCG.

Question 22

What is measured in conjunction with ultrasound in the first trimester?

Answer 22

Nuchal translucency.

Question 23

What can be performed on mother in the second trimester for screening?

Answer 23

Maternal serum quad screen laboratory value and a targeted ultrasound examination.

Question 24

What is the detailed anatomy sonogram?

Answer 24

A detailed evaluation of all fetal anatomy that can be seen between 18 and 20 weeks’ gestation.

Question 25

What condition involves excessive fluid accumulation in fetal body cavities?

Answer 25

Hydrops fetalis.

Question 26

What is an antigen?

Answer 26

Any substance that elicits an immunologic response, such as production of an antibody to that substance.

Question 27

What is cordocentesis?

Answer 27

A procedure in which a needle is placed into the fetal umbilical vein to obtain a blood sample.

Question 28

What risk do infants with thrombocytopenia face?

Answer 28

Increased risk for intracerebral hemorrhage in utero and spontaneous bleeding.

Question 29

What is non-immune hydrops?

Answer 29

A group of conditions in which hydrops is present in the fetus but is not a result of fetomaternal blood group incompatibility.

Question 30

What are common causes of NIH (non-immune hydrops)?

Answer 30

Cardiovascular lesions, functional cardiac problems, and structural anomalies.

Question 31

What may occur if maternal glucose levels are very high and uncontrolled?

Answer 31

The fetus may become macrosomic.

Question 32

In which individuals is caudal regression syndrome seen almost exclusively?

Answer 32

Diabetic individuals.

Question 33

Small placentas may be associated with?

Answer 33

Hypertensive pregnancies due to pressure effects on blood vessels.

Question 34

What does the occurrence of seizures or coma in a preeclamptic patient represent?

Answer 34

Eclampsia.

Question 35

What is lupus?

Answer 35

A chronic autoimmune disorder that can affect almost all organ systems in the body.

Question 36

What is hyperemesis gravidarum?

Answer 36

When a pregnant woman vomits so much that she develops dehydration and electrolyte imbalance.

Question 37

What accounts for roughly one-half of all perinatal mortality?

Answer 37

Intrauterine fetal death.

Question 38

At 20 weeks' gestation, where should the uterine fundal height be?

Answer 38

The uterine fundal height should have risen to the umbilicus, measuring approximately 20 cm above the symphysis pubis.

Question 39

When should the mother begin to perceive fetal movements?

Answer 39

The mother should perceive fetal movements on a daily basis beginning between 16-20 weeks' gestation.

Question 40

What is the chance of perinatal death for a twin compared to a singleton fetus?

Answer 40

A twin has a times greater chance of perinatal death than a singleton fetus.

Question 41

How can multiple pregnancies be identified during the first trimester?

Answer 41

Multiple pregnancy can be identified by visualizing more than one gestational sac within the uterus.

Question 42

What are dizygotic twins?

Answer 42

Dizygotic twins arise from two separately fertilized ova.

Question 43

What is the placenta and chorion configuration in a dizygotic pregnancy?

Answer 43

In a dizygotic pregnancy, each ovum implants separately in the uterus and develops its own placenta and chorion, called dichorionic.

Question 44

What is a separate amnion called in a dizygotic pregnancy?

Answer 44

A separate amnion is called diamniotic.

Question 45

What are identical twins?

Answer 45

Identical or monozygotic twins arise from a single fertilized egg, which divides, resulting in one or two placentas, chorions, and amniotic sacs.

Question 46

What happens if the fertilized egg divides early (0 to 4 days post conception)?

Answer 46

If division occurs early, two amnions and two chorions (dichorionic, diamniotic) will be present.

Question 47

What occurs if division happens at 4-8 days post conception?

Answer 47

If division occurs at 4-8 days, one chorion and two amniotic sacs (monochorionic, diamniotic) will be present.

Question 48

What is the result of division occurring after 8 days?

Answer 48

If division occurs after 8 days, two fetuses will be present but only one chorion and one amnion (monochorionic or mono-amniotic).

Question 49

What may result if division occurs after 13 days?

Answer 49

If division occurs after 13 days, the division may be incomplete and conjoined twins may result.

Question 50

What characterizes stuck twin syndrome?

Answer 50

Stuck twin syndrome, or poly-oli sequence, is characterized by a diamniotic pregnancy with polyhydramnios in one sac and severe oligohydramnios in the other sac.

Question 51

What is twin-twin transfusion syndrome?

Answer 51

Twin-twin transfusion syndrome exists when an arteriovenous shunt is placed within the placenta.

Question 52

What is an Acardiac anomaly?

Answer 52

A rare anomaly occurring in monochorionic twins in which one twin develops without a heart and often with absence of the upper half of the body.

Question 53

What should a sonographer determine when scanning multiple gestations?

Answer 53

The sonographer should always attempt to determine whether one or two amniotic sacs are present by locating the membrane that separates the sacs.

Question 54

How does the size of a fetus from a multiple gestation compare to a singleton fetus?

Answer 54

A fetus from a multiple gestation is usually smaller than a singleton fetus.

Question 55

What are signs of fetal jeopardy during diastole?

Answer 55

No flow and reversed flow during diastole are signs of fetal jeopardy that may prompt further testing or delivery.