Ch. 54 Test

Question 1

List 3 ways that sonography plays an important role in the management of obstetric patients

Answer 1

guide invasive procedures, placental location, determine gest age, fetal growth

Question 2

List two ways that sonography has improved patient care

Answer 2

needle guide for amniocentesis, chorionic villous sampling, intrauterine transfusion without radiation

Question 3

Why are all multiple pregnancies considered high risk

Answer 3

3rd trimester bleeding, preeclampsia, premature delivery, prolapsed umbilical cord, congenital anomalies, 5 times more likely for fetal death

Question 4

What must be seen on the 1st trimester sonogram to definitely diagnose multiple pregnancy

Answer 4

multiple fetal poles with heart beats

Question 5

What are three clinical findings that would lead the attending physician to suspect multiple pregnancy

Answer 5

elevated AFP, elevated HCG, increased fundal height

Question 6

A complication of pregnancy characterized by increasing hypertension, proteinuria, and edema is

Answer 6

toxemia and pre eclampsia

Question 7

_____ is a type of monozygotic twinning that occurs when the egg divides into twins after 13 days

Answer 7

conjoined

Question 8

______ refers to coma and seizures in the 2nd or 3rd trimester patient due to pregnancy induced HTN

Answer 8

eclampsia

Question 9

______ refers to excessive vomiting caused by pregnancy leading to dehydration and electrolyte imbalance

Answer 9

hyperemesis gravidarum

Question 10

_____ is a lack of development of the lower limbs of the fetus

Answer 10

caudal regression syndrome

Question 11

_____ twins come from two ova

Answer 11

fraternal

Question 12

_____ times come from the same ovum

Answer 12

identical, monozygotic

Question 13

______ is the result of an AV fistula in a multiple pregnancy with a single placenta. It results in one fetus being starved while the other goes into fluid overload

Answer 13

twin twin transfusion

Question 14

_______ MSAFP is associated with neural tube defects

Answer 14

increased

Question 15

Which is the safest type of twinning

Answer 15

di, di

Question 16

Which is the most dangerous type of twinning

Answer 16

mono, mono

Question 17

Why is it so important to document the presence/absence of a membrane between fetuses in a multiple pregnancy

Answer 17

If there are 2 separate sacs, the risk goes down

Question 18

_____ of pregnancies that begin as twins end up as singleton pregnancies

Answer 18

70%

Question 19

How does fetus papyraceous occur

Answer 19

fetus too large to be reabsorbed, when fetus dies, becomes compressed, dehydrated

Question 20

In twin twin transfusion, the _____ twin develops oligohydramnios and the ______ twin develops polyhydramnios

Answer 20

donor, recipient

Question 21

What is stuck twin

Answer 21

donor pushed against uterine wall because it has oligohydramnios

Question 22

If there is discordant growth between twins, does it definitely mean that twin twin transfusion is present

Answer 22

no

Question 23

What must be included in the report of a multiple gestation sonogram

Answer 23

gest sacs, # and location of placentas, gender, fetal measurements, detailed anatomical survey, biometrical data, presence of anomalies

Question 24

Can sonography determine whether or not twins are identical? How or why not?

Answer 24

yes/sometimes, gender and presence of membrane

Question 25

If the sonographer fails to detect a membrane separating the fetuses in a multiple pregnancy, does it automatically mean that the pregnancy is monoamniotic

Answer 25

no

Question 26

What other parameters can be used to determine the chorionicity and amnioticity of a multiple pregnancy

Answer 26

gender/dizygotic, entwined cords/monozygotic, more than 3 vessels in umbilical cord/mono amnionicity

Question 27

Why is it important to determine the gender of the fetuses in a multiple pregnancy

Answer 27

rule out twin twin transfusion

Question 28

What is hydrops fetalis

Answer 28

excessive accumulation of fluid in two or more fetal tissues/body cavities

Question 29

Immune hydrops is caused by _______ which is caused by

Answer 29

erythroblastosis fetalis, baby is Rh+ and mother is Rh- (isoimmunization)

Question 30

Erythroblastosis fetalis is prevented in sensitized women giving them ______ shots

Answer 30

RhoGAM

Question 31

Once a fetus develops erythroblastosis fetalis, how is the condition treated

Answer 31

intrauterine transfusion

Question 32

Name the 2 most current methods of detecting and assessing fetal anemia

Answer 32

portosynthesis, doppler MCA in fetus

Question 33

Describe the sonographic findings in fetal hydrops

Answer 33

ascites, pericardial effusions, edema, thickened placenta, polyhydramnios, pleural effusion, skin thickening

Question 34

Describe the two methods of performing fetal transfusion

Answer 34

intraperitoneal (old) needle to peritoneal cavity | intravascular (new) via umbilical vein

Question 35

__________ is a rare condition in which a mother becomes sensitized to fetal platelets, much like a Rh reaction, resulting in a fetus with an extremely low platelet count. What can happen to a fetus in this condition

Answer 35

alloimmune thrombocytopenia, fetal intracerebral hemorrhage (spontaneous bleeds in fetus)

Question 36

What is non-immune hydrops

Answer 36

hydrops is present in fetus but not a result of fetomaternal blood group incompatibility

Question 37

What are the most frequent/common causes on non-immune hydrops

Answer 37

cardiovascular lesions, hydrops due to any cause other than Rh sensitation

Question 38

List five other causes of non immune hydrops

Answer 38

chromosomal, twins, urinary problems, GI problems, placenta/limb problems, infetions

Question 39

Why is a pregnancy high risk if the mother is diabetic

Answer 39

liver controls serious infections, macrosomia, stillbirth, congenital anomalies, preterm labor, caudal regression syndrome

Question 40

______ is the primary fuel for fetal growth

Answer 40

glucose

Question 41

List three things that are associated with poor glucose control

Answer 41

macrosomia, 3rd trimester loss, respiratory distress, polyhydramnios, PROM

Question 42

List eight congenital anomalies that are associated with maternal diabetes

Answer 42

caudal regression syndrome, congenital heart defects, neural tube defects, duodenal atresia, renal agenesis, hydronephrosis, ventricular septal defect, microcephaly

Question 43

What fetal tests are done to determine lung maturity

Answer 43

LS ratio, PG levels, aminocentesis, lung surfacant

Question 44

What negative effects does maternal hypertension have on a pregnancy

Answer 44

oligohydramnios, preeclampsia, IUGR, placenta abruption, eclampsia, small placenta

Question 45

What is thought to cause pregnancy induced hypertension

Answer 45

prostaglandin abnormalities

Question 46

How does lupus affect a pregnancy

Answer 46

placenta affected by immune complex deposits and inflammatory responses in placental vessels, increased spontaneous abortions, stillbirths, IUGR

Question 47

What are symptoms of lupus

Answer 47

butterfly rash on face, BUN and creatine elevated

Question 48

What role does sonography play in evaluating hyperemesis gravidarum

Answer 48

rule out trophoblastic disease and gallstones, multiple gestations

Question 49

What maternal complications are obese women at increased risk for

Answer 49

hypertension, preeclampsia, UTI, gestational diabetes

Question 50

How can uterine fibroids complicate pregnancy

Answer 50

cause premature birth, obstruct pathway for delivery, poor placental prefusion (IUGR), interfere with placental growth

Question 51

Which trimester has the highest rate of fetal death

Answer 51

1st

Question 52

What landmarks are followed in the doctor's office during the 2nd trimester

Answer 52

fetal heart tones, fundal height, fetal movements felt by mom

Question 53

The primary sonographic indicator of fetal demise is _____. What are the indicators?

Answer 53

absent heartbeat, absent fetal movement, overlap of skullbones (spaulding sign), exaggerated curved spine, gas in fetal abdomen, Duels sign (halo)

Question 54

If the fetus has died, why is it important for the sonographer to still do a complete sonogram

Answer 54

obtain structural anomalies and biometry to determine estimated weight for delivery

Question 55

______ is defined as the onset of labor before 37 weeks

Answer 55

preterm

Question 56

_____ is the inhibition of labor

Answer 56

tocolysis

Question 57

The more premature a baby is, the more problems it will have

Answer 57

true

Question 58

What is the role of sonography in preterm labor

Answer 58

assess AFI, assist for amniocentesis, fetal weight

Question 59

Why is amniocentesis often done on patients in premature labor

Answer 59

determine lung maturity

Question 60

What are the two views on management of patients with premature rupture of membranes

Answer 60

conservative-observe and wait to induce for fetal distress/infection active- deliver within 48 hours to prevent infection

Question 61

What is external cephalic version

Answer 61

external manipulation to put baby head down

Question 62

Why is external cephalic version performed

Answer 62

to avoid c-section

Question 63

What are the contra-indications for external cephalic version

Answer 63

low fluid, obese, prior c section, anterior placenta, tight abdomen

Question 64

List the functions of amniotic fluid

Answer 64

protect, cushion, allows movement, maintain intraunterine temperature

Question 65

What is produced by umbilical cord and membranes, the fetal lungs, skin and kidneys

Answer 65

amniotic fluid

Question 66

Which method is used for visual assessment of AFV

Answer 66

subjective assessment of fluid

Question 67

Fetal production of urine and ability to swallow begin in what weeks

Answer 67

8-11 weeks

Question 68

Amniotic sheets are believed to be caused by what

Answer 68

synechiae (uterine scars)