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ARRT (Ob/gyn US) > Chapter 32 Fetal Environment And Maternal Complications > Flashcards

Chapter 32 Fetal Environment And Maternal Complications Flashcards

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1
Q

What would increase the likelihood of developing placenta previa?

A

Previous C-section

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2
Q

_______is described as the situation in which the placenta edge extends into the lower uterine segment but ends more than 2cm away from internal os

A

Low-lying placenta

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3
Q

Mothers with gestational diabetes run the risk of having fetuses that are considered:

A

Macrosomic

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4
Q

Doppler assessment of the middle cerebral artery can evaluate the fetus for:

A

Hypoxia

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5
Q

The measurement that should be carefully scrutinized in cases of IUGR is the:

A

AC

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6
Q

The abnormal insertion of the umbilical cord into the membranes beyond the placental edge is termed:

A

Velamentous insertion

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7
Q

The cervix should measure at least _____ in length

A

3cm

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8
Q

IUGR is evident when the EFW is:

A

Below the 10th percentile

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9
Q

What is associated with polyhydramnios:

A
  • Omphalocele
  • Gastroschisis
  • Esophageal atresia
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10
Q

Evidence of polyhydramnios should warrant a careful investigation of the fetal:

A

Gastrointestinal system

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11
Q

Fetal TORCH is frequently associated with:

A

Intracranial calcifications

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12
Q

Normally, the S/D ratio:

A

Decreases with advancing gestation

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13
Q

The normal umbilical cord insertion point into the placenta is:

A

Central

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14
Q

A velamentous cord insertion is associated with:

A

Vasa previa

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15
Q

Increased S/D ratio is associated with:

A

*IUGR
*Placental insufficiency
*Perinatal mortality

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16
Q

Nonimmune hydrops is associated with:

A
  • Pleural effusion
  • Turner syndrome
  • Fetal infections
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17
Q

The maternal contribution to the placenta is the:

A

Decidua vera

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18
Q

A succenturiate lobe of the placenta refers to a:

A

Accessory lobe

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19
Q

The fetal contribution of the placental is the:

A

Chorion frondosum

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20
Q

_______would be least likely associated with immune hydrops:

A

Leiomyoma

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21
Q

The placenta is considered too thick when it measures:

A

> 4cm

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22
Q

What is associated with a thin placenta (3):

A
  • Preeclampsia
  • IUGR
  • Long-standing diabetes
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23
Q

What would be most likely confused for a uterine leiomyoma?

A

Myometrial contration

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24
Q

What is associated with a thick placenta:

A
  • Fetal infections
  • Rh isoimmunization
  • Multiple gestations
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25
Q

Placenta accrete denotes:

A

The placenta adheres to the myometrium

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26
Q

Clinical features of placental abruption:

A
  • Vaginal bleeding
  • Uterine tenderness
  • Abdominal pain
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27
Q

The most common placental tumor is the:

A

Choriangioma

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28
Q

What is associated with oligohydramnios:

A

*Bilateral renal agenesis
*Infantile polycystic kidney disease
*Premature rupture of membranes

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29
Q

The normal umbilical cord has:

A

Two arteries and one vein

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30
Q

The placenta releases ______ to maintain the corpus luteum

A

hCG

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31
Q

An anechoic mass is noted within the umbilical cord during a routine sonographic exam, what is the diagnosis?

A

Allantoic cyst

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32
Q

With Rh isoimmunization, the maternal antibodies cross the placenta and destroy the fetal:

A

RBC

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33
Q

Mothers with presentational diabetes as opposed to gestational diabetes, have an increase risk of a fetus with:

A

Neural tube defect

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34
Q

Pools of maternal blood noted within the placental substance are referred to as:

A

Maternal lakes

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35
Q

When the placenta completely covers the internal os, it is referred to as:

A

Total previa

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36
Q

One of the most common causes of painless vaginal bleeding in the second and third trimester is:

A

Placenta previa

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37
Q

Doppler sonography reveals vascular structures coursing over the internal os of the cervix. this is indicative:

A

Vasa previa

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38
Q

Penetration of the placenta beyond the uterine wall would be referred to as:

A

Placenta percreta

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39
Q

Pregnancy-induced maternal high blood pressure and excess protein in the urine after 20 weeks is termed:

A

Preeclampsia

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40
Q

Insertion of the umbilical cord at the edge of the placenta is referred to as:

A

Marginal cord insertion

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41
Q

Placental thickness should not exceed _____

A

4cm

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42
Q

______is an abnormally shaped placenta caused by the membranes inserting inwards from the edge of the placenta producing a curled-up plecental

A

Circumvallate placenta

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43
Q

________ are pools of maternal blood within the placental substance

A

Venous lakes

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44
Q

Abnormal cord insertion sites are described as:

A

Marginal or velamentous

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45
Q

The umbilical cord may be seen encircling the fetal neck, this is called:

A

Nuchal cord

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46
Q

______are linear bands of scar tissue within the uterus

A

Uterine synechiae (amniotic sheets)

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47
Q

Uterine synechaie are the result of:

A

Intrauterine adhesions

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48
Q

Those with an increased risk of preeclamsia include:

A

*Advanced maternal age
*Diabetic patients
*Gestational trophoblastic disease

49
Q

_______is a common benign smooth muscle uterine tumor

A

Leiomyoma (Fibroid)

50
Q

With _______ diabetes, the mother already has a history of diabetes

A

Pregestational

51
Q

Retained products of conception is typically treated with:

A

Dilation and curettage

52
Q

Incompatibility between the fetal and maternal RBC, a condition known as:

A

Erythroblastosis fetalis

53
Q

The treatment of an incompetent cervix is a:

A

Cerclage

54
Q

TORCH is an acronym that stands for:

A
  • Toxoplasmosis
  • Other infections
  • Rubella
  • Cystomegalovirus
  • Herpes
55
Q

Echogenic debris in the amniotic fluid may be:

A

Vernix or Meconium

56
Q

Normally, the S/D ratio will ______ with advancing gestation

A

Decrease

57
Q

The cord develops from the fusion of the:

A

Yolk stalk and vitelline duct (omphalomesenteric duct)

58
Q

Marginal cord insertion is at the:

A

Edge of the placenta

59
Q

_______ are the most common placental tumor

A

Chorioangioma

60
Q

The most common location of a chorioangioma is:

A

Adjacent to the umbilical cord insertion site at the placenta

61
Q

_______often results in only a few centimeters of placental separation

A

Partial abruption

62
Q

The ______is the element of the placenta closest to the fetus

A

Chorionic plate

63
Q

The ______is the area adjacent to the uterus

A

Basal layer

64
Q

_______denotes the insertion of the umbilical cord into the membranes beyond the placental edge

A

Velamentous cord insertion

65
Q

An ________is a mass that may be noted in the umbilical cord adjacent to the umbilical vessels

A

Allantoic cyst

66
Q

_______is essentially the focal dilation of the abdominal portion of the umbilical vein

A

Umbilical vein varix

67
Q

_______is the painless dilation of the cervix in the second or early third trimester

A

Cervical incompetence

68
Q

______is a result of the premature opening of the internal os and the subsequent bulging of the membranes into the dilated cervix

A

Funneling of the cervix

69
Q

_______is defined as the presence of pregnancy induced hypertension accompained by proteinuria

A

Preeclampsia

70
Q

_______diabetes, which is the most common type of diabetes during pregnancy, is pregnancy induced

A

Gestational

71
Q

The major risk for the fetus of a mother with gestational diabetes is:

A

Macrosomia

72
Q

The normal postpartum uterus returns to its normal nongravid size ______ after delivery

A

6 to 8 weeks

73
Q

______ occurs when the mother has RH- negative blood and the fetus has Rh positive blood

A

Maternal Rh sensitization

74
Q

_______is caused by the absence of a detectable circulating fetal antibody against the RBC in the mother

A

Immune hydrops

75
Q

________occurs when there is an accumulation of fluid within at least two fetal body cavities

A

Fetal hydrops (hydrops fetalis)

76
Q

The ______is defined as a fetus that has an EFW of greater than the 90th percentile

A

Obese fetus

77
Q

________is a rare disorder in which the mother suffer from edema and fluid buildup similar to hydropic fetus

A

Maternal mirror syndrome

78
Q

The prevention of immune hydrops caused by Rh sensitization is the administration of:

A

RhoGAM (Rh immune globulin)

79
Q

________is defined as an estimated fetal weight (EFW) that is below the 10th percentile at a given gestational age

A

IUGR

80
Q

In the neonatal period ________ is technically defined as the neonate that measure more than 4,500g in nondiabetic mothers and 4,000g in diabetic mothers

A

Macrosomia

81
Q

The two most commonly performed cerclage techniques are the:

A

*Shirodkar
*The McDonald

82
Q

The right and left middle cerebral arteries are branches of the anterior portion of the:

A

Circle of Willis

83
Q

The measurement that should be scrutinized closely in fetuses that are at risk for growth abnormalities is the:

A

Abdominal circumference (AC)

84
Q

The most widely accepted means of evaluating the volume of amniotic fluid is the:

A

Amniotic fluid index (AFI)

85
Q

The _______assesses the vascular resistance in the placenta by taking a sample of the umbilical artery

A

S/D ratio

86
Q

The umbilical vessels are surrounded by a gelationous material called ________ which is covered by a single layer of amnion

A

Wharton jelly

87
Q

_______often results in the development of a retroplacental hematoma, which is located between the placenta and the myometrium

A

Complete abruption

88
Q

______is defined as the abnormal adherence of the placenta to the myometrium in an area where the decidual is either absent or minimal

A

Placenta Accreta

89
Q

______is the premature separation of the placenta from the uterine wall before the birth of the fetus

A

Placental abruption

90
Q

______ lies at the edge of the placenta and the most common placental hemorrhage identified with sonography

A

Marginal abruption

91
Q

The complication of fetal vessels resting over the internal os of the cervix is called:

A

Vasa previa

92
Q

Implantation of the placenta may occur within the lower uterine segment which leads to the placenta covers the internal os is called

A

Placenta previa

93
Q

The placenta normally weighs between _____ and has a diameter of ______

A

*450 and 550g
*16 to 20cm

94
Q

The placenta consists of approximately ________ cotyledons, which are groups or lobes of chorionic villi

A

10 to 30

95
Q

The ________contains the functional parts of the placenta and is located between the chorionic plate and the basal layer

A

Placental substance

96
Q

Sonographic findings of retained products of conception

A
  1. Echogenic intracavitary mass that may contain some calcifications
  2. Color doppler signals within the retained placental tissue
97
Q

Sonographic findings of bladder flap hematoma

A
  1. Anechoic or complex mass located between the lower uterine segment and the posterior bladder wall
98
Q

Sonographic findings of cervical incompetence

A
  1. Cervical length of less than 3cm
  2. Funneling of the cervix (can produce a “U” or “‘V” shape)
99
Q

Sonographic findings of hemangiomas of the umbilical cord

A
  1. Solid hyperechoic mass within the umbilical cord
  2. Most often noted close to the insertion into the placenta
100
Q

Sonographic findings of allantoic cysts

A
  1. Cystic mass within the umbilical cord
  2. Most often noted closed to the fetal abdomen
101
Q

Sonographic findings of uterine synechia(e)

A
  1. Linear, echogenic band of tissue traversing the uterine cavity
  2. The band does not involve fetal parts and the normal fetus appears to move freely
102
Q

Sonographic findings of a chorioangioma

A
  1. Solid hypoechoic or hyperechoic mass within the placenta
103
Q

Sonographic findings of placenta accreta, increta and percreta

A
  1. Placenta previa
  2. Loss of the normal hypoechoic interface between the placenta and the myometrium
104
Q

Sonographic findings of placental abruption

A
  1. Hematoma located either at the edge of the placenta or between the placenta and the myometrium
105
Q

Sonographic findings of vasa previa

A
  1. Identification of vessels over the internal os of the cervix with the use of color doppler
  2. Velamentous cord insertion
106
Q

Sonographic findings of preeclampsia and eclampsia (5):

A
  1. Oligohydramnios
  2. IUGR
  3. Gestational trophoblastic disease
  4. Placental abruption
  5. Elevated S/D ratio
107
Q

Sonographic findings of fetal hydrops (4):

A
  1. Fluid accumulation within at least two fetal body cavities
  2. Fetal hepatosplenomegaly
  3. Polyhydramnios
  4. Thickened placenta
108
Q

Sonographic findings of fetal alcohol syndrome

A
  1. Microcephaly
  2. Dysgenesis of the corpus callosum
  3. Long round philtrum
  4. Malformed ears
  5. Microphthalmia
  6. Cleft palate
  7. Heart defect such as ventricular septal defects
109
Q

Sonographic findings of TORCH (5):

A
  1. Intracranial calcifications
  2. Microcephaly
  3. Microphthalmia
  4. Ventriculomegaly
  5. Hepatosplenomegaly
110
Q

Clinical findings of retained products of conception

A
  1. Postpartum vaginal bleeding
111
Q

Clinical findings of bladder flap hematoma

A
  1. Recent C-section
112
Q

Clinical findings of eclampsia

A
  1. Long-standing, uncontrolled preeclampsia
  2. Headaches
  3. Seizures
113
Q

Clinical findings of preeclampsia

A
  1. Maternal hypertension
  2. Maternal edema
  3. Maternal proteinuria
114
Q

Clinical findings of cervical incompetence (3):

A
  1. Painless dilation of the cervix
  2. Premature rupture of membranes
  3. Vaginal bleeding
115
Q

Clinical findings of a chorioangioma

A
  1. Possible elevation in maternal serum alpha-fetoprotein (MSAP)
116
Q

Clinical findings of placenta previa

A
  1. Previous c-section or uterine surgery
  2. Painless vaginal bleeding
  3. Possibly asymptomatic
117
Q

Clinical findings of placenta accreta, incretam and percreta

A
  1. Previous c-section or uterine surgery
  2. Painless vaginal bleeding if placenta previa is present
  3. Possibly asymptomatic
118
Q

Clinical findings of placental abruption

A
  1. Abdominal pain
  2. Possible vaginal bleeding
  3. Uterine contractions
  4. Uterine tenderness

ARRT (Ob/gyn US) (18 decks)

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