Chapter 48 - First 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