Chapter 52 and 53 Test Review Flashcards
Caudal regression syndrome is commonly found in patients with what?
diabetes
What term defines the appearance of over lapping skull bones that indicate fetal death?
Spalding’s Sign
What would fetal hydrops appear like under ultrasound?
extensive accumulation of fluid in fetal tissues scalp edema pleural effusion pericardial effusion ascites polyhydramnios thickened placenta
If hydrops is caused by tachycardia what would the fetal heart rate be?
a range from 200 to 240 bpm
If a patient of size has a baby, what would there be a more incidence of because the patient is of size?
neural tube defects
may be attributed to a deficiency in diet
What is caudal regression syndrome?
lack of development of the caudal spine and cord that may occur in the fetus of diabetic mother
Skeletal and central nervous system congenital anomalies in infants of diabetic mothers include…
caudal regression syndrome
neural tube defects excluding anencephaly
anencephaly with or without herniation of neural elements
microcephaly
When is it considered premature labor?
labor that begins before 37 wks
Monochroionic twin pregnancy during which one fetus develops without a heart or upper body, what is that condition?
Acardiac twin
Twin to twin transfusion
monozygotic twin pregnancy with single placenta and arteriovenous shunt within the placenta
monozygotic twins are at higher risk because of the shared placenta
twin to twin transfusion cannot exist between male/female twins
What is poly-oli sequence?
diamniotic pregnancy with polyhydramnios in one sac and severe oligohydramnios and smaller twin in the other sac
Poly-oli sequence is referred to what?
stuck twin syndrome
The development of conjoined twins occurs after how many day of conception?
13 days
Stuck twin syndrome is usually observed between what weeks?
16 to 26 weeks
Diamniotic/dichroionic twin pregnancy demonstrates what sonographic findings?
each fetus has their own placenta, chorion and amniotic sac
What one of the following demonstrated the division of one fertilized egg occurs 4-8 days after fertilization?
monochorionic, diamniotic
In twin to twin transfusion what is know to be true..
it exist when there is an arteriovenous shunt with the placenta.
The arterial blood of one twin is pumped into the venous system of the other twin.
The donor twin becomes anemic and growth restricted.
The twin has less blood flow through it’s kidneys and urinates less, causing it to develop oligohydramnios,
The recipient twin
gets too much blood flow
may be normal or larger in size
has excess blood flow through kidneys and urinates more, causing polyhydramnios
may go into heart failure and become hydropic
What are the predictors of discordance and the growth of twins?
a difference in estimated fetal weight of more than 20%
a difference in BPD of 6 mm
a difference in AC of 20 mm
a difference in femur length of 5 mm
Most frequent cause of non-immune hydrops is what?
cardiovascular lesions
What are the advantages of Chorionic villi sampling (CVS)?
biopsy of the placenta to obtain a fetal karyotype
performed early in pregnancy (10-14 wks)
results are available within 1 wk
early results allow more options for parents
Cordocentesis is mostly common used for what procedure?
to obtain a blood sample
evaluates blood type
hematocrit
hemoglobin
Amniocentesis may be used for what?
obtain a sample of amniotic fluid for Rh testing
monitor the isoimmunized pregnancy with delta optical denstiy 450
Why do we perform amniocentesis?
relieve polyhyramnios
to predict Rh isoimmunization
document fetal lung maturity
Twins that arise from two separately fetilized ova are what kind?
dizygotic
Sonographic findings may suggest chromosomal anomalies include what?
?
High levels of AFP indicate what?
neural tube defects
anencephaly
open spina bifida
The quad screen evaluates all of the following markers…
AFP (Alpha-Fetoprotein)
hCG
unconjugated estriol
inhibin-A
An abnormality in the number of chromosomes is called what?
aneuploidy
An early noninvasive means of assessing the risk of aneuploidy is what?
nuchal fold measurement
Secondary to pregnancy induced hypertension of coma and serizures of a patient in the 2nd and 3rd trimester represents what?
eclampsia
A large cystic hygroma, hydrops, coarctation of the aorta may be seen in a fetus with what?
Turner’s Syndrome
A common reason for an elevated maternal serum AFP (MSAFP) is what?
to rule out neural tube defects
Free beta hCG can be assessed in maternal serum in the first trimester to evaluate for an increased risk in what condition?
Down Syndrome
After amniocentesis the sonographer should demonstrate and document which one of the following?
cardiac activity (heart rate)
Continuous monitoring during an amniocentesis with ultrasound is invaluable in patients with which one of the following conditions?
oligohydramions
anterior placental placement
premature rupture of membranes (PROM)
Fetal death occurs after the fetus has reached a certain growth that is too large to reabsorb into the uterus is called what?
fetal papyraceous
What structures is AFP found?
fetal spine
gastrointestinal tract
liver
kidneys
The following sonographic findings of increased nuchal thickening, shorten femurs, cardiac anomalies and pyelectasis (fetal hydro) is what?
Trisomy 21
Sonographic findings of cranial anomalies, chroid plexus cysts, facial abnormalities and rocker bottom feet (talipes), is what?
Trisomy 18
Holoproscenphaly and proboscis are most likely to be found in a fetus with what?
Trisomy 13
Pregnancy associated plasma protein A (PAPP-A) levels what do they do during the pregnancy?
a glycoprotein derived from the trophoblastic tissue that is then diffused into the maternal circulation
it increases in the maternal serum throughout pregnancy
levels decrease with pregnancies affected by aneuploidy
AFP is produced early in gestation by which of the following structures?
yolk sac - early gestation
fetal liver - later in gestation
The most common aneuploid condition is what?
Down Syndrome
An optimal collection site in an amniocentesis includes all of the following…
away from the fetus
away from the central part of the placenta
away from the umbilical cord
near the maternal midline to avoid the maternal uterine vessels
Maternal serum AFP increase with advancing gestational age and peak at how many weeks gestation?
15 to 18 weeks
Low AFP levels have been found in what condition?
closed spina bifida (occulta) because there is no opening to allow leakage
What is the picture the chromosomes?
Karyotyping
An abnormal nuchal translucency increase fetal risk for all of the following…
chromosomal abnormalities trisomy 13 trisomy 18 trisomy 21 triploidy turners syndrome
Which one of the following is included in a first trimester serum screening?
nuchal translucency measurement
PAPP-A
Free BhCG
Age
Which one of the following is not associated with turner’s?
advanced maternal age
What are the 5 most common types of conjoined twins?
pygopagus (joined at the ischial region) ischiopagus (joined at the buttocks) thoracopagus (joined at the thorax) omphalopagus (joined at the anterior wall) craniopagus (joined at the cranium)
What is auto-somomal recessive?
a pair of defective gene
inherited by both parents
What is auto-somomal dominate?
a single defective gene
inherited by one parent
What are mosaic patterns?
is the occurrence of a gene mutation or chromosomal abnormality in a portion of an individual’s cells. It is difficult to predict the types of problems that will occur when mosaicism is found.
