Chapter 54 Flashcards
What type of screening test can be done in the 1st trimester ?
plasma protein A and free beta-human chorionic gonadotropin.
The laboratory values of PAPP-A and free beta-hCG can determine ?
chromosomal abnormality, congenital heart defect, skeletal dysplasia, or other syndromes.
what are some additional tests, a parent can choose aside from PAPP-A and free beta-hCG ?
- noninvasive prenatal testing (NIPT)
2. invasive testing such as: chorionic villus sampling (CVS) or amniocentesis
NIPT test can be done as early as?
10 weeks
Which test has a much higher detection, screening test, for down syndrome and trisomy 18/13 ?
NIPT
What four serum markers are done under the maternal serum quad screen?
- alpha-fetoprotein (AFP),
- human chorionic gonadotropin (hCG)
- unconjugated estriol (uE3),
- inhibin-A.
Define: detaild fetal anatomic survey
a detailed evaluation of specified fetal anatomy and biometry that can be seen at the time of examination.
Most ultrasound departments prefer to perform the detailed fetal anatomic survey examination between____ weeks.
18 to 20 weeks
define: Advance maternal age (AMA)
describes a patient who will be 35 or older at the time of delivery
AMA can be an indicator for what?
high-risk pregnancy, example down syndrome
define: hydrops fetalis
a condition in which excessive fluid accumulates within the fetal body cavities.
what are the 2 type of fetal hyprops?
immune hydrops
nonimmune hydrops
immune hydrops is initiated by the_____?
Presence of maternal serum IgG antibody against one of the fetal red blood cell antigens (mixing of blood)
The mixing of maternal and fetal blood, can be prevented? true or false ?
True, with RhoGAM
If a sensitized pregnancy is not treated with RhoGAM, what will happen to fetus ?
Hemolysis: attaches to the fetal RBCs and destroys them.
anema, heart failure, hydrops
Of the ultrasound tools,what is one way to predict fetal anemia?
doppler evaluation of the middle cerebral artery.
define: cordocentesis
a procedure in which a needle is placed into the fetal umbilical vein to obtain a blood sample.
there are two types of fetal blood transfusion, One is cordocentesis and the other______?
intraperitoneal transfusion: ultrasound guidance to place a needle in the peritoneal cavity of the fetus
define Alloimmune thrombocytopenia.
a mother may develop an immune response to fetal platelets.
The result of an Alloimmune thrombocytopenia, the fetus may__?
have a low platelet count and intracerebral hemorrhage
nonimmune hydrops is?
A group of conditions, which hydrops is present in the fetus but is not a result of fetomaternal blood group incompatibility.
what are the most frequent causes for Nonimmune hydrops?
cardiovascular lesions
vaginal bleeding in the 2nd or 3rd trimester can be associated with___?
placental abruption and placenta previa
the condition that the placenta covers the internal os and prohibits the delivery of the fetus, is due to ___?
placenta previa
If the placenta and the internal os distance is less than 2 cm, the condition may be classified as
low-lying placenta
Placental abruption is a vaginal bleeding entity that___?
premature separation of the placenta from the uterine wall.
how can you tell if an placental abruption has happened, using ultrasound?
If the area between the placenta and uterine wall is thicker than 1 to 2 cm and by use of color doppler.
Mothers with insulin-dependent diabetes mellitus are at an increased risk for pregnancy-related complications. They are?
include early- and late-trimester pregnancy loss and congenital anomalies
A fetus that has a diabetic mother may become_____?
macrosonia,
polyhydramnios can be seen with ___ and _____.
elevated blood sugar and macrosomic fetuses.
Premature rupture of membranes (PROM)
fetuses of diabetic mother may measure large for Gestation age, making pregnancy date inaccurate.
define: Caudal regression syndrome
(lack of development of the caudal spine and cord) is seen almost exclusively in diabetic individuals.
Hypertension places both mother and fetus at risk? true or false?
true
hypertension pregnancy, the placenta is big or small?
small due to poorly blood supply
terminology currently used in clinical practice to describe hypertensive states during pregnancy is?
pregnancy-induced hypertension (preeclampsia, severe preeclampsia, and eclampsia
If hypertention is neglected, the patient may develop ___?
seizures- life treating to both mother /fetus
Eclampsia means:
the number of times/occurrence of sizures or comas in a preclamptic patient.
Systemic lupus erythematosus (SLE)
chronic autoimmune disorder that can affect almost all organ systems in the body.
Hyperemesis gravidarum menas?
a pregnant woman vomits so much that she develops dehydration and electrolyte imbalance.
If bacteria is left untreated in a Urinary tract disease _____may develop
pyelonephritis (presents with flank pain, fever, and white blood cells in the urine)
which type of cysts can be associated with early pregnancy ?
Physiologic ovarian cysts as ( 8-10 cm)
Fibroid benign tumor can cause premature labor due to ?
excessive growth due to hormones of pregnancy.
Preterm, or premature, labor is anything before____ weeks
37
fetal movement begins at ____ to ___ weeks.
16 to 20 weeks
A 20 weeks, the uterine fundal height should have risen to _____ and should measure____?
umbilicus and 20 cm
Fetal heart tones should be heard with Doppler at approximately ___to ___ weeks.
10 to 12
spalding’s sign is?
overlap of skull bones
Maternal serum alpha-fetoprotein (MSAFP) is ?
screening is performed routinely to detect neural tube defects.
what should be done Once a multiple gestation has been identified?
a detailed fetal anatomic survey ultrasound examination should be performed –look for fetal anomalies
Dizygotic twins are?
arise from two separately fertilized ova. Each ovum implants separately in the uterus and develops its own placenta, chorion, and amniotic sac
monozygotic twins are?
(identical) arise from a single fertilized egg, which divides, resulting in two genetically identical fetuses
conjoined twins may result, if after ____ days
13 days
Twin-to-twin transfusion syndrome (TTTS)?
The arterial blood of one twin is pumped into the venous system of the other twin.
oligohydramnios is developed through?
lack of blood flow through the kidneys and urinates less
polyhydramnios is developed through?
excessive blood flow to kidneys, and urinates too much.
sonographic findings for Nonimmune Hydrops are:
- fetus may appear similar to sensitized baby.
* scalp edema, pleural and pericardial effusion ascites
mother with diabetes, the placenta and fetus will present Big or small?
placenta - big
baby- big
mother with hypertention, the placenta and fetus will present Big or small?
placenta- small
baby-small
mother with systemic lupus erythematosus, the placenta and fetus will present Big or small?
placenta-big
baby-small
how many IUGR are there?
2: asymmetric and symmetric
IUGR is most commonly define as a fetal birth weight ____ for a given gestational age.
at or below 10%
early noninvasive means of assessing the risk of aneuploidy is which one of the following?
Nuchal translucent
after amniocenteses the sonographer should check ?
the fetal heart
AFP is produced in early gestation by which one of the following structures ?
yolk sac
