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OB-Hagen > Chapter 54 Sonography & High Risk Pregnancy > Flashcards

Chapter 54 Sonography & High Risk Pregnancy Flashcards

1
Q

Screening for fetal anomalies is performed in either the _____ trimester

A

1st or 2nd

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2
Q

First trimester testing looks for the pattern of biochemical markers associated with

A

PAPP-A and Beta-hCG

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3
Q

Second trimester screening is performed with ____

A

maternal serum quad screen lab value and a target ultrasound

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4
Q

Quad screen consists of

A

HCG
AFP
Inhibin-A
Uncongugated Estriol

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5
Q

AMA refers to a patient who ___

A

Will be 35 by the day of delivery

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6
Q

Risk of Down syndrome at age 35

A

1 in 385

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7
Q

Risk of Down syndrome at age 45

A

1 in 32

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8
Q

Condition in which excess fluid accumulates within fetal body cavities

A

Hydrops fetalis

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9
Q

Fluid surrounding the abdominal/pelvic organs

A

Ascites

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10
Q

When skin Adema is massive, encasing the majority of the body

A

Anasarca

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11
Q

When the maternal clinical symptoms mimic the clinical features of the fetus

A

Mirror syndrome

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12
Q

In mirror syndrome the mother will exhibit features of

A

Edema, rapid weight gain, hypertension, and mild proteinurea

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13
Q

Two classifications of fetal hydrops

A

Immune and non-immune

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14
Q

Hydrops caused by RH-sensitization

A

Immune

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15
Q

How is RH sensitization prevented?

A

RhoGAM shot

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16
Q

Maternal(RH-) and fetus’(RH+) blood mix, mother develops antibody(___) which causes ____

A

IgG, hemolysis

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17
Q

IgG attaches to fetal RBC and destroys them

A

Hemolysis

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18
Q

Hemolysis can result in

A

Fetal anemia, congestive heart failure, anasarca(edema of tissues)

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19
Q

The placenta will be _____ in immune hydrops

A

Thickened

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20
Q

Doppler of _____ can predict fetal anemia

A

middle cerebra artery(MCA)

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21
Q

Doppler of MCA with fetal anemia :

A

Decrease viscosity results in decrease resistance to flow

This is detected by an increase in velocity in the MCA

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22
Q

Increase of velocity in the MCA indicates:

A

Decrease in viscosity/resistance to flow—- fetal anemia

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23
Q

Where is the MCA located?

A

Circle of Willis

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24
Q

Procedure where the needle is placed into the fetal umbilical vein and a blood sample is obtained

A

Cordocentesis

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25
Nonimmune hydrops is caused by
Anything other than RH-sensitization
26
Most frequent cause of nonimmune hydrops(NIH)
Cardiovascular lesions
27
Prognosis of NIH is poor, with a mortality rate of
50-98%
28
The primary fuel for growth is _____
Glucose
29
If glucose levels are very high and uncontrolled, the fetus may become
Macrosomic
30
Hypertension is associated with _____ placentas
Small
31
Pregnancy condition in which high blood pressure develops with proteinuria and edema
Preeclampsia
32
Severe hypertension and proteinurea refers to
Severe preeclampsia
33
Occurrence of seizures in the preeclamptic patient
Eclampsia
34
Chronic hypertension is diagnosed in patients that have high blood pressure before ____
20 weeks gestation
35
Chronic hypertension can result from ____
Primary/secondary hypertension
36
Umbilical artery Doppler can provide information regarding
Fetal and maternal circulatory status and help determine risk of IUGR
37
Chronic autoimmune disorder that can affect almost all organ systems in the body
Lupus
38
Lupus is most common in women of ____ age
Childbearing age
39
Incidence of miscarriage and fetal death in patients with lupus is ___ %
22-49%
40
In patients with lupus the fetus must be monitored to rule out
Congenital heart block and pericardial effusion
41
In patients with lupus the placenta is affected by
Immune complex deposits and inflammatory responses in placental vessels
42
If UTIs are left untreated, the patient may develop
Pylonephritis
43
Maternal obesity is associated with increased incidence of fetal anomalies, especially;
Neural tube defects
44
Uterine fibroids may cause ___
Pain and premature labor
45
Uterine fibroids may be stimulated by
Excess growth in pregnancy hormones, especially estrogen
46
With premature labor, _____ of cases there is no cause or association identified
Half/50%
47
Ultrasound assessment should include
``` AFI Cervix length Fetal # Placental assessment Targeted ultrasound ```
48
Fetal death causes cannot be determined in ____ of the cases
About half
49
Approximately ___% of fetal deaths occur in the first trimester
80%
50
Overlapping of skull bones _____ sign
Spalding sign
51
Gas in fetal abdomen—-___ sign
Roberts sign
52
A twin has ____ times greater chance of perineal death than a singletons fetus
5 times
53
Two types of twins
Monozygotic(identical) | Dizygotic(fraternal)
54
Arise from two separately fertilized eggs
Dizygotic twins
55
Dizygotic is ALWAYS _____
Dichorionic and diamniotic
56
Arise from single fertilized egg that then divides
Monozygotic
57
Monozygotic: If division occurs 0-4 days post conception:
Dichorionic/Diamniotic
58
Monozygotic: If division occurs 4-8 days post conception:
Monichorionic/Diamniotic
59
If division occurs after day 8 post conception
Monochorionic/monoamniotic
60
If division occurs after 13 days
Conjoined twins
61
____% of pregnancies that begin as twins end as singletons
70%
62
Conjoined twin Thoracopagus:
Thorax
63
Conjoined twin Omphalopagus:
Anterior wall
64
Conjoined twin Craniopagus:
Cranium
65
Conjoined twins with one head:
Syncephalus
66
Conjoined twins Pyopagus:
Ischial region
67
Conjoined twins Ischiopagus
Buttocks
68
If fetus dies after reaching a size too large for absorption—fetus is markedly flattened from loss of fluid and most soft tissue
Fetus Papyraceous/Paper doll twin
69
Aka stuck twin
Poly-Oli sequence
70
Characterized by a Diamniotic pregnancy with polyhydramnios in one sac and severe oligohydramnios in the other.
Poly-Oli twin sequence
71
Poly-oli twin sequence usually manifests between ____
16-26 weeks
72
Exists with vascular connection shared within the placenta, arterial flow of one twin is pumped into the venous system of the other twin.
TTTS
73
Smaller twin in TTTS is at risk for dying because
Nutritional & oxygen rich blood supply is restricted
74
Larger twin in TTTS is at risk for death because
Heart failure—overworked
75
Aka TRAP syndrome
Acardiac anomaly
76
One twin develops w/o a heart and often absence of upper body. This twin has no direct vascular connection to the placenta
TRAP syndrome / acardiac anomaly Twin Reversed Arterial Perfusion syndrome
77
The donor or “pump” twin in TRAP syndrome may develop
Cardiomegaly, heart failure, hydrops
78
In addition to the required anatomy, the preliminary report should include:
Chorionicity/amnionicity Gender Biometric data Anomalies
79
When scanning multiple gestational always document the _______ separating the sac
Membrane
80
If only 1 placenta is seen, and a membrane can’t be visualized, it’s most likely a ______ pregnancy
Mono/mono
81
Male & female fetus’ are always ____ pregnancies
Di/di
82
Twin pregnancy with intertwined umbilical cords, conjoined twins or greater than 3 vessels in the umbilical cord:
Monozygotic, monochorionic, and monoamniotic
83
Body of placenta should be scanned to determine whether line of separation can be see: ____ sign
Twin peak/ lambda sign
84
Discordant growth of the twins can occur when there is a difference in EFW of ___%
20%
85
If growth discordance is between twins but one is male and one is female, then ____
TTTS cannot occur
86
Can be common in twins due to crowding ______
Dolichocephaly
87
No flow/reversal of flow are both signs of ___
Fetal jeopardy and prompt delivery
88
Multifetal pregnancy reductions is performed when?
Toward the end of the 1st trimester

OB-Hagen (17 decks)

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