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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
Q

Nonimmune hydrops is caused by

A

Anything other than RH-sensitization

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26
Q

Most frequent cause of nonimmune hydrops(NIH)

A

Cardiovascular lesions

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27
Q

Prognosis of NIH is poor, with a mortality rate of

A

50-98%

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28
Q

The primary fuel for growth is _____

A

Glucose

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29
Q

If glucose levels are very high and uncontrolled, the fetus may become

A

Macrosomic

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30
Q

Hypertension is associated with _____ placentas

A

Small

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31
Q

Pregnancy condition in which high blood pressure develops with proteinuria and edema

A

Preeclampsia

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32
Q

Severe hypertension and proteinurea refers to

A

Severe preeclampsia

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33
Q

Occurrence of seizures in the preeclamptic patient

A

Eclampsia

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34
Q

Chronic hypertension is diagnosed in patients that have high blood pressure before ____

A

20 weeks gestation

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35
Q

Chronic hypertension can result from ____

A

Primary/secondary hypertension

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36
Q

Umbilical artery Doppler can provide information regarding

A

Fetal and maternal circulatory status and help determine risk of IUGR

37
Q

Chronic autoimmune disorder that can affect almost all organ systems in the body

A

Lupus

38
Q

Lupus is most common in women of ____ age

A

Childbearing age

39
Q

Incidence of miscarriage and fetal death in patients with lupus is ___ %

A

22-49%

40
Q

In patients with lupus the fetus must be monitored to rule out

A

Congenital heart block and pericardial effusion

41
Q

In patients with lupus the placenta is affected by

A

Immune complex deposits and inflammatory responses in placental vessels

42
Q

If UTIs are left untreated, the patient may develop

A

Pylonephritis

43
Q

Maternal obesity is associated with increased incidence of fetal anomalies, especially;

A

Neural tube defects

44
Q

Uterine fibroids may cause ___

A

Pain and premature labor

45
Q

Uterine fibroids may be stimulated by

A

Excess growth in pregnancy hormones, especially estrogen

46
Q

With premature labor, _____ of cases there is no cause or association identified

A

Half/50%

47
Q

Ultrasound assessment should include

A 
AFI 
Cervix length
Fetal #
Placental assessment 
Targeted ultrasound
48
Q

Fetal death causes cannot be determined in ____ of the cases

A

About half

49
Q

Approximately ___% of fetal deaths occur in the first trimester

A

80%

50
Q

Overlapping of skull bones _____ sign

A

Spalding sign

51
Q

Gas in fetal abdomen—-___ sign

A

Roberts sign

52
Q

A twin has ____ times greater chance of perineal death than a singletons fetus

A

5 times

53
Q

Two types of twins

A

Monozygotic(identical)

Dizygotic(fraternal)

54
Q

Arise from two separately fertilized eggs

A

Dizygotic twins

55
Q

Dizygotic is ALWAYS _____

A

Dichorionic and diamniotic

56
Q

Arise from single fertilized egg that then divides

A

Monozygotic

57
Q

Monozygotic:

If division occurs 0-4 days post conception:

A

Dichorionic/Diamniotic

58
Q

Monozygotic:

If division occurs 4-8 days post conception:

A

Monichorionic/Diamniotic

59
Q

If division occurs after day 8 post conception

A

Monochorionic/monoamniotic

60
Q

If division occurs after 13 days

A

Conjoined twins

61
Q

____% of pregnancies that begin as twins end as singletons

A

70%

62
Q

Conjoined twin

Thoracopagus:

A

Thorax

63
Q

Conjoined twin

Omphalopagus:

A

Anterior wall

64
Q

Conjoined twin

Craniopagus:

A

Cranium

65
Q

Conjoined twins with one head:

A

Syncephalus

66
Q

Conjoined twins

Pyopagus:

A

Ischial region

67
Q

Conjoined twins

Ischiopagus

A

Buttocks

68
Q

If fetus dies after reaching a size too large for absorption—fetus is markedly flattened from loss of fluid and most soft tissue

A

Fetus Papyraceous/Paper doll twin

69
Q

Aka stuck twin

A

Poly-Oli sequence

70
Q

Characterized by a Diamniotic pregnancy with polyhydramnios in one sac and severe oligohydramnios in the other.

A

Poly-Oli twin sequence

71
Q

Poly-oli twin sequence usually manifests between ____

A

16-26 weeks

72
Q

Exists with vascular connection shared within the placenta, arterial flow of one twin is pumped into the venous system of the other twin.

A

TTTS

73
Q

Smaller twin in TTTS is at risk for dying because

A

Nutritional & oxygen rich blood supply is restricted

74
Q

Larger twin in TTTS is at risk for death because

A

Heart failure—overworked

75
Q

Aka TRAP syndrome

A

Acardiac anomaly

76
Q

One twin develops w/o a heart and often absence of upper body. This twin has no direct vascular connection to the placenta

A

TRAP syndrome / acardiac anomaly

Twin Reversed Arterial Perfusion syndrome

77
Q

The donor or “pump” twin in TRAP syndrome may develop

A

Cardiomegaly, heart failure, hydrops

78
Q

In addition to the required anatomy, the preliminary report should include:

A

Chorionicity/amnionicity
Gender
Biometric data
Anomalies

79
Q

When scanning multiple gestational always document the _______ separating the sac

A

Membrane

80
Q

If only 1 placenta is seen, and a membrane can’t be visualized, it’s most likely a ______ pregnancy

A

Mono/mono

81
Q

Male & female fetus’ are always ____ pregnancies

A

Di/di

82
Q

Twin pregnancy with intertwined umbilical cords, conjoined twins or greater than 3 vessels in the umbilical cord:

A

Monozygotic, monochorionic, and monoamniotic

83
Q

Body of placenta should be scanned to determine whether line of separation can be see: ____ sign

A

Twin peak/ lambda sign

84
Q

Discordant growth of the twins can occur when there is a difference in EFW of ___%

A

20%

85
Q

If growth discordance is between twins but one is male and one is female, then ____

A

TTTS cannot occur

86
Q

Can be common in twins due to crowding ______

A

Dolichocephaly

87
Q

No flow/reversal of flow are both signs of ___

A

Fetal jeopardy and prompt delivery

88
Q

Multifetal pregnancy reductions is performed when?

A

Toward the end of the 1st trimester

OB-Hagen (17 decks)

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