Class 20: Maternal Disease Flashcards by Jenelle Nuqui

what can cross the placental barrier than can cause abnormalities in the fetus? (3)

infection, antibodies, drugs

How well did you know this?

Not at all

Perfectly

what 3 factors of maternal infections affect the fetus?

virulence
transmission route
gestational age at time of infection

How well did you know this?

Not at all

Perfectly

when is the fetus most susceptible to infections?

during the 1st tri

How well did you know this?

Not at all

Perfectly

what are 5 viral infections that can affect the fetus?

cytomegalovirus
herpes simplex
varicella zoster
rubella
HIV

How well did you know this?

Not at all

Perfectly

what is the most common cause of congenital infections?

cytomegalovirus (CMV)

How well did you know this?

Not at all

Perfectly

CMV is a type of __

herpes

How well did you know this?

Not at all

Perfectly

how can CMV be transmitted?

transplacental & upward through cervix

How well did you know this?

Not at all

Perfectly

S&S of CMV include __, __, __

fever, fatigue, tiredness

How well did you know this?

Not at all

Perfectly

what antiviral meds can help reduce transmission of CMV?

cytovene

How well did you know this?

Not at all

Perfectly

if herpes simplex is transmitted to the fetus at ___ weeks, it can lead to stillbirth or spontaneous abortion

20 weeks

How well did you know this?

Not at all

Perfectly

when is a C-section indicated with herpes simplex?

if it is present in the genital tract at the time of delivery

How well did you know this?

Not at all

Perfectly

varicella is a danger to the fetus if exposed between ___ to ___ weeks

8-12 weeks

How well did you know this?

Not at all

Perfectly

another name for rubella

german measles

How well did you know this?

Not at all

Perfectly

the following are associated with which viral infection?
blindness, deafness, heart defects, microcephaly, hydrocephaly, cephalocele

german measles

How well did you know this?

Not at all

Perfectly

when does transmission of HIV occur?

near time of birth

How well did you know this?

Not at all

Perfectly

3 factors relating to transmission of HIV

placental barrier effectiveness
immunologic factors
# of HIV particles present

How well did you know this?

Not at all

Perfectly

3 types of bacterial infections that can spread to the fetus

syphilis
gonorrhea
UTI

How well did you know this?

Not at all

Perfectly

2 types of parasitic infections that can spread to the fetus

toxoplasmosis
malaria

How well did you know this?

Not at all

Perfectly

what parasite spreads toxoplasmosis?

toxoplasma gondii

How well did you know this?

Not at all

Perfectly

how can one contract toxoplasmosis? (2)

eating raw meat
cat feces

How well did you know this?

Not at all

Perfectly

when is toxoplasmosis more transmittable?

3rd tri

How well did you know this?

Not at all

Perfectly

consequence of toxoplasmosis?

repeated miscarriage

How well did you know this?

Not at all

Perfectly

treatment for toxoplasmosis?

antibiotics

How well did you know this?

Not at all

Perfectly

what type of mosquito spreads malaria?

female anophales mosquitos

How well did you know this?

Not at all

Perfectly

what are the effects on the placenta with malaria?

placental insufficiency

5 types of endocrine & metabolic maternal diseases

1. diabetes mellitus 2. gestational diabetes 3. hyperthyroidism 4. hypothyroidism 5. hyperparathyroidism

which type of diabetes is known as juvenile onset?

type 1

which type of diabetes is insulin dependent?

type 1

which type of diabetes is the more common type of diabetes mellitus?

type 2

faulty ____ metabolism is related to decreased insulin

carbohydrate

frequency of abnormalities with diabetic mothers

3-6%

why is there such a broad spectrum of associated fetal effects with mothers with diabetes mellitus?

diabetes mellitus affects organogenesis

diabetes mellitus is associated with macrosomia. T/F?

true

what is a macrosomic baby?

> 4000 g (90th percentile at birth)

most common trisomy associated with diabetes mellitus?

trisomy 21

what can happen to the placenta with a mother with diabetes mellitus?

thickened placenta (>6cm)

how many pregnancies are affected by gestational diabetes?

25/1000 (4%)

gestational diabetes is early onset. T/F?

false -- late onset

what is the most common type of hyperthyroidism?

grave's disease

lab values for hyperthyroidism?

elevated thyroxine

what does increased thyroxine lead to?

abnormal cell development --> FGR

hydatidiform mole can lead to hypothyroidism. T/F?

false -- hyperthyroidism

hypothyroidism can lead to decreased fertility. T/F?

true

what can cause hyperparathyroidism?

parathyroid adenoma

3 types of maternal hematologic disorders?

1. sickle cell anemia 2. thalessemia 3. toxemia of pregnancy

what happens to RBCs in patients with sickle cell anemia?

RBC's are abnormally shaped & can get stuck in blood vessels --> slows down blood flow --> anemia

which population is affected by sickle cell anemia?

black population

which population is affected by thalassemia?

mediterranean descent

what is thalassemia?

form of anemia with decreased RBC production

what is the cause of toxemia of pregnancy?

unclear

2 stages of toxemia of pregnancy?

1. preeclampsia 2. eclampsia

toxemia of pregnancy can lead to increased placental volume & decreased placental maturation. T/F?

false -- DECREASED placental volume & INCREASED placental maturation

what is fetal alcohol syndrome?

when alcohol crosses placental barrier, leading to cell death or inhibiting fetal growth

diagnosis criteria of FAS depends on ___

severity

what is fetal growth restriction?

when fetus is less than 10% of the predicted fetal weight for its gestational age

how many infants born <2500 g (5lb 8oz) have true IUGR?

1/3

what types of metabolic conditions can IUGR infants have later in life? (2)

1. abdominal obesity 2. type 2 DM

the cause of IUGR is ___ 50% of the time

idiopathic

2 fetal factors that can lead to FGR?

1. genetic/chromosomal ABNL 2. chronic fetal infx

6 maternal factors that can lead to IUGR?

1. drug use 2. poor nutrition 3. poor pregnancy weight 4. multiple gestation 5. maternal disease 6. placental insufficiency

2 environmental factors that can lead to IUGR?

1. irradiation 2. high altitude

2 types of IUGR?

1. symmetric 2. asymmetric/head sparing

most common type of IUGR?

head sparing

which trimester is affected with the fetus with symmetric IUGR

1st tri

what is asymmetric IUGR?

head & long bones are normal measurements but abdomen & organs are small

which trimester is affected with the fetus with head sparing IUGR?

2nd tri

the HC/AC ratio will be ___ in a fetus with head sparing IUGR

increased

why is the brain not spared with symmetric FGR?

because it occurs in early pregnancy (long duration)

symmetric IUGR leads to a ___ in cell number & size

decreased

symmetric IUGR is caused by __ & ___ factors

fetal & environmental

asymmetric IUGR is caused by ___ factors

maternal

head sparing IUGR occurs in the last ___ to ___ weeks of pregnancy

8-10 weeks

there is normal cell numbers in head sparing IUGR. T/F?

true

there is normal cell size in head sparing IUGR. T/F?

false -- decreased cell size

pulse wave of which arteries may help diagnose FGR?

UTA & umbilical artery

normally, in early pregnancy, flow in UTA & UA is ___ resistance

higher

normally, as pregnancy progresses, flow in UTA & UA is ___ resistance

lower

as pregnancy progresses, the systolic/diastolic ratio ___

decreases

in 80% of cases with FGR, the systolic/diastolic ratio ___ & the UTA & UA exhibit ___ resistance

increases; higher

if a grade __ placenta is seen <35-36 weeks with an EFW of less than ___ grams, this can indicated FGR

grade 3; 2700 (5lb 14 oz)