Complications in Pregnancy Flashcards
1
Q
turner syndrome
A
- 45 chromosomes, including a single X chromosome
- elevated AFP
- female fetus
- 1:5000
- cystic hygroma, cardiac defects, renal anomalies, cubitus valgus, short femur, general lymph edema
- differential: cephalocele, trisomy 13, hydrops fetalis
2
Q
beckwith-wiedemann
A
- classic triad of macrosomia, omphalocele, and macroglossia
- increases risk of developing wilms tumor, hemihypertrophy, renal anomalies,a nd hepatosplenomegaly
- hemihypertrophy, macroglossia, omphalocele
- differential: down syndrome
3
Q
sequence
A
refers to a pattern of multiple anomalies that results from a single anomaly or mechanical factor
4
Q
monochorionic/monoamniotic
A
- two or more fetuses
- single gestational sac
- no membrane
- zygote splits 10-14 days postfertilization
- differential: technical difficulty in locating membrane
5
Q
dichorionic/diamniotic
A
- zygote splits within 3-5 days of fertilization
- four-layered membrane
- two or more individual gestational sacs and placentas
- thick membrane with V shape called twin peak or lambda sign
- differential: mirror image artifact
6
Q
twin to twin transfusion syndrome
A
- same sex fetuses
- single placenta
- arterial blood of the donor twin pumps into the venous system of the recipient twin
- recipient twin ultimately receives too much blood
- donor twim may display IUGR and oligo
- receiving twin may aquire hydrops and poly
- differential: acardiac twin or poli-oli syndrome
7
Q
cubitus valgus
A
abnormal outward bending or twisting of the elbow
8
Q
exencephaly
A
a condition where the skull is defective causing exposure or extrusion of the brain
9
Q
disruption
A
is a defect of an organ resulting from the breakdown of previously normal tissue
10
Q
hydrops fetalis
A
- an abnormal interstitil accumulation of fluid in the body cavities and soft tissues
- fluid accumulation may results in anasarca, ascites, pericardial effusion, pleural effusion, placentomegaly, and polyhydramnios
- may result from antibodies in the maternal circualtion that destroythe fetal red blood cells or without evidence of clood group incompatibility
- sonography cannot differentiate immune from nonimmune hydrops
11
Q
multifetal gestations
A
- 70% of pregnancies beginning with twins will deliver a singleton pregnancy
- monozygotic twins results from a single fertilized ovum
- dizygotic twins results from two separate ova
- majority of pregnancies are dizgotic
- dizygotic pregnancies are always dichorionic/diamniotic
- twin A closet to the internal os
- IUGR most common causediscordant growth in a dichrionic multifetal gestation
- twin-twin transfusion syndrome is the most common cause of discordant growth in a monochrorionic multifetal gestation
12
Q
chorionic villi sampling
A
- performed between 10 and 12 gestational wks
- results after 1 wk
- identify masses
- assess fetus postprocedure
13
Q
limb body wall complex
A
- rare complex malformation caused by the failure of closure of the ventral body wall
- two or more defects
- ventral wall defect, cranial anomalies, marked scoliosis, limb defects, short umbilical cord, amniotic bands
- differential: amniotic band syndrome or trisomy 13
14
Q
conjoined twins
A
- monozygotic
- fusion of twin fetuses
- usually anterior and one body part
- inseparable fetal bodies and skin contours, no membrane
- differential: acardiac twin or normal twin pregnancy
15
Q
amniotic band syndrome
A
- ruptured amnion sticks and entangles fetal parts
- associated with fetal abnormalities and amputations
- thin hyperechoic linear structure floating within the amniotic cavity
- feta abnormalities
- differential: synechia, amniotic chorionic separation, limb-body wall complex, placetnal shelf
16
Q
fetus papyraceus
A
- demise of a twin that is too large to reabsorb
17
Q
clinodactyly
A
- inward curving of the fifth finger associated with Downs
18
Q
acardiac twin
A
- rare
- diamniotic/monochorionic
- twin reversed arterial perfusion
- blood shunted through a vein to vein and artery to artery
- places a large cardiovascular burden on the normal twin
- acardiac
- poorly developed upper body, anencephaly, absent or poor heart, limbs may be present
- normal
- hydrops, poly, cardiac failure
19
Q
immune hydrops
A
- rh sensitivity
- scalp edema, pleural effusion, poly, placentomegaly
- differential: nonimmune hydrops or pleural effusion
20
Q
eagle-barret syndrome
A
- prune belly syndrome
- hypotonic abdominal wall muscles
- associated with dialted fetal bladder, small thorax, and imperforate anus
- hydronephrosis, megaureter, oligo, small thorax, large abdomen, cryptorchidism, hip dislocation, scoliosis
- differential: urinary obstruction or urethral atresia
21
Q
deformation
A
refers to an abnormal form, shape, or position of a part caused by mechanical forces antenatally
22
Q
spalding sign
A
overlapping of the crainal bones associated with fetal demise
23
Q
meckel-gruber syndrome
A
- lethal condition
- occurs equally in males and females
- autosomal recessive
- encephalocele, infantile polycystic renals, oligo, bladder not visualized, polydactyly
- differential: trisomy 13 or infantile polycystic disease
24
Q
vanishing twin
A
- early fetal demise of one embryo
- twin pregnancy
- demised twin resolves
- becomes singleton pregnancy
- differential: succenturine placenta or subchorionic hemorrhage
25
Q
edward syndrome
A
- trisosmy 18
- 80% of cases display a clenched fist
- decrease in AFP
- overall poor prognosis
- female prevalence
- heart defects, choroid plexus cysts, clenched hands, micrognathia, renal anomlaies, cleft lip and palate, omphalocele, two vessel cord
- differential: trisomy 13 or triploidy
26
Q
anasarca
A
severe generalized massive edema often seen with hydrops fetalis
27
Q
stuck twin
A
- poli-oli sequence
- monochorionic/diamniotic
- usuallyamnifests between 16 and 26 gestational weeks
- one twin oligo, other twim poly
- differential: acardiac twin, twin to twin
28
Q
triploidy
A
- three complete sets of chromosomes
- most will abort spontaneously
- 1:5000
- early onset IUGR, holoprosencephaly, hypertelorism, micrognathia, microphthalmia, ventriculomegaly, oligo, 2 vessel cord, cardiac anomalies, clubfeet, syndactyly
- differential: trisomy 13 or 18
29
Q
embryoscopy
A
- permits direct viewing of the developing fetus
- assess fetus after procedure
30
Q
malformation
A
refers to a defect of an organ that results from an intrinsically abnormal development process
31
Q
cordocentesis
A
- used to analyze fetal chromosomes
- fetal blood is aspirated through the umbilical cord
- assess fetus postprocedure
32
Q
amniocentesis
A
- used to analyze fetal chromosomes in early pregnancy
- typically between 15-18 wks
- can be preformed as early as 12 gestational wks
- recheck fetal well being after procedure
33
Q
patau syndrome
A
- trisomy 13
- 90% of cases display cardiac defects
- syndrome of midline defects
- 1:25,000
- poor prognosis
- holoprosencephaly, microcephaly, cystic hygroma, absent or small eyes, cardiac defects, omphalocele, polycystic kidneys, clubfoot, polydactyly, IUGR, poly, facial cleft
34
Q
sandal toe deformity
A
increased distance between the first and second toes associated with Downs
35
Q
eclampsia
A
gravest form of pregnancy induced maternal hypertension characterized by seiures, coma, proteinuria, and edema
36
Q
pentalogy of cantrell
A
- congenital disorder characterized by two out of the following major defects
- cardiac, abdominal wall defect, diaphragmatic hernia, defect of diaphragmaric pericardium, ectopia cordis
- pulsating mass outside of the chest, ophalocele, gastroschisis
- differential: beckwith-wiedemann or acardiac twin
37
Q
syndactyly
A
congential anomaly characterized by the fusion of the finger and toes
38
Q
nonimmune hydrops
A
- large for dates
- anasarca, edema, ascites, pleural effusion, pericardial effusion, poly, placentomegaly, fetal tachycardia, 200-240 bpm
- differential: immune hydrops or pleural effusion
39
Q
down syndrome
A
- trisomy 21
- decrease in AFP
- 1:800 live births
- coexisting anomalies dicate overall prognosis
- 30% of cases demonstrate duodenal atresia
- nuchal fold >6mm, cardiac folci, macroglossia, low set ears, short stature, brachycephaly
- differential: beckwith-wiedemann syndrome
40
Q
monochorionic/diamniotic
A
- zygote splits 5-10 days after fertilization
- three layer membrane
- two or more individual gestational saces with shared placenta
- membrane attachment of one chorion creates a T shape
- moderately thick membrane
- differential: mirror image artifact
