Complications In Pregnancy Notes

Question 1

What is premature rupture of membranes (PROM)?

Answer 1

Early rupture of the gestational sac with leakage of part or all of the amniotic fluid.

Question 2

What is preterm labor?

Answer 2

Onset of labor before 37 weeks’ gestation.

Occurs in approximately 0.9% of newborns.

Question 3

What percentage of chromosomally abnormal conceptions are lost before term?

Answer 3

95% of chromosomally abnormal conceptions are lost before term.

Question 4

What is Rh disease caused by? What does this result in?

Answer 4

1. Caused when the mother forms a corresponding antibody to the fetal blood
2. Resulting in destruction of fetal red blood cells.

Overall poor prognosis.

Question 5

What is cystic hygroma?

Answer 5

A fluid-filled sac that can be associated with chromosomal abnormalities.

Question 6

What is sandal toe deformity?

Answer 6

Increased distance between the first and second toes associated with Down syndrome.

Question 7

What is the Spalding sign? What is this sign associated with?

Answer 7

Overlapping of the cranial bones associated with fetal demise.

Question 8

What is syndactyly?

Answer 8

A congenital anomaly characterized by the fusion of the fingers or toes.

Question 9

What is twin-twin transfusion syndrome (TTS)?

Answer 9

The arterial blood of the donor twin pumps into the venous system of the receiving twin.

Question 10

What is the significance of an elevated AFP level?

Answer 10

1:700 live births.

Question 11

What do coexisting anomalies dictate?

Answer 11

Troventricular defect and ventricular septal defect.

Question 12

What is nuchal thickening? What does this indicate?

Answer 12

An increased thickness of the nuchal fold, which can indicate chromosomal abnormalities.

Question 13

What is duodenal atresia?

Answer 13

A congenital condition where the duodenum is not fully developed.

Question 14

What does hyperechoic bowel indicate?

Answer 14

It can be associated with chromosomal abnormalities.

Question 15

What does a femur length below the 10th percentile indicate?

Answer 15

It is associated with chromosomal abnormalities.

90% of cases display cardiac anomalies.

Question 16

What is polydactyly?

Answer 16

A condition characterized by the presence of extra fingers or toes.

Question 17

What are chromosomal abnormalities?

Answer 17

Can be either numeric or structural.

Question 18

What is a vertebral defect?

Answer 18

A defect of the vertebrae that may be associated with various fetal syndromes.

Question 19

What is a malformation?

Answer 19

A defect of an organ resulting from an intrinsically abnormal development process.

Question 20

What is a deformation?

Answer 20

An abnormal form, shape, or position of a part caused by mechanical forces antenatally.

Question 21

What is a disruption?

Answer 21

A defect of an organ resulting from the breakdown of previously normal tissue.

Question 22

What does sequence refer to in fetal syndromes?

Answer 22

A pattern of multiple anomalies that result from a single anomaly or mechanical factor.

Question 23

What is hydrops fetalis?

Answer 23

An abnormal interstitial accumulation of fluid in the body cavities and soft tissues.

Question 24

What are the potential results of fluid accumulation in hydrops fetalis? 6 (what they may result in)

Answer 24

May result in:
1. Anasarca
2. Ascites
3. Pericardial effusion
4. Pleural effusion
5. Placentomegaly
6. Polyhydramnios.

Question 25

What are the two types of hydrops?

Answer 25

Immune hydrops and nonimmune hydrops.

Question 26

Can sonography differentiate between immune and nonimmune hydrops?

Answer 26

No, sonography cannot differentiate immune from nonimmune hydrops.

Question 27

What are some clinical findings associated with hydrops? 7

Answer 27

1. Scalp edema
2. Pleural effusion
3. Pericardial effusion
4. Polyhydramnios
5. Placentomegaly
6. Anasarca
7. Ascites.

Question 28

What is fetal tachycardia?

Answer 28

A heart rate of 200-240 bpm.

Question 29

What are differential considerations for hydrops?

Answer 29

Nonimmune hydrops and immune hydrops.

Question 30

What percentage of pregnancies beginning with twins will deliver a singleton?

Answer 30

70% of pregnancies beginning with twins will deliver a singleton.

Question 31

What are monozygotic twins?

Answer 31

Monozygotic twins result from a single fertilized ovum.

Question 32

What are dizygotic twins?

Answer 32

Dizygotic twins result from two separate ova.

Question 33

What twin type of pregnancies are the majority?

Answer 33

The majority of pregnancies are dizygotic.

Question 34

What type of chorionic structure do dizygotic pregnancies have?

Answer 34

Dizygotic pregnancies are always dichorionic/diamniotic.

Question 35

How should each fetus be labeled in a twin pregnancy?

Answer 35

Label each fetus with Twin A closest to the internal os.

Question 36

What is the most common cause of discordant growth in a dichorionic multifetal gestation?

Answer 36

IUGR is the most common cause of discordant growth in a dichorionic multifetal gestation.

Question 37

What is the most common cause of discordant growth in a monochorionic multifetal gestation?

Answer 37

Twin-twin transfusion syndrome is the most common cause of discordant growth in a monochorionic multifetal gestation.

Question 38

What are the criteria for abnormal growth in multifetal gestations? 3

Answer 38

Abnormal growth criteria include:
- 10% discrepancy in crown rump lengths.
- 5 days or more difference in gestational age.
- 20 mm or more difference in abdominal circumferences.

Question 39

What is evaluated in sonographic evaluation of multifetal gestations?

Answer 39

Sonographic evaluation includes:
- Number of embryos/fetuses.
- Presence or absence of dividing membrane(s).
- Number or placentas and locations.
- Biometric measurements.
- Fetal surveillance (same as singleton).
- Amniotic fluid volume.

Question 40

What is a common association with a clenched fetal fist? 4

Answer 40

A clenched fetal fist is commonly associated with
1. Patau
2. Down
3. Edward
4. Eagle-Barrett syndromes.

Question 41

What condition is often seen in cases of anasarca?

Answer 41

Anasarca is a condition often seen in cases of multifetal gestations.