Definitions- OB Flashcards
SGA neonate
birth weight <10% for GA
Grand multipara
> 4 live births
velamentous cord
divergent umbilical vessels at cord insertion to placenta
surrounded only by fetal membranes
no wharton’s jelly
umbilical vein varix
focal dilation of umbilical vein located inside fetal abdomen; resolves after birth
spina bifida/tethered cord
incomplete closure of vertebra by day 28
cord attached to caudal structures
damage caused by repeated flexion/extension (weakness, bladder sensation etc)
Recurrent pregnancy loss
classic definition = 3 or more losses
ASRM recently changed to 2 or more (clinically recognized by sono or pathology < 20 weeks)
Tucker McLane Forceps
Solid blade, overlapping shanks with rounder curve, no molding
Simpson-Liukhart forceps
pseudofenestrated blade, parallel split shanks with longer curve for molding
Gestational thrombocytopenia
diagnosis of exclusion; plts <150; normal outside of pregnancy
retained placenta
not delivered with active management by 30 minutes. Longer if physiologic management or 2nd trimester
98% of placentas delivered by then
Postpartum hemorrhage
1) cumulative blood loss of >1000 mL
2) bleeding associated with signs or symptoms of hypovolemia within 24h of birth
REGARDLESS OF ROUTE OF DELIVER
Cervical insufficiency
inability of the uterine cervix to retain a pregnancy in the second trimester in the absence of clinical contractions, labor or both
polyhydramnios
MVP >8 or AFI >24
Accreta
abnormal trophoblastic invasion into the myometrium of the uterine wall due to placental implantation at an area of defective decidualization typically caused by preexisiting damage to the endometrial-myometrial interface
Increta
anchoring placental villi penetrate into the myometrium
Percreta
anchoring placental villi penetrate through the myometrium to the uterine serosa or adjacent organs
intraoperative hemorrhage
> 1000 mL blood loss; massive hemorrhage refers to acute blood loss >25% of patients blood volume or bleeding that requires emergency intervention to save the patient’s life
Chorio
T > 39 or T>38+ fetal tacy, WBC >15k or purulent discharge
Factor V leiden
mutant form of coagulation factor V which renders factor V insensitive to the actions of activated protein C (a natural anticoagulant)
Prothrombin gene
substitution of adenine (a) for guanine (g) at position 20210 in a non coding region; causes increased concentration of prothrombin in circulation
FGR
EFW <10% for GA; symmetric = early onset, asymmetric = late onset
single umbilical artery
one artery; due to secondary atresia or atrophy of a previously normal umbilical artery, primary agenesis of UA, persistence of original single allantoic artery of body stalk
umbilical artery doppler
evaluation of peak systolic and end-diastolic frequency shift of UA;
measure the pulsatility of the doppler waveform reflecting the dynamic changes in circulation through the cardiac cycle
Abnormal S/D ratio
Abnormal if > 3 or >95%ile for GA
MCA doppler
evaluate PSV:normal if <1.5 MoM for GA; do PUBS if >1.5 MoM
Tetralogy of Fallot
1) VSD
2) overriding Aorta
3) RVOT (pulmonary stenosis)
4) RV hypertrophy
associated with DiGeorge, T21, VACTERL, IV prostaglandin until repair
complete/marginal previal
low lying if <2 cm from os but not covering os
abruption
partial or complete placental detachment prior to delivery of fetus
discordancy
bigger baby - smaller baby / bigger baby
if >20% dont do breech of twin B
TTTS
relative hypovolemia in one twin and hypervolemia of the other as a result of many or large AV anastomoses deep in the placenta
1) poly/oligo
2) absent bladder
3) abnormal dopplers
4) hydrops
5) IUFD (one or both)
T1DM
insulin deficiency following destructio of theinsulin producing pancreatic beta cells
cholestasis
presence of pruritus associated with elevated total serum bile acid levels, elevated aminotransferases or both
lie
longitudinal, transverse, oblique
presentation (denominator)
occpiut
sacrum
mentum
frontum (brow)
scalpula
position
left/right; ant/post
attitude
flexed, extended, neutral
Massive transfusion
1) transfusion of 10 or more units of pRBCs within 24h
2) 4 units in 1 hour with ongoing need of more blood anticipated
3) replacement of whole blood volume
