Effects of maternal disease on pregnancy Flashcards
What does TORCH stand for?
- Toxoplasmosis
- Other - varicella zoster, syphilis, parovirus B19
- Rubella
- CMV
- Herpes simplex
What infection is transmitted through uncooked food or water?
Toxoplasmosis
In what trimester is the fetus MOST at risk for toxoplasmosis?
Third
Sonographic features seen in Toxoplasmosis? Baby say this is BSMAH
- Brain calcifications
- Seizures after birth
- Microcephaly
- Ascites
- Hepatosplenomegaly
What do the “other” infections encompass?
- Varicella-zoster
- Syphilis
- Parovirus B19 AKA fifths disease
In what infection may you seen echogenic hepatic foci in the fetus?
Varicella zoster
What features characterize syphilis in the fetus? Syphilis is HHHL
- Hyperbilirubinemia
- Hemolysis
- Hepatosplenomegaly
- Lymphadenopathy
In what trimesters is the highest risk for a fetus to contract varicella-zoster?
first and second
What sonographic features are seen in fetal varicella zoster? you wanna make a MMVIE starring varicella zoster
- Micropthalmia
- Microcephaly
- Ventriculomegaly
- IUGR
- Echogenic intrahepatic foci
Non-immune hydrops is mostly attributed to what infection in pregnancy?
Parovirus B19
Measuring the peak systolic velocity of the MCA in the fetus can help diagnose what?
Anemia and fetal hydrops
Exposure in what trimester can cause malformations due to rubella?
First
What was one of the first maternal infections recognized that resulted in fetal malformations?
Rubella AKA 3 day german measles
Sonographic features of rubella- 3 day german measles. Germans make me wanna COMM pneumonic
- Cardiac and great vessel abnormalities
- Osteopathy
- Micropthalmia
- Microcephaly
What is the most common known cause of congenital infections in humans?
CMV
Jaundice and thromobocytopenia in neonates can indicate what kind of infection?
CMV
Sonographic features of CMV? (HIPS pneumonic)
- Hydrocephaly
- IUGR
- Polyhydramnios
- Splenomegaly
What virus indicates c-section delivery?
Herpes simplex
Hydrocephaly is seen in what infection?
HydrANencephaly is seen in what infection?
Hydro = CMV
Hydran = herpex simples
What is the difference between hydrocephaly and hydranencephaly?
Hydrocephaly contains some cortical tissue, where as hydranencephaly does not
Sonographic findings of herpes simplex? (you can get herpes in yo BHMM)
- Brain calcifications
- HydrANencephaly
- Micropthalmia
- Microcephaly
What two infections commonly result in brain calcifications?
- Toxoplasmosis
- CMV
What is a typical finding when an infection has crossed the placenta?
Polyhydramnios
What is the most common maternal disorder?
Diabetes mellitus
What type of diabetes is insulin dependent?
Type 1 AKA juvenile onset
Hyperglycemia from diabetes mellitus causes disruption of what in the fetus?
Organogenesis
Fetal hyperinsulinemia is thought to contribute to?
Macrosomia
T or F? In diabetic mothers, fetuses can either suffer from IUGR or macrosomia?
True
What fetal weight constitutes macrosomia?
9 lbs 9 ounces or 4500g
When is shoulder dystocia seen in the fetus?
When the mother has diabetes mellitus
If a fetus needs a follow-up exam in determining fetal anomalies, how many weeks between appointments is necessary?
Every 4 to 6 weeks
When does gestational diabetes usually present?
5th or 6th month : 24-28 weeks
Risk factors for gestational diabetes
- Previously had a stillbirth
- Baby with congenital anomalies
- Previous macrosomic baby
- Family history
Preferred diagnostic method to diagnose gestational diabetes?
Glucose Tolerance Test (GTT), done between 24-28 weeks
Criteria to diagnose gestational diabetes?
When TWO or more high blood sugar readings occur within 3 hours of the glucose tolerance test
Preeclampsia is also known as?
Toxemia
What is known as a third trimester disease characterized by proteinuria, hypertension, and maternal edema?
Toxemia
Preeclampsia vs Eeclampsia?
Preeclamsia - hypertension, edema, and proteinuria
Eeclampsia - when one or more convulsions occur
Toxemia occurs mostly in what population of women?
Younger nulliparous
Older multigravidas
What three factors attribute to toxemia?
- Nutritional
- Immunologic
- Hormonal
What three things are associated with toxemia?
- Placental abruption
- Fetal distress
- LBW
What does HELLP syndrome stand for?
- Hemolysis
- Elevated liver enzymes
- Low platelets
T or F? HELLP syndrome occurs most often in African women and nulliparous white women with toxemia
True
Patient presents with visual symptoms, n/v, and RUQ pain. What may be a cause?
HELLP syndrome
S/D ratios that indicate a higher resistance in placental vasculature should raise suspicion of what?
Maternal Hypertension
Woman complains of abdominal pain who has chronic hypertension, what should we suspect?
Placental abruption
What is the leading cause of mental retardation in the West?
FAS
Sonographic findings of FAS? MMV over, I’m goin FAS
- Microcephaly
- Micropthalmia
- VSD