Exam #4 Flashcards
What are the landmarks for the 2nd trimester fetal biometry?
- BOD
- HC
- AC
- FL
BPD
*biparietal diameter
-most reliable for predicting fetal age
HC
AC
FL
What are the landmarks for the posterior fossa?
- arnold chiarri (banana sign)
- spina bifida
- cisterna magna
Why is it important to image the posterior fossa?
to monitor if fluid increases, nuchal fold thickens
IUGR
- what is it?
- list some causes?
*Intrauterine Growth Restriction
- fetal birth weight AT or BELOW 10% for gestational age
- causes:
- HTN
- smoking
- previous IUGR
- UT anomaly (bicorn or fibroid)
- placenta hemorrhage/insufficiency
Symmetric IUGR occurs in the __ trimester and is generally caused by _____.
- 1st
- severe insult:
- intrauterine infection
- maternal malnutrition
- fetal alcohol syndrome
- chromosomal anomaly
- severe congenital anomaly
Asymmetric IUGR occurs in the __ trimester and is often caused by _____.
- 2nd
- placental insufficiency
What tests are included in the biophysical profile?
- cardiac non stress test (NST)
- Doppler: heart rate & UT contractions
- fetal breathing movements
- fetal movements
- fetal tone
- AFV
Biophysical profile is used to determine __.
fetal well-being
AFI
- what is it?
- what is the normal range?
- Amniotic Fluid Index
- normal range:
- four quadrant (total): 5-22 cm
- single pocket: 2-8 cm
AFI: Polyhydroamnios
- four quadrant (total): >22 cm
- single pocket: >8 cm
AFI: Oligohydroamnios
- four quadrant (total): <5 cm
- single pocket: <2 cm
List the dangers of Maternal Diabetes:
- polyhydramnios
- macrosomic baby
- very severe vascular disease can cause IUGR
Macrosomic baby
a birth weight AT or ABOVE the 90th percentile
It is important not to confuse IUGR with a baby who is just ___.
SGA
SGA
- what factors result in this type of baby?
*
- AT or BELOW 10th percentile
- factors
- genetics
- poor maternal weight gain & nutrition
- intrauterine infections
- chromosomal anomaly
- placental insufficiency
What are the functions of the placenta?
(HINT: P.H.E.R.N.)
- protection
- hormone production
- excretion
- respiration
- nutrition
TORCH
- what is it?
- what can it lead to?
- Toxoplasmosis
- Ruebella
- Cytomegalovirus
- Herpes
What are the abnormal umbilical cord insertion types?
- Battledore (Marginal)
- Succenturiate
- Velamatous
Describe the normal central insertion type of the umbilical cord.
Vasa Previa
*what is it?
- what does it result from?
*
- Velamatous
What are the types of abnormal placental attachment?
- placenta accreta
- placenta increta
- placenta percreta
Placenta Accreta
invades 50% through the myometrium
Placenta Increta
invades <50% through the myometrium
Placenta Percreta
extends through UT into the bladder and adjacent pelvic structures
Name the four grades of placenta previa from least to most severe?
- Low Lying
- Marginal
- Partial
- Complete
What are the dangers of nuchal cord?
The dangers of nuchal cord to the fetus may result in…
Mid Gut Herniation
*what is it?
- why it happens
- when it happens
- when it should resolve
- happens around 8 wks; resolve by 12 wks
Omphalocele
when the midgut herniation fails to resolve
Gastroschisis
an abdominal defect (more likely RT-sided) where intestines spill out into the amniotic fluid
Why is there an increase in AFP in association with ____?
How many vessels are in the umbilical cord?
How long is the umbilical cord (in cm)?
3– 1 vein, 2 arteries
- 40-60 cm
What are two ways to image the umbilical cord vessels?
The umbilical cord is covered in ___. What is the purpose?
- ## Wharton’s jelly
What is placental abruption?
What type of placental abruption presents with NO vaginal bleeding?
Dizygotic
two zygotes (fertilized eggs)
Monozygotic
one fertilized egg (which divides)
Chorion refers to the…
placenta
What are the types of twins?
- MA/MC (monoamniotic/monochorionic)
- DA/DC (diamniotic/dichorionic)
- DA/MC (diamniotic/monochorionic)
- conjoined
What is the most dangerous twinning?
mono/mono
The ‘Twin Peak” or ‘Lambda Sign’ indicates what type of twinning?
Di/Di
The ‘T-sign’ indicates what type of twinning?
Diamniotic/Monochorionic
TRAP
*Twin Reversed Arterial Perfusion
- 1 twin is acardiac (receives ALL bl. supply from pump twin)
TTTS
*Twin Twin Transfusion Syndrome
- 1 twin recieves majority of blood over the other due to an AV shunt w/in placenta
What is a vanishing twin?
a twin that dies early in 1st trimester and the mother’s body absorbs the remains
What is a “stuck twin”?
*diamniotic pregnancy
- polyhydramnios in one sac
- severe oligohydramnios in other sac
- manifests 16-26 wks
What are the tests in the Quadruple screen?
- AFP
- Elevated neural tube defects/anencephaly & spina bifida
Trisomy 21
*aka Down Syndrome
- very common chromosomal defects
- adv. maternal age
- nuchal translucency (>3mm) & nuchal fold (>6mm)
- mental retardation
- hygroma
- duodenal atresia (double bubble)
- echogenic bowel
- mild ventriculomegaly
Trisomy 18
*aka Edwards Syndrome
- 2nd most common chromosomal defect
- abnormal quad screen
- heart defects
- clenched hands
- rocker bottom foot
- cleft lip & palate
- omphalocele
- congenital diaphragmatic hernia
- cerebellar hypoplasia
- profoundly retarded w/ 90% dying in 1st year of life
Trisomy 13
*aka Patau’s Syndrome
- extremely severe w/ multiple brain anomalies
- holoprosencephaly
- cyclopia & proboscis
- polydactyly, omphalocele
- micrognathia
- meningomyecele
- 80% die in 1st month
Micrognathia
small chin
Talipes Equinovarus
clubfoot (abnormal medial rotation of foot)
Syndactyly
same, or all of the fingers/toes, partly or wholly united
Polydactyly
extra fingers/toes
Proboscis
a rare fetal anomaly
- appendage-like structure projecting from the ML fetal face/forehead.
Cyclopia
prosencephalon fails to properly divide the orbits into two cavities
(often with a proboscis)
Turner’s Syndrome
*45X
- genetic abnormality
- absence of an X or Y chromosome
Cystic Hygroma
*
- infants CAN survive
- physical ft:
- short stature
- webbed neck
Triploidy
- extra set of chromosomes
- physical/mental ft:
- head defects
- cranial & renal anomalies
- omphalocele
- mental retardation
Dominant disorder
*autosomal dominant
- caused by a single defective gene
Recessive disorder
*autosomal recessive
- caused by a PAIR of defective genes
- one from each parent
