Exam Pro day 7

Question 1

Latency antibiotics

Answer 1

IV 48 hour
Amp 2 gm q 6 hr
Erythro 250 mg q 6 hr

PO 5 days
Amoxicillin 250 mg q 8
Erythro 333 mg q 8 hour

Question 2

amnio for infection

Answer 2

LDH <400

Glucose >14

Question 3

Methylation studies during pregnancy

Answer 3

Need amniocentesis due to difference in methylation in placenta/ fetus

Question 4

strongest risk factors for SPTB

Answer 4

Multiples - 6 
Prior SPTB- 4
Bleeding- 3
AA- 2
IVF 2

Question 5

Prior preterm birth at what gestational age are different options avaliable ?

Answer 5

37 weeks- progesterone (most effective if cervix <20mm)

34 weeks- cerclage if cervix <25 mm

Question 6

singleton with prior preterm birth of twins…

Answer 6

can start progesterone and do cervical lengths

Question 7

Criteria for NT

Answer 7

margins clear
mid-saggital position
fetus occupies most of image
neutral position
measurement at wides area
measure 3 times and report that largest
Cut off CRL 40-85 mm

Question 8

LBW
VLBW
ELBW

Answer 8

<2500
<1500
<1000

Question 9

Incerased risk for stillbirth with FGR

Answer 9

6-10 fold

Question 10

Short term complications of FGR

Answer 10

MEC aspiration

Hypo

Question 11

Elevated Nuchal

Answer 11

remember noonan and do a noonan panel 
aneuploidy
CHD
Skeletal Dysplasia
SLO-facial features, small head size, growth and developmental delays, and intellectual and behavioral problems. Individuals with SLOS have abnormally low levels of cholesterol in their blood and high levels of a chemical known as 7-dehydrocholestrol.

If array/noonan normal anatomy, normal fetal - 95% normal outcome

Question 12

Recurrance risk for FGR

Answer 12

1 prior - 25%

2 prior -50%

Question 13

What serum markers are concerning for FGR

Answer 13

low papp-a

high AFP

Question 14

cystic hygroma

Answer 14

abnormal karyotype in 50%

Question 15

Fundal height sensitivity

Answer 15

sensitivity 27%

PPV 18%

Question 16

best predictor of morbidity in FGR

Answer 16

serial growth measurements

Question 17

ratio normals
FL/AC
HC/AC

Answer 17

reflect AC lag
FL/AC 0.24
HC/AC 1
- elevated is bad

Question 18

why do umbilical artery dopplers in FGR

Answer 18

decreases perinatal mortality by 30%

Question 19

upper limit of S/D ratio

Answer 19

90%

Question 20

Why use CPR

Answer 20

Don't! 
MCA PI/ UA PI
Abnormal <1
stronger association with adverse perinatal outcomes prior to 34 weeks?
PORTO study

Question 21

what is the DV a wave?

Answer 21

Right atrium systole

Question 22

why use DV for delivery planning in FGR with AEDF or REDF

Answer 22

decreased neurodevelopmental impairment at age 2