Extra

Question 1

CA-125

Answer 1

Ovarian Ca.
Other Ca - endometrial, pancreatic, breast, lung, colorectal
Endometriosis, PID

Question 2

Soft signs

Answer 2

Increased nuchal thickness >6
Ventriculomegaly
Hypoplastic nasal bone
Echogenic cardiac focus
Choroid plexus cysts
Echogenic bowel
Shortened long bones
Aberrant subclavian artery

Question 3

Increased risk of non-chromosomal abnormalities

Answer 3

Single umbilical artery
Fetal pyelectasis
Enlarged cisterna magna

Question 4

Ovarian tumours

Answer 4

Surface epithelial, sex-cord stromal, germ cell
Serous, mucinous, Brenner (TCC), endometrioid, clear cell, sqaumous cell
Fibroma, thecoma, granulosa cell
Teratoma (inc. struma ovarii), dysgerminoma, yolk sac, embryonal, choriocarcinoma

Question 5

TTTS Grading

Answer 5

1 - normal dopplers, visible bldder
2 - empty donor bladder, normal doppler
3 - empty donor bladder, abnormal doppler
4 - hydrops
5 - demise

Doppler: UA absent or reversed diastolic flow, and abnormal ductus venosus waveform./

Question 6

TTTS features

Answer 6

Must be monochorionic
Growth discordance
Bladder discordances
Poly, oligohydramnios
Polycythaemia / anaemia

Tx: amnioreduction, septostomy, laser of chorionic plate, conservative, maternal digitalis.

TAPS is a variant with just anaemia / poly, with no amniotic fluid discordance

Demise can give twin emoblisation syndrome