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Obstetrics and Gynecology > Fetal Growth Disorders > Flashcards

Fetal Growth Disorders Flashcards

1
Q

BW <10th percentile for GA

A

SGA

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2
Q

BW 10th-90th percentile

A

AGA

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3
Q

BW >90th percentile for GA

A

LGA

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4
Q

BW 1500-2500 g

A

Low birth weight

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5
Q

BW 1000-1500 g

A

VLBW

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6
Q

BW 500-1000 g

A

Extremely low birth weight

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7
Q

Threshold variability

A

Births before 26 weeks AOG

22-25

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8
Q

Late preterm (34 - 36 6/7 weeks) morbidities

A 
Respiratory distress
Intubation
IVH
Sepsis
Phototherapy
NEC
APGAR = 3 at 5 min
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9
Q

Major causes of spontaneous preterm labor

A

Uterine distention - multifetal births, hydramnios/polyhydramnios
Premature cervical changes - cervical insuffiency
Maternal-fetal stress
Infection

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10
Q

Important risk factor for preterm birth in multifetal pregnancies

A

Premature cervical changes

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11
Q

Useful biomarker for preterm birth risk assessment

More accurate predictor of preterm birth if rate of increase is measured

Inc in CRH and ACTH stimulate fetal adrenal dehydroepiandrosterone sulfate -> inc estrogen (estriol) -> loss of uterine quiesence

A

CRH

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12
Q

Microbiome during pregnancy with increased dominance of Lactobacillus

Identifies microbial pooulation associated with subclinical infection induced preterm birth

A

Metagenomics

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13
Q

Ascending microorganisms invade membranes and amniotic sac leading to release of cytokines and IL

A

1
6
8
TNF a

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14
Q

Four stages of intrauterine infection

A

I - bacterial vaginosis
II - decidual infection
III - amniotic infection
IV - fetal systemic infection

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15
Q

Microbes associated with preterm birth

A

Gardnerella vaginalis
Fusobacterium
Mycoplasma hominis
Ureaplasmaurealyticum

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16
Q

More capable of burrowing through exposed tissues after cervicsl dilatation

A

Fusobacteria

17
Q

PPROM Risk factors:

A 
Low socioeconomic
BMI = 19.8 
Nutritional deficiencies
Cigarette smoking
Prior PPROM
18
Q

Normal H2O2 producing lactobacillus replaced by

Gardnerella
Mobinculus
Mycoplasma

A

Bacterial vaginosis

19
Q

Gold standard for diagnosing bacterial vaginosis

Based on a gram-staining study of the cervical discharge

A

Nuget scoring

Count the morphotype

20
Q

Intracellular adhesion during implantation and in maintenance of placenta adherence to uterine decidua

Detected in cervico-vaginal secretions
Possible marker for impending preterm labor (>50 ng/ml is positive)

fFN screening is not recommended

fetal glue/pregnancy glue

A

Fetal fibronectin

21
Q

Single course corticosteroid use is recommended in management of preterm ruptured membrane of week

A

24 to 31 completed weeks

22
Q

42 completed weeks or 294 weeks

A

Post term pregnancy

23
Q

Major causes of death in post term pregnancy

A

GHTN
Prolonged labor with CPD
Unexplained anoxia
Malformations

Lower intelligence quotient IQ
in >/= 42 weeks gestation

24
Q

Post maturity Syndrome

A

Wrinkled, patchy, peeling skin
Long, thin body suggesting wasting
Open-eyed, unusually alert, appears old and worried
Skin wrinkling - palms and soles due to loss of protective effects of vernix caseosa
Long fingernails

25
Q

Substantially increases the likelihood of postmaturity

A

Oligohydramnios

26
Q

Cord compression associated with oligohydramnios

A

Intrapartum fetal distress

27
Q

Amniotic fluid volume decrease after 38 weeks + meconium release = thick viscous meconium

A

Meconium aspiration syndrome

28
Q

Velocity of fetal weight gain peaks at

A

37 weeks

29
Q

Fetal growth phases

A

Phase of hyperplasia (first 16 weeks) : rapid increas in cell number
Phase of cellular hyperplasia and hypertrophy (32 weeks)
Phase of cellular hypertrophy (after 32 weeks) : most fetal fat and glycogen accumulated

30
Q

Usually due to early insult causing relative decrease in cell number and size - viral infection, cellular maldevelopment, aneuploidy

A

Symmetrical proportionally small

31
Q

More common
Usually caused by insult in the late pregnancy (third tri)
Placental insufficiency
Diminished glucose transfer

Sacrifice of blood flow to other improtant structures such as liver (decrease in abdominal circumference) and kidney which leads to decreased urine production causing oligohydramnios

A

Asymmetrical disproportionately lagging abdominal growth

32
Q

Fetal growth restriction can lead to hypertension, atherosclerosis, DM Type 2, metabolic derangement

A

Barker’s Hypothesis

33
Q

Triple screen in Down

A

Unconjugated estriol
AFP
HCG

Obstetrics and Gynecology (18 decks)

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