Fetal & Maternal Complications Flashcards
When is a fetus considered to be IUGR?
< 10% percentile for GA
pg. E 192
What are the maternal causes for IUGR?
poor nutritional status smoking multiple gestation drug/alcohol abuse anemia chronic renal disease diabetes Rh sensitization asthma under 17 over 35 heart disease high altitude pg. E 192
What are the placental causes for IUGR?
placental infarcts small placenta single umbilical artery abruptio placenta placental insufficiency pg. E 192
What are the fetal causes for IUGR?
genetic or chromosomal defects
intrauterine infection
pg. E 192
What is a symmetric IUGR?
growth restrictions affecting entire fetus
begins in first tri
pg. E 193
What is asymmetric IUGR?
HC/AC > 2 SD
occuring later in pregnancy
pg. E 193
What would the umbilical systolic/diastolic ratio be for a fetus with IUGR?
> 3.0 after 30 weeks
pg. E 193
What is erythroblastosis fetalis?
destruction of RBCs by antibodies typically from Rh incompatibility
pg. E 195
What is hydrops fetalis?
excessive accumulation of fluid in fetal tissues and body cavities
pg. E 195
What is immune hydrops?
hydrops due to Rh isoimmunization
What is non-immune hydrops?
hydrops from anything but Rh sensitization cardiac anomalies chromosomal abnormalities etc pg. E 197
What are the sonographic findings of hydrops fetalis?
pericardial effusion ascites fetal skin thickening (anasarca) placental thickening pleural effusion hepatosplenomegaly polyhydramnios enlarges umbilical vein pg. E 197
What is the songraphic appearance of fetal demise?
no cardiac activity exaggerated fetal position Robert's sign Spaulding's sign Deuel's (halo) sign pg. E 198
What are the effects of diabetes mellitus on pregnancy?
caudal regression syndrome neural tube defects cardiovascular malformations GU anomalies single umbilical artery GI anomalies skeletal anomalies pg. E 200
When a mother has diabetes that predates pregnancy, what can that cause fetal weight to be?
IUGR
pg. E 200
When a mother has gestational diabetes, what can that cause fetal weight to be?
macrosomia
pg. E 200
What is macrosomia?
birth weight > 4000 g
> 90th %
What are some maternal complications with diabetes?
polyhydramnios pre-eclampsia renal dysfunction hypoglycemia peripheral vascular disease postpartum hemorrhage pg. E 201
Why would a glucose intolerance test be taken?
patient with diabetes to help manage pregnancy
pg. E 201
What systolic pressure is considered hypertension?
> 140 mm Hg
pg. E 201
What is pre-eclampsia?
hypertension edema proteinuria rapid weight gain pg. E 201
What is eclampsia?
pre-clampsia + convulsions coma death (if not treated) pg. E 202
What are the TORCH infections?
infections that are most common in utero Toxoplasmosis Other (syphilis) Rubella Cytomegalovirus Herpes pg. E 202
How does HTN affect a pregnancy?
IUGR
prematurely mature placenta
oligohydramnios
pg. E 204
How does Type 1 diabetes affect a pregnancy?
IUGR
thin placenta
oligo or poly
pg E 204
How does gestational diabetes affect a pregnancy?
Macrosomia
placentamegaly
polyhydramnios
pg. E 204
How does infection (TORCH) affect a pregnancy?
IUGR
increase or decrease in placenta size
normal, increase, or decrease in fluid depending on anomaly
pg. E 204
What is an incompetent cervix?
premature dilatation of cervix
pg. E 206
What are the songraphic findings of an incompetent cervix?
shortened cervix <2.5 cm
dilatation > 2 cm
bulging membranes
pg. E 206
What is considered preterm labor?
onset before 37 weeks
pg. E 208
What is premature rupture of membranes (PROM)?
spontaneous rupture of membranes prior to labor
pg. E 208
What is common to see in maternal abdomen during a pregnancy?
hydronephrosis (right side more common)
pg. E 209
Why do fibroids enlarge through a pregnancy?
estrogen stimulation
pg. E 209
What is the typical size of the postpartum UT?
14 x 7 x 7 cm
pg. E 218
What is the period after giving birth when the body returns back to normal called? how long does it last?
puerperal period
4-6 weeks
pg. E 218
What are the sonographic findings of a postpartum UT?
large hypoechoic
fluid in endo
cervical internal os may be open
pg. E 218
What is the most lethal complication in the puerperal period?
postpartum hemorrhage
pg. E 219
What is a postpartum hemorrhage?
blood loss greater than 500 mL following a vaginal delivery
pg. E 219
What is associated with postpartum hemorrhage?
retained products of conception UT atony UT overdistention UT manipulation pg. E 219
What are the clinical signs of postpartum infection?
elevated body temp increased WBC's tachycardia UT tenderness pg. E 220
What is associated with infection?
poor nutrition and hygiene anemia vaginitis invasive fetal monitoring C-section prolonged labor pg. E 220
What would an abscess appear as sonographically?
complex fluid collection w/ debris
acoustic shadowing/ring down
pg. E 221
What is a hematoma?
result of failure to stop bleeding after closing the UT C-section incision
pg. E 221
What are the sonographic findings of a hematoma?
complex fluid collection in anterior cul-de-sac
appears same as abscess
pg. E 221
What might the umbilical artery flow be in a fetus with IUGR?
Increased resistance
Decreased diastolic flow
URR Exam
In IVF where is the embryo placed?
Uterus
URR Exam
When is a glucose screening performed?
24-28 weeks
If maternal syphillis goes untreated, what change will be seen in the fetus?
Hepatomegaly
Where does fetal anemia most likely cause increased flow?
Umbilical vein
Middle cerebral artery
Descending aorta
What is asymmetric IUGR associated with?
Malnutrition
Uretoplacental insufficiency
Drug abuse
