Fetal Medicine

Question 1

Role of Chorionicity in Multiple Pregnancy?

Answer 1

Monochorionic twins are at higher risks of adverse outcomes than dichorionic twins – miscarriage (6x), growth retardation (2x), preterm delivery (2x), and perinatal death (2x)

Chorionicity is determined with US in the first trimester

Question 2

Signs of Dichorionic Pregnancy on ultrasound?

Answer 2

Lambda sign at the site of membrane insertion

Widely separated caesarean or placentae

Features of different sexes (dizygotic twins are always dichorionic)

Question 2

Signs of Monochorionic Pregnancy on ultrasound?

Answer 2

T sign at the site of membrane insertion

Absence of the lambda sign at <14 weeks is diagnostic

Question 2

Complications of Multiple Pregnancy?

• Maternal?
• Fetal

Answer 2

Question 2

Delivery of Multiple Pregnancies?

Answer 2

Question 3

Management of twin-to-twin transfusion Syndrome

Answer 3

Laser ablation of the placental anastomoses

Question 4

Classification of Small for Gestational Age?

Answer 4

SGA refers to a fetal weight that is less than the 10th centile for a given gestational age

Question 5

Causes of SGA?

Answer 5

Question 6

Risk Factors for SGA?

Answer 6

Question 7

Complications of SGA?

Answer 7

Question 8

Investigations for SGA?

Answer 8

Question 9

Post Natal Care of SGA?

Answer 9

Question 10

Causes/Risk Factors for Intrauterine Growth Restriction?

Answer 10

Question 11

Complications of IGR?

Answer 11

Question 12

Investigations for Intrauterine Growth Restriction?

Answer 12

Question 13

Management of IGR?

Answer 13

Question 14

Indications/Benefit/MOA of Steroids in Pregnancy?

Answer 14

Indication:

• Planned Pre-Term Delivery
• Spontaneous Preterm Labour
• Preterm Prelabor ROM

Reduced Risk of:

• RDS: By accelerating lung maturity, the risk of respiratory distress syndrome is significantly decreased. Stimulate the production of surfactant
• Intraventricular hemorrhage
• Necrotizing enterocolitis
• Neonatal mortality.

Question 15

Dosage/Timing of Steroids in Pregnancy?

Answer 15

Question 16

Special Considerations when giving patient with Diabtetes Steroids?

Answer 16

People with diabetes should be carefully monitored, as they may require additional insulin (steroids cause hyperglycemia)

Question 17

Dosage/Timing/Benefit of Magnesium Sulfate?

Answer 17

Reduced Risk of Cerebral Palsy: Administration of magnesium sulfate before preterm birth has been associated with a significant reduction in the risk of cerebral palsy and other severe motor dysfunctions in the infant.

Tocolytic Effect: Additionally, magnesium sulfate has a tocolytic effect, meaning it can help to relax the uterine muscles and potentially delay preterm labor, although this is a secondary benefit.

Question 18

________________ refers to a low amniotic fluid volume.

Definition?

Answer 18

Oligohydramnios refers to a low amniotic fluid volume

Question 19

Causes of Oligohydramnios?

Answer 19

Question 20

Complications of Oligohydramnios

Answer 20

Question 21

Investigations for Oligohydramnios?

Answer 21

Question 22

________________ refers to the presence of excess amniotic fluid

Definition?

Answer 22

Polyhydramnios refers to the presence of excess amniotic fluid

Question 23

Causes of Polyhydramnios?

Answer 23

Question 24

Complications of Polyhydramnios?

Answer 24

Question 25

Clinical Features of Polyhydramnios?

Answer 25

Question 26

Management of Polyhydramnios?

Answer 26