Fetal Medicine Flashcards
Role of Chorionicity in Multiple Pregnancy?
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
Signs of Dichorionic Pregnancy on ultrasound?
Lambda sign at the site of membrane insertion
Widely separated caesarean or placentae
Features of different sexes (dizygotic twins are always dichorionic)
Signs of Monochorionic Pregnancy on ultrasound?
T sign at the site of membrane insertion
Absence of the lambda sign at <14 weeks is diagnostic
Complications of Multiple Pregnancy?
- Maternal?
- Fetal
Delivery of Multiple Pregnancies?
Management of twin-to-twin transfusion Syndrome
Laser ablation of the placental anastomoses
Classification of Small for Gestational Age?
SGA refers to a fetal weight that is less than the 10th centile for a given gestational age
Causes of SGA?
Risk Factors for SGA?
Complications of SGA?
Investigations for SGA?
Post Natal Care of SGA?
Causes/Risk Factors for Intrauterine Growth Restriction?
Complications of IGR?
Investigations for Intrauterine Growth Restriction?
Management of IGR?
Indications/Benefit/MOA of Steroids in Pregnancy?
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.
Dosage/Timing of Steroids in Pregnancy?
Special Considerations when giving patient with Diabtetes Steroids?
People with diabetes should be carefully monitored, as they may require additional insulin (steroids cause hyperglycemia)
Dosage/Timing/Benefit of Magnesium Sulfate?
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.
________________ refers to a low amniotic fluid volume.
Definition?
Oligohydramnios refers to a low amniotic fluid volume
Causes of Oligohydramnios?
Complications of Oligohydramnios
Investigations for Oligohydramnios?
________________ refers to the presence of excess amniotic fluid
Definition?
Polyhydramnios refers to the presence of excess amniotic fluid
Causes of Polyhydramnios?
Complications of Polyhydramnios?
Clinical Features of Polyhydramnios?
Management of Polyhydramnios?
