Fetal Medicine

Question 1

hysterotomy

Answer 1

making uterine incision to repair specific problem

-risk for PROM & preterm delivery

Question 2

fetoscopy

Answer 2

laparoscopic intervention with ultrasound guidance

Question 3

shunt

Answer 3

placed under ultrasound guidance

Question 4

ablation

Answer 4

-used most commonly for selective reduction in multiples pregnancies (cord occlusion)
+increases risk for brain bleeds related to cytokine release, pressure changes
-can be used to treat TTTS in-utero to separate placenta in two
+recommended to be completed prior to viability (before 20w)

Question 5

injections

Answer 5

usually KCl for late term abortions-really only works for singletons and when babies have own placenta in multiples pregnancies

Question 6

mono-chorionic di-amniotic (mono-di)

Answer 6

-one placenta two sacs

Question 7

mono-mono

Answer 7

-shared placenta and amniotic sac
-high risk for cord complications
+usually delivered around 34w to avoid this

Question 8

siamese twins

Answer 8

risk of shared organs with two habitudes (ex: one pericardial sac)

Question 9

Twin-Twin Transfusion Syndrome

Answer 9

-sharing unequally, osmosis occurs with mono-di twins
+one baby shunts oxygen (donor), nutrients, etc to other baby (recipient) through placenta
-sometimes called poly-oly
+need to check for GU anomaly and fluid in donor bladder and do MCA to look for anemia

Question 10

multifetal pregnancy reduction and ST

Answer 10

-typically done between 10-13w when there is the lowest chance for risks and highest chance of success
+SABs often happen prior to 10w especially with high-order multiples
+want to perform early for patient privacy
-fetuses should be easily visualizable transabdominally
+NT measurement and CVS can be performed to identify some anomalies

Question 11

loss rate when CVS is done with reduction

Answer 11

no increased risk

Question 12

ex-utero intrapartum therapy (EXIT)

Answer 12

procedures completed during c-sections