Fetal Physiology and Anomalies Flashcards
Cyanotic CHD
Five Ts + 1-2-3-4-5
- TA (one trunk)
- TGA (switch of two great vessels)
- Tricuspid atresia (tri-)
- TOF (tetra-) [depending on whether pulmonary valve obstruction vs overt atresia)
- TAPVR (five words)
CHD with normal 4CH
TOF (unless big VSD)
D-TGA
When treat fetal SVT?
- > 1/3 of time in SVT
- CHD
- Hydrops
During which phase of lung development do CPAMs develop?
Pseudoglandular (7-17 wks)
What formula and what value for predicting CPAM prognosis (and whether to treat)?
CPAM volume ratio (CPAM lxwxh / HC) > 1.6 = bad prognosis
AF by gestational age
8 weeks: 10 mL 12: 50 20: 400 22: 630 28: 770 Max @ 30-34 and plateau until 36-38 then begins to decline 41: 515 mL
Oligo/Poly by volume #s
Oligo < 300-500
Poly > 1500-2000 mL
Bladder tap with good prognosis
Na < 100
Cl < 90
Ca < 8
osmolality < 200
Probability sensitization
- Without RhoGAM after 2nd pregnancy
- With just postpartum RhoGAM
- With postpartu mand 3rd tri RhoGAM
16%
1-2%
0.1-0.3%
99% of people’s platelet genotype is…
HPA 1a/1a
NAIT risk if mom HPA-1a neg (i.e. HPA-1b at all) and dad positive?
10%
Treatment of NAIT
IF high risk (e.g. previous sensitized neonate), steroids and IVIG 16-36 weeks
Omphalocele types and cardiac risk
- Cephalic: pentalogy of Cantrell or epigastric omphalocele. 100% have cardiac
- Lateral: classic with mid-abdomen defect. 10% cardiac.
- Caudal: hypogastric omphalocele + bladder/cloacal exstrophy and low cardiac risk
Omphalocele syndrome (non-aneuploidy)
Beckwith Wiedemann, cloacal exstrophy, fibrochondrogenesis, Marshall-Smith, Meckel-Gruber
Omphalocele incidence with aneuploidies?
Trisomy 18 22%
Triploidy 13%
Trisomy 13 9%
MC complication omphalocele
PTB (26-65%)
IUGR 6-35%
C/S
When consider C/S for omphalocele?
“Giant” >=75% liver and defect > 5 cm
Probability of HSV transmission primary, vaginal delivery vs recurrent?
50%, 3%
Unique VZV findings in fetus?
Limb hypoplasia
CMV infection stats
Of all susceptible moms, 3% convert during pregnancy.
Of all who convert (i.e. get infected), 30-40% infect fetus.
Of all infected fetus, 10% get severe complications i.e. 3% among those who converted.p
Toxoplasmosis treatment
First tri spiramycin; thereafter pyrimethamine
Complications malaria in pregnancy (P falciparum)
- Growth restriction (13-70%)
- Anemia 3-15%
- LBW 8-14%
- Infant mortality (3-8%)
Gene mutation Achondroplasia
FGFR3
Gene mutation Thanatophoric Dysplasia
FGFR3
