Fetal Things Flashcards
What are facts about CMV?
MOST COMMON
- Fetus: congenital hearing loss from maternal re-activation
congenital CMV: jaundice, petechiae, thrombocytopenia, HSM, FGR, myocarditis, hydrops
- Primary maternal CMV: risk of transmission to fetus 30-40%
- highest transmission rate in 3rd trimester but MOST SEVERE if 1st trimester infection.
- Labs: avidity=0.6 or higher (acute infection)
- US findings: microcephaly, ventriculomegaly, ascites, hydrops, echogenic bowel, IUGR, oligo
What are facts about parvovirus?
MOST LETHAL
assoc w/ SAB, hydros, stillbirth
- hydrops is 2/2 aplastic anemia
- Labs: IgG, IgM, PCR. ONLY absence of all 3=non-exposure
What are facts about varicella zoster?
30% mortality with pneumonia
congenital varicella low.
- sx of congenital infection: skin scarring, limb hypoplasia, chorioretinitis, microcephaly
- high rate neonatal death
- tx=PO acyclovir for mom, immune globulin (VZIG) to infants and then IV acyclovir
What are facts about toxoplasmosis?
caused by intracellular parasite . 2/2 cysts in undercooked meat (#1), oocysts from cat poop (#2).
- sx=asymptomatic cervical LAD, fever, malaise, night sweats, myalgias.
- congenital toxo: chorioretinitis, hearing loss, rash, HSM, periventricular calcifications, ventriculomegaly
- IgM stays positive long time post exposure. If possible false pos IgM, collect 2nd sample 2 weeks later.
- Treat to decrease risk of fetal death!!
What is a lemon sign?
when sides of forehead are pulled in due to pull of cisterns magna from spina bifida that distorts intracranial contents
What is a banana sign?
associated with Arnold Chiari malformation
- herniation through cisterns magna
- also hydrocephalus
- - from OPEN neural tube defect!!
What is blueberry muffin sign?
associated with CMV-infected baby
What are signs of cerebral palsy?
low agars, low birth weight (500-1500g), hypoxia (pH<7), chorioamnionitis, periventricular leukomalacia
What is fetal circulation?
Placenta (oxygen rich) -> umbilical vein -> bypass fetal liver -> IVC -> RA -> foramen ovale -> LA -> LV-> aorta -> fetal brain. Oxygen poor blood from fetus returns to RA -> RV -> ductus arteriosus -> lower half of fetal body -> umbilical artery.
- Highest Co2 concentration is in fetal RV.
What is the appropriate ratio of chest compressions to breaths in term neonate?
3:1 compressions-to-breath per minute
- 90 compressions and 30 breaths
What are characteristic of mono mono twins on ultrasound?
T-sign
- less than 2mm membrane thickness
Gender concordant
One placenta
- 2 membrane layers
Which antigens related to hemolytic disease require fetal assessment?
Kell (k)
Kidd (JKa) - not jKb
Rh E
Rh C
Duffy (A) - not duffy B
M
What is path of fetal endocrinology?
Fetal pituitary -> ACTH -> fetal adrenal -> DHEAS -> fetal liver -> 17-OH DHEAS -> placenta -> unconjugated estriol -> maternal liver -> conjugated estriol sulfate -> estriol glucuronide -> maternal urine
hypoWhat is VACTERL?
vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities. People diagnosed with VACTERL association typically have at least three of these characteristic features.
- can also have mullerian agenesis
What is the effect of tetracycline on the fetus?
hypoplasia and staining of fetal teeth
