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Abnormal OB > final > Flashcards

final Flashcards

1
Q

what is spine hypotensve syndrome?

A

a temporary acute disorder due to compression of the IVC by the weight of the pregnant uterus

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2
Q

how is spine hypotensive syndrome detected?

A

when a pregnant women feel faint while laying on her back

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3
Q

what are risk factors for hypertensive disorders?

A
  • chronic hypertension
  • diabetis mellitus
  • multiple pregnancy
  • chronic renal disease
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4
Q

what is chronic hypertension?

A

blood pressure 140/90 mmHg or greater prior to pregnancy in the absence of hydatiform molemole or hypertension that persists for more than 42 days postpartum.

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5
Q

what are most affected in preeclampsia?

A
  • kidney
  • liver
  • hematologic system
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6
Q

what are significant fetal complications associated with hypertensive disorders?

A
  • IUGR
  • hypoxia (fetal distress)
  • fetal dealth
  • placenta in severe hypertensive disease may be small or prematurely calcified
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7
Q

what is the clinical classification of hypertensive disorders?

A
  • chronic hypertension
  • pregnancy-induced hypertension
  • preclampsia
  • eclampsia
  • HELLP syndrome
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8
Q

what is an abnormal doppler waveform in hypertensive patients?

A
  • early diastolic notch
  • reduced end diastolic flow resulting in high pulsatility index
  • high resistive index
  • RI above 95th percentile for GA
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9
Q

what are the 3 common types of gestational hypertension?

A
  • chronic hypertension
  • gestational hypertension
  • preeclampsia
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10
Q

what is hypertension define as?

A

systolic >140mmHg

diastolic >90mmHg

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11
Q

what may increase the risk of developing gestational hypertension?

A
  • first time mom
  • fam history
  • multiple gestation
  • younger than 20 or older than 40
  • high blood pressure or kidney disease prior to pregnancy
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12
Q

what are the signs and symptoms of pregnancy induce hypertension?

A
  • blood pressure over 140/90
  • proteinuria >5gm/24 hours
  • oliguria (small amounts of urine)
  • edema
  • weight gain
  • headaches, visual disturbance
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13
Q

what is preeclampsia?

A

term describing hypertension with proteinuria, generalized edema, or both

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14
Q

what are some symptoms of preclampsia?

A

oliguria, cerebral or visual disturbances (headache, blurred vision)

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15
Q

what is associated with mild preeclampsia?

A
  • HBP
  • water retention
  • protein in the urine
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16
Q

what is associated with severe preeclampsia?

A
  • headaches
  • blurred vision
  • inability to tolerate bright light
  • fatigue
  • nausea/vomiting
  • urinating small amounts
  • RUQ pain
  • shortness of breath
  • tendency to bruise easily
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17
Q

what is eclampsia?

A

development of seizure or coma without an underlying neurologic or febrile origin (epilepsy or systemic infection) in a patient with preeclampsia

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18
Q

what is hellp an accronym for?

A

Hemolysis
ELevated liver enzymes
Low Platelets

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19
Q

what are complications associated with hellp?

A
  • acute renal failure
  • hepatic rupture
  • adult respiratory distress syndrome
  • disseminated intravascular coagulation
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20
Q

what is diabetes mellitus?

A

medical disease that leads to hyperglycemia and glycosuria as the hyperglycemia increases

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21
Q

what is the classification of diabetes?

A
  • insulin-dependant diabestis
  • non-insulin-depandant diabetis
  • gestational diabetis
  • impaired glucose tolerance
  • diabetis associated with certain known conditions and symptoms
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22
Q

what is insulin dependant diabetis (type 1)?

A

the deficiency of insulin accelerates the break down of the body’s reserve of fat resulting in the production of organic acids called ketones

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23
Q

what are the complications of diabetes mellitus?

A
  • loss of vision due to cataracts

- severe kidney disorders

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24
Q

what is the most common diabetis?

A

Non-insulin-dependant diabetis

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25
Q

which diabetes is associated with obesity?

A

non-insulin-dependant diabetes

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26
Q

how is diabettis controlled?

A

mild and the high glucose levels in the blood can usually be controlled by diet alone or with anti-diabetic drugs

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27
Q

what are risk factors of Gestational diabetes?

A
  • strong family history
  • fasting glycosuria (glucose in urine)
  • previous unexplained prenatal loss
  • preious large for dates infant
  • previous gestational diabetis and maternal obesity
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28
Q

what are the maternal risks of diabetis mellitus?

A
  • preeclampsia and eclampsia in patients with vascular disease
  • infection (acute pyelonephritis)
  • fetal macrosomia
  • C-section
  • risk of pre term labour
  • post pardum hemorrhage
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29
Q

what are the fetal risks of diabetis mellitus?

A

intrauterine demise

  • perinatal morbidity
  • IUGR in patients with vascular disease
  • fetal congenital anomalies
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30
Q

what are the most common fetal anomalies with diabetes mellitus?

A
  • caudal regression syndrome
  • situs inversus
  • holoprosencephaly
  • renal anomalies
  • duplex kidney
  • renal agenesis
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31
Q

what are the cardiac anomalies that may happen with diabetis?

A
  • VSD, ASD (most common)

- transposition of the great vessels

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32
Q

what are the neural tube defects with diabetis mellitus?

A
  • ancephalocele

- meningomyelocele

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33
Q

why may ultrasound in diabetic pregnancy be helpful?

A

assess:

  • macrosomia
  • polyhydramnois
  • IUGR
34
Q

what may happen to the urinary system during pregnancy?

A

dilation of renal collecting system (hydronephrosis) from compression of enlarging uterus

35
Q

what urinary tract infection besides hydronephrosis is common?

A

ureteral reflux is common

36
Q

what are the ultrasound findings associated with acute pyelonephritis?

A
  • renal enlargment
  • generalized decrease in echogenicity of the cortex and medulla
  • decreased sound attenuation due to increased fluid content of the edematous inflamed kidney
37
Q

what is ultrasound most valuable to assess in the biliary system?

A
  • extrahepatic biliary tree for obstruction
  • cholelithiasis/acute cholecystitis
  • pregnancy increases the risk of cholelthiasis and cholecystitis
38
Q

what does budd-chiari syndrome do to other places in the body?

A
  • abdominal pain
  • acites
  • hepatosplenomegaly
  • porta hypertension
39
Q

what are harmful infections known as in pregnancy?

40
Q

what does TORCH stand for?

A 
Toxoplasmosis
Others
-syphillis
-varicella or chicken pox
-parovirus B19 infection
-hepatitis B
Rubella
Cytomegalovirus
Herpes simplex
41
Q

when does toxoplasmosis usually occur?

A

third trimester

42
Q

in severe toxoplasmosis, what is the classic triad of anomalies?

A
  • chorioentinitis
  • hydrocephaly or microcephaly
  • cerebral calcification
43
Q

what may hydrops be associated with?

A

fetal infection

44
Q

what is maternal infection occuring in the 1st trimester not associated with?

A

fetal disease

45
Q

When Rubella infections occur in the first month of pregnancy, there is a________chance of congenital anomalies.

46
Q

what is important in rubella virus (german measles)?

A

timing of the infection

47
Q

what happens if rubulla virus occurs in week 6?

48
Q

what happens if rubulla virus occurs in week 7?

49
Q

having rubella infection in the first 3 months increases the risk of what?

A

having a misscariage

50
Q

what are associations associated with cytomegalovirus?

A
  • hydrops
  • microcephaly
  • hydrocephaly
  • chorioetinitis
  • hepatosplenomagaly
  • cerebral calcification
  • mental retardation
  • heart block
  • petechia
51
Q

what are the congenital anomalies associated with herpes simplex virus?

A
  • microcephaly
  • chorioentintis
  • cerebral calcification
  • microphthalmia (one or both eyeballs are abnormally small)
  • encephalitis
52
Q

what is the definition of preterm labour?

A

regular uterine contractions that cause progressive dilation of the cervix BEFORE 37 weeks gestation

53
Q

what are the main complications of preterm labour?

A
  • prematurity

- associated neonatal complications

54
Q

Arrestation of preterm labour is contraindicated in the presence of any of the following conditions:

A
  • fetal maturity is indicated
  • fetal demise
  • fetal anomaly incompatible with life
  • fetal distress
  • active bleeding associated with moderate or severe placental abruption or placenta previa
  • chorioamniotitis
  • severe preeclampsia
55
Q

what are the ultrasound results indicating preterm delivery?

A
  • cervical length <25 mm=shortnened cervix

- funneling of internal os >5mm before 30weeks

56
Q

what are postpardum complications?

A
  • uterine bleeding
  • uterine atony
  • lacerations
  • retained placental fragments
  • inversion of the uterus
  • placenta accreta
  • uterine infection
57
Q

what is uterine entrapment syndrome?

A

acute problem of early pregnancy due to pelvic entrapment of a retroverted or retroflexed uterus

58
Q

what are the symtoms of uterine entrapment syndrome?

A
  • pelvic pain
  • back ache
  • urethra is compressed and elongated causing urinary frequency and infection
59
Q

what is the prognosis of uterine entrapment syndrome?

A

spontaneous correction between the 9th and 12th weeks

60
Q

how can uterine entrapment syndrome be fixed?

A

manual compression

61
Q

amniocentesis permits safe access to the fluid avoiding what?

A
  • fetus
  • umbilical cord
  • large uterine blood vessels
  • placenta
62
Q

how do we know if needle traverses the placenta in amniocentesis?

A

blood is streaming from the placenta into amniotic fluid as soon as needle is removed

63
Q

what are the indications of an amniocentesis?

A
  • assess the risk of open neural defect
  • assess the risk of down syndrome
  • checking for fetal lung maturity is most common indication in 3rd trimester
  • checking for fetal hemoglobin breakfdown products in cases of suspected hemolysis due to maternal antibodies to fetal blood
64
Q

what are the risks of an amniocentesis?

A
  • amniotic fluid leak
  • chorioamnionitis
  • unexplained post-procedure fetal demise
  • pregnancy loss rate after second trimester amniocentesis has been estimated to be approx 0.4%
65
Q

when is amniocenteisis preformed?

A

16 week pregnancy

66
Q

what can amniocentesis provide information about?

A
  • neural tube defects
  • blood type of fetus
  • genetic disorders (sickle cell)
  • fetal infection
  • readiness of fetus’s lungs to live outside of uterus
67
Q

does CVS disturb amniotic sac?

68
Q

where are samples from CVS sent?

A

lab for genetic analysis

69
Q

what is the purpose of CVS?

A
  • assess fetal karyotype
  • biochemical test of fetal cells for evaluation of disease status
  • detects gentic disorders
70
Q

when is CVS preformed?

A

10-13 weeks

71
Q

what is the indication of CVS?

A

more quickly than amniocentesis. can detect chromosomal abnormalities and can see if termination is needed

72
Q

is pregnancy loss higher with CVS or amniocentesis?

73
Q

what is mosaicism?

A

when an organism has two genetically distinct cell lines derived from a single fertilization

74
Q

what are contraindications for a CVS?

A
  • placenta problems
  • history of premature labour
  • incompetent cervix
75
Q

what is another name for PUBS?

A

cordocentesis

76
Q

what is PUBS?

A

A diagnostic test that examines blood from the fetus to detect fetal abnormalities

77
Q

when is cordocentesis preformed?

A

17 weeks into pregnancy

78
Q

where should the puncture be made in posterior placenta?

A

1-2 cm from the placenta insertion site of cord

79
Q

what does PUBS detect?

A

chromosome abnormalities

blood disorders

80
Q

what disorders can cordocentesis detect?

A
  • malformation of the fetus
  • fetal infection
  • fetal platelet count in the mother
  • fetal anemia
  • isoimmunisation
81
Q

what is fetoscopy?

A

endoscopic procedure during pregnancy to allow access to the fetus, the amniotic cavity, the umbilical cord, and the fetal side of the placenta

82
Q

what 3 conditions use fetoscopy?

A
  • twin to twin trasfusion
  • amniotic band syndrome
  • congenital diaphragmatic hernia

Abnormal OB (7 decks)

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