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Registry Review OB/GYN > First trimester Abnormalities > Flashcards

First trimester Abnormalities Flashcards

1
Q

___: bleeding into uterine wall and chorion

A

subchorionic hemorrhage

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2
Q

subchorionic hemorrhage can lead to what

A

spontaneous abortion

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3
Q

S/A subchorionic hemorrhage

A
  • hypoechoic structure between chorion and uterine wall

- usually crescent shaped

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4
Q

what are some risk factors of ectopic pregnancy

A
  • history of PID
  • history of fertility treatment
  • history of tubal surgery or trauma
  • history of previous ectopic
  • IUD
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5
Q

what is the number 1 risk for an ectopic pregnancy

A

history of tubal surgery or trauma

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6
Q

list the most common to least common locations for ectopics to occur

A
  • ampulla
  • isthmus
  • interstitial
  • c section scar
  • ovary
  • abdomen
  • retroperitoneal
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7
Q

___: an ectopic pregnancy that implants at the upper lateral corner of the endometrial cavity near the opening of the Fallopian tube

A

angular pregnancy or corneal pregnancy

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8
Q

an ectopic pregnancy usually occurs on which side

A

the same side as the corpus luteal cyst

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9
Q

where is the most dangerous place for an ectopic to occur

A

interstitial portion of Fallopian tube

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10
Q

what is the classic triad of symptoms for ectopic pregnancy

A
  • pain
  • vaginal bleeding
  • fever
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11
Q

what happens to the HCG levels with an ectopic pregnancy

A

will not increase as fast as in normal intrauterine pregnancy

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12
Q

___: ectopic and IUP coexisting with each other

A

heterotypic pregnancy

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13
Q

what is the drug that is used to treat early enraptured ectopics

A

methotrexate

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14
Q

S/A ectopic pregnancy

A
  • free fluid in cul de sac or adnexa
  • empty gestational sac
  • single decidual layer
  • complex adnexal mass
  • adnexal tubal ring or bagel/donut sign
  • ring of fire sign (increased vascularity)
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15
Q

___: hyperplasia and overgrowth of the trophoblastic material

A

hydatidiform mole or gestational trophoblastic disease

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16
Q

what causes gestational trophoblastic disease

A

two sperm fertilize a single egg

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17
Q

hydatidiform more is associated with what kind of ovarian cyst

A

theca lutein cyst

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18
Q

S/S hydatidiform mole

A
  • excessively high levels of bHCG

- acute onset of maternal systemic HTN in the first trimester

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19
Q

what are the two forms of hydatidiform mole

A

complete and incomplete

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20
Q

which form of hydatidiform mole is the most common

A

complete

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21
Q

which type of hydatidiform mole does not involve a fetus

A

complete

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22
Q

S/A hydatidiform mole

A
  • may be seen with theca lutein cyst
  • enlarged uterus with heterogeneous endometrial cavity (snowstorm appearance)
  • hydropic villi appear as multiple cystic structures within the uterine cavity
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23
Q

which form of hydatidiform mole includes a fetus and a molar pregnancy

A

partial mole

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24
Q

___: invasive malignant molar pregnancy that moves int the myometrium uterine wall and peritoneum

A

chorioadenoma destruens

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25
Q

___: malignant molar pregnancy that metastasizes usually to the liver

A

choriocarcinoma

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26
Q

S/A choriocarcinoma

A
  • can see theca lutein cyst due to elevated bHCG levels
  • may see masses in the cervix and vagina
  • highly vascular complex mass
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27
Q

what is the most common solid mass found in pregnancy

A

fibroid

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28
Q

which type of fibroid has the highest rate for early pregnancy complications

A

submucosal

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29
Q

which type of fibroid has the highest risk for delivery complications

A

cervical fibroids

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30
Q

if surgical removal of a fibroid is required during pregnancy when should the procedure be preformed

A

between 16-20 weeks

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31
Q

what are some major anomalies seen in the 1st trimester

A
  • acrania
  • anecncephaly
  • alobar holoprosencephaly
  • body stalk anomaly
  • ectopia cordis
  • megacystitis
  • omphalocele
  • gastroschesis
32
Q

at what gestational age should the NT be done

A

11-14 weeks

33
Q

the optimal view for the NT includes what things

A
  • echogenic tip of nose
  • rectangualr palate
  • translucent diencephalon
  • nt
34
Q

how is the NT measured

A

inner to inner

35
Q

what mmt is considered abnormal for an NT

A

> 3mm

36
Q

at what gestational age is the nuchal skin fold measured

A

15-21 weeks

37
Q

what mmt is considered abnormal for the nuchal skin fold

A

> 6mm

38
Q

S/A acrania

A
  • no calvarium
  • abnormal brain tissue
  • Mickey Mouse sign
39
Q

S/A anencephaly

A
  • no calvarium
  • absent brain tissue above orbits
  • frog eyes
40
Q

S/A lobar holoprosencephaly

A
  • single ventricle
  • fused thalami
  • absent corpus collosum
41
Q

what is the only type of holoprosencephaly that can be detected in the first trimester

A

alobar

42
Q

S/A cephalocele

A

-bony defect with intracranial contents protruding

43
Q

S/A ventriculomegaly

A

-dialted lateral ventricles with dangling choroid plexus

44
Q

S/A open spina bifida

A
  • small or absent IT space
  • obliterated cisterna magna
  • thickened brain stem
  • skin defect
45
Q

S/A dandy walker malformation

A
  • enlarged intracranial translucency space
  • compressed brainstem
  • large posterior fossa
46
Q

what are some of the major cranial anomalies seen in the 1st trimester

A
  • acrania
  • anencephaly
  • alobar holoprosencephaly
  • cephalocele
  • ventriculomeglay
  • open spina bifida
  • dandy walker malformation.
47
Q

what are some of the major abdominal anomalies seen in the 1st trimester

A
  • omphalocele
  • gastroschesis
  • pentalogy of Cantrell
  • ectopia cordis
  • limb body wall complex
  • bladder extrophy
48
Q

S/A omphalocele

A
  • midline wall defect

- covered by a membrane

49
Q

S/A gastroschesis

A
  • wall defect adjacent to cord insertion
  • herniated bowel
  • not covered by membrane
50
Q

S/A pentalogy of cantrell

A
  • midline supra umbilical wall defect
  • diaphragmatic defect
  • defect in pericardium
  • intracardiac defect/ ectopia cordis
51
Q

S/A ectopia cordis

A

-sternal defect with hear protruding out of chest

52
Q

S/A limb body wall complex

A
  • large wall defect

- short or no umbilical cord with fetus fixed to the placenta

53
Q

S/A bladder exstrophy

A
  • wall defect below the cord insertion

- bladder protrudes outside the body

54
Q

what are the major chest/thorax anomalies seen in the first trimester

A
  • malposition of the heart
  • abnormal cardiac axis
  • diaphragmatic hernia
  • lung agenesis
55
Q

S/A malposition if the heart

A

-heart in mid or right of chest

56
Q

S/A abnormal cardiac axis

A

-rotation from axis

57
Q

S/A diaphragmatic hernia

A

stomach and or liver in the chest cavity

58
Q

S/A lung agenesis or hypoplasia

A
  • absence of echogenic lung tissue surrounding the heart
  • small thoracic circumference
  • cardiac malpositon
59
Q

what are the major first trimester skeletal dysplasia findings

A
  • increased NT
  • short, broken, bowed, absent long bones
  • asymmetric extremities
  • shortened ribs, narrow thorax
60
Q

what are the most common neural tube defects

A

anencephaly and spina bifida

61
Q

___: cephalic end of the neural tube fails to close

A

anencephaly

62
Q

if cerebral tissue is present but the cranial vault is absent it is considered ___

A

acrania or exencephaly

63
Q

anencephaly can be see with what other spinal defects

A
  • exophthalmos
  • macroglossia
  • polyhydramnios
64
Q

___: lack of cranial bone formation

A

acrania

65
Q

what is the Mickey Mouse sign that is associated with acrania

A

-brain tissue droops to the side

66
Q

what are the signs that are associated with spina bifida that are not usually seen in the 1st trimester

A

banana and lemon sign

67
Q

what are some sonographic markers for trisomy 21

A
  • hypoplasia/absence of nasal bone
  • AV septal defect
  • tricuspid regurgitation
  • echogenic cardiac foci
  • retrograde A wave on the ductus venosus
68
Q

what are some sonographic findings associated with trisomy 13

A
  • alobar holprosencephaly
  • midline facial anomalies
  • megacystitis
  • severe hydrops
  • tricuspid regurgitation
  • retrograde A wave on ductus venous
69
Q

which aneuploidy usually has the largest NT measurement

A

trisomy 18

70
Q

what are some sonographic findings associated with trisomy 18

A
  • dilated 4th ventricle
  • choroid plexus cyst
  • spina bifida
  • omphalocele
  • diaphragmatic hernia
  • severe hydrops
  • tricuspid regurgitation
  • retrograde A wave on ductus venous
71
Q

what are some sonographic findings associated with Turner syndrome

A
  • normal nasal bone
  • tachycardia
  • hypoplastic left heart
  • hydrops
  • renal anomalies
  • tricuspid regurgitation
  • retrograde A wave on ductus venous
72
Q

___: complete extra set of chromosomes

A

triploidy

73
Q

what is the term for an extra paternal chromosome

A

diandric triploidy

74
Q

what is the term for an extra maternal chromosome

A

dysgenic triploidy

75
Q

with diandric triploidy:

  • ___ NT thickness
  • bhCG ___
  • PAPP-A ____
  • CRL ____
A
  • increased NT
  • HCG normal
  • PAPP-A decreased
  • normal or short CRL
76
Q

with dysgenic triploidy

  • ___ NT
  • bhCG ____
  • PAPP-A ___
  • CRL ___
A
  • normal NT
  • bhCG decreased
  • PAPP-A decreased
  • severe growth restriction
77
Q

what are some sonographic findings of dysgenic triploidy

A
  • large head with small abdomen
  • compressed posterior fossa
  • small placenta
  • cardiac anomalies
  • echogenic bowel
  • spina bifida

Registry Review OB/GYN (31 decks)

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