MATERNAL CONDITIONS IN PREGNANCY Flashcards
cervical insufficiency
cervix begins to dilate or efface before pregnancy reaches term
or
inability of the cervix to retain fetus, in the absence of uterine contractions owing to functional or structural defect
cervical effacement
thinning of the cervix
-physiologic, onset of labor to prepare for delivery
cervical dilation
opening of the cervix
cervical dilation
opening of the cervix
short cervix
a cx less than 25mm (2.5cm) in length @ 18-24 weeks gestation
funneling
protrusion of the amniotic membranes of >5mm into the internal os
types of funneling
T, Y, U, V
transvaginal cerclage
suture placed as cranial as possible for longest CL, removed at 36-38 weeks
McDonald technique
purse string or cloverleaf configuration
Shirodkar technique
aims for higher placement on cx
transabdominal cerclage (TAC)
placed around lower uterine segment caesarean delivery required
TAC used for
-if transvaginal cerclage not possible or prior failure
-congenital or surgical short cx
-scarred or lacerated cervix
-equivalent to open and laparoscopic placement
myoma
fibroid
leiomyoma
myoma
fibroid
leiomyoma
myoma definition
benign uterine tumor composed of smooth muscle
myoma imaging
note location, type, and size
measure in 3 orthogonal planes
note relationship with placenta and internal os
myoma US
well defined
hypoechoic myometrial mass
degenerated - often cystic and heterogenous
placenta implants on fibroid
-increases risk of complications
-abruption
-spontaneous abortion
-preterm labor
-intrauterine growth restriction
-postpartum hemorrhage
retained products of conception RPOC signs
-delayed post partum bleeding
-present within few days of delivery or abortion
-endometritis
-puerperal infection (postpartum infection)
RPOC
incomplete uterine evacuation with retention of placental/trophoblastic tissue within endometrial cavity
RPOC US
-echogenic endometrial mass with low resistance, high velocity flow
-early loss has small cystic areas
-postpartum appears more like placenta
-solid, heterogenous, echogenic mass
-persistent thickened endometrium (>10mm)
-may have calcifications
-intrauterine fluid
synechiae
destruction of endometrial basal layer resulting in adhesions
uterine adhesions from scarring
synechiae causes
-curettage
-trauma
-infection
synechiae imaging
-band-like structure crossing uterine cavity
-variable thickness, complete or incomplete
