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DMST 285 OBGYN 2 > Maternal Diseases And Pregnancy > Flashcards

Maternal Diseases And Pregnancy Flashcards

1
Q

Maternal disease can be categorized into what kind of categories? 3

A
  1. Infection
  2. Endocrine disorders
  3. Hypertension
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2
Q

What is the function the placenta? 3

A

Exchange of
1. Gas
2. Nutrients
3. Waste products

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3
Q

Harm can be done to the fetus in what two ways?

A
  1. Directly by transmission of disease from maternal circulation to the fetal circulation
  2. Indirectly by the disease affecting the placenta itself
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4
Q

What are maternal infections? 4

A
  1. TORCH (some of the most common maternal infection)
  2. Viral
  3. Bacterial
  4. Parasitic infection
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5
Q

What happens in terms of infection early in the pregnancy? What happens during if it happens during organogenesis?

A
  1. Infections usually result in spontaneous abortions
  2. Occurring during organogenesis (week 6-8) results in the largest number of adverse fetal effect
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6
Q

What happens if there is an infection later in pregnancy?

A

Usually results in IUGR or stillborn

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7
Q

What does TORCH stand form?

A

Toxoplasmosis
Other trans placental infections
Rubella
Cytomegalovirus (CMV)
Herpes simplex

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8
Q

What are some complications of TORCH? 10

A
  1. Small head
  2. Cataracts
  3. Conjunctivitis
  4. Heart diseases
  5. Enlarged spleen
  6. Hepatitis and jaundice
  7. Pneumonia
  8. Small eyes
  9. Brain calcifications
  10. Skin hemorrhages
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9
Q

What is toxoplasmosis? Where can the mom get affected by this?

A
  1. A parasitic infection
  2. Can be from cat feces, undercooked or raw lamb or pork
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10
Q

During the 1st trimester what is the risk of toxoplasmosis transferring from a fetus?

A

Low, parasite is a large cell, can’t permeate through placenta

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11
Q

What is the risk of toxoplasmosis transferring to mom in later pregnancy?

A

Much higher, increased placental surface area and aging placenta makes it easier

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12
Q

What are some fetal features of toxoplasmosis? 7

A
  1. Ventriculomegaly
  2. Cerebral calcification
  3. Microcephalic
  4. Hepatosplenomegaly
  5. General Hydrpps
  6. IUGR
  7. Demise
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13
Q

For acute toxoplasmosis when will we see potential demise?

A

24 weeks?

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14
Q

What are some things we see on the ultrasound for toxoplasmosis in terms of the abdomen? 3

A

Larger abdomen
1. AC measures 29 weeks
2. Due to hepatosplenomegaly
3. Ascites and pleural effusions

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15
Q

What will the heart look like during acute toxoplasmosis?

A

No heart motion with colour doppler over the heart

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16
Q

What does the head look like during acute toxoplasmosis? 3

A
  1. Ventriculomegaly due to brain atrophy
  2. Head measured normal
  3. No brain calcinations seen (probably would have seen them in a later gestation)
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17
Q

What does the placenta/ Amniotic fluid look like during acute toxoplasmosis? 2

A
  1. Thick placenta
  2. No amniotic fluid
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18
Q

What can be included in the other category in terms of the TORCH? 5

A
  1. Malaria
  2. Syphilis
  3. Varicella zoster virus
  4. HIV
  5. Parvaovirus
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19
Q

What is malaria? How does it affect the fetus?

A
  1. Another common parasitic infection
  2. Placental insufficiency resulting in IUGR, low birth weight, abortion and still birth
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20
Q

Why does malaria affect the fetus?

A

The anti parasitic drug therapy manages toxoplasmosis and malaria in pregnancy but the drug may be teratogenic

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21
Q

How does syphilis affect early fetus?

A

Can lead to spontaneous abortion

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22
Q

How does syphilis affect the fetus later? What do we see? 5

A

Later infection can lead to neonatal
1. Hepatosplenomegaly
2. Hyperbilirubinemia
3. Evidence of hemolysis
4. Generalized lymphadenopathy

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23
Q

What is a potential consequence of syphilis?

A

Stillborn

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24
Q

What is the varicella zoster virus? When will anomalies are at the highest?

A
  1. Chicken pox
  2. Fetal anomalies are highest in the 1st and 2nd trimester
25
Q

When does the postnatal newborn disease varicella zoster virus occur? How serious is it? What is it called when it occurs in later years of life?

A
  1. Occurs with a 3rd trimester maternal infection
  2. Benign to fatal
  3. Shingles - can occur months of ages to years after birth
26
Q

What are some fetal features of varicella zosters virus? 8

A
  1. Demise
  2. IGUR
  3. MSK abnormalities
  4. Hydrops and polyhydraminos
  5. Microcephaly
  6. Ventriculomegaly
  7. Brain calcification
  8. Microphthalmia
27
Q

When does transmission of HIV to the infant?

A

From mother to infant near or at delivery

28
Q

Transmission of HIV to infant depends on what? 3

A
  1. Number of maternal HIV particles
  2. Effectiveness of the placental barrier
  3. Maternal/ Fetal immune response
29
Q

What are some possible effects of HIV on the infant? 4

A
  1. IUGR
  2. Hepatomegaly
  3. Lymphadenopathy
  4. Premature delivery
30
Q

What is parvovirus (fifth disease) not? 2

A
  1. Not the virus that effects pets
  2. Not transmitted between humans and pets
31
Q

What does parvovirus look like?

A

Slapped cheek virus

32
Q

If most moms have had the infection as a child what does this do for the fetus?

A

They will have antibodies

33
Q

What are some sonographic features of parvovirus? 8

A
  1. Demise
  2. Non immune hydrops
  3. Fetal anemia
  4. Neurological anomalies
  5. Heart anomalies
  6. Hepatosplenomegaly
  7. Polyhydraminos
  8. Placental enlargement
34
Q

What is rubella? When does it affect the fetus?

A
  1. German measles
  2. Malformation with 1st trimester exposure
35
Q

With rubella the earlier exposure what happens to the fetus?

A

More severe defects

36
Q

What is the main effects of exposures for rubella? 3

A
  1. Cataracts
  2. Cardiac defects
  3. Deafness
37
Q

What are some non specific effects of rubella exposure? 6

A
  1. IUGR
  2. Great vessel abnormalities
  3. Microcephaly
  4. Microphthalmia
  5. Hepatosplenomegaly
  6. Osteopathy
38
Q

Is cytomegalovirus common? And where is it found?

A

Common and found in largely populated areas

39
Q

In adults cytomegalovirus presents as what? How often and who is usually affected? 2

A
  1. Mild infection
  2. Many women have already had the CMV infection
40
Q

What is a benefit of already having CMV?

A

Women who already had CMV antibodies can’t contract it again during pregnancy

41
Q

When is CMV dangerous to the fetus?

A

Danger to the fetus when a primary infection occurs during pregnancy

42
Q

What are some CMV sonographic features? 7

A
  1. Hepatosplenomegaly
  2. Intracranial calcification
  3. Brain atrophy
  4. Non immune hydrops
  5. Hyperechoic bowel
  6. IUGR
  7. Polyhydraminos
43
Q

How is herpes simplex virus usually acquired? How is it rarely acquired?

A
  1. Usually acquired from herpes type 2 from maternal genital herpes
  2. Rarely from herpes type 1
44
Q

Primary infection of herpes simplex virus results in what?

A

More severe reactions

45
Q

Secondary infection of herpes simplex virus tends to a affect the fetus how? 2

A
  1. Not to cause much of a problem
  2. If there is an active outbreak - c section is performed to protect fetus from infection during birth
46
Q

What does primary infection during the first 1/2 of the pregnancy with Herpes virus?

A

Increased rate of spontaneous abortions, stillbirths and premature delivery

47
Q

What are some sonographic features of herpes virus? 6

A
  1. Microcephaly
  2. Ventriculomegaly or even hydranecepahly
  3. IUGR
  4. Cataracts
  5. Microphthalmia
  6. Hepatosplenomegaly
48
Q

What does having the zika virus increase the risk of? 2

A
  1. Miscarriage, preterm birth and stillbirth
  2. Serious birth defects (congenital zika syndrome)
49
Q

What are some of the serious birth defects of zika virus? 5

A
  1. Microcephaly
  2. Brain damage
  3. Eye damage
  4. Joint problems
  5. Reduced body movement due to hypertonia
50
Q

How does COVID affect pregnancy? 5

A

Increased risk of
1. Hospitalization
2. Intensive care and or ventilator
3. Death
4. Preterm birth
5. Pregnancy loss

51
Q

What is Epstein- Barr virus? What does it cause? 2

A
  1. Common childhood viral infection
  2. Causes mononucleosis
52
Q

What are some sonographic fetal features of Epstein Barr virus? 6

A
  1. Spontaneous abortion
  2. Stillbirth
  3. IUGR
  4. Microcephaly
  5. Congenital heart abnormalities
  6. Microphthalmia
53
Q

How does gonorrhea affect pregnancy? 4

A
  1. IUGR
  2. Chorioamnionitis
  3. PROM
  4. Prematurity
54
Q

Gonococcal infections in neonates can result in what?

A

Meningitis and arthritis

55
Q

What is the most common complication in pregnancy? (Mother)

A

Urinary tract infection

56
Q

When UTIs are asympotomatic it can cause what?

A

IUGR and premature delivery

57
Q

If UTI progress to pyelonephritis, it can cause what? 5

A
  1. IUGR and premature delivery
  2. PROM
  3. Perinatal mortality
  4. Anemia an toxaemia
  5. Impaired mental and motor developed ent
58
Q

How are UTIs treated?

A

Antibiotics

DMST 285 OBGYN 2 (15 decks)

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