Maternal fetal health 1

Question 1

thyroid storm clinical (5)

assoc

Answer 1

fever, tachycardia

altered mental state

diarrhea

vomitng

arrhythmia

assoc - infection, labor, hypoglycemia, DKA inciting event

Question 1

impact of DM vs gestational diabetes

Answer 1

in DM, fetus experiences high glucose levels earlier

at 7wks - glucose toxic in organogenesis

Question 1

contributing factors antepartum hemorrhage (after 20 weeks gestaion)

Answer 1

palcental abruption

vasa previa

uterine ruprture

placenta previa

Question 1

getational HTN cutoff

Answer 1

140/90

Question 2

catalyzes iodiantion of tyrosine residues of Tg in the formation of T3/T4

Answer 2

thyroid peroxidase

Question 4

fetal mortality ratio =

Answer 4

fetal deaths >20wks or 500g divinded bytotal births (still and live)

Question 4

prolactin trends after pregenancy

Answer 4

return to baseline 3 months post

remain high longer in lactating women)

Question 5

live birth =

Answer 5

expulsion or extraction of fetus at any stage in which fetus breathes or has beatin heart, pulsation of ubiical cord, or definite movemnet of voluntary mucles

Question 5

side effects Mg Sulfate

Answer 5

warmth, flushing

Nausea/vomiting

Rare - loss of patellar reflex

respiratory depression

Question 6

maternal death =

maternal mortality =

maternal mortality ratio =

Answer 6

death while pregnant or within 42 days termination of prenancy

Rate = # of deaths per 100,000 women of reproductive age 15-49yr

Ratio = maternal deats per 100,000 live births (deaths/live briths)x100,000

Question 6

Rx for preeclamspia

seizure phrphylaxis

for fetal lung maturation

Answer 6

Mg sulfate for seizure proph

Betamethasone for fetal lungs dev

Question 7

pathophys TSH drop in first try mester

Answer 7

hcG beta subunit has wek ability to activate TSH receptor, increased hCG leads to decreased TSH

Question 8

fetal outcomes in gestational diabetes

Answer 8

macrosomia = growth beyon 4500g

polyhydramnios

neomnatal hypoglycemia

risk of brith trauma

risk of long term metabolic disorders

Question 10

Graves in pregnancy pathophys and associations

Answer 10

antibodies cross placenta

risk of abortion, preterm, low birth weight, still birth, preeclampsia

Question 11

neonatal mortality rate =

Answer 11

neonatal deats per 1,000 live births

Question 13

contributing factors to postpartum hemorrhage (4)

Answer 13

uterine atony

coagulaition defects

trauma

placenta accreta

Question 14

pathophys sheehan syndrome

Answer 14

ischemic injury to hypothal-pituitary axis

(due to pregnancy assoc increase in pituitary size and low flow, low pressure nature of portal circullation)

Question 15

leading cause of maernal mortality in US

Answer 15

CV disease

infection / sepsis

Question 16

mother uses ____ for fuel after mels, leaving ___ for fetal growth

Answer 16

mother uses TAG, glyccerol, FFa

glucose adnd maino acids for fetal growth

Question 17

gestational hyperthyroidism assoc

treatment

Answer 17

first half of pregnacy

associated with increased hCG or increaed thyroid stimualting activity of hCG

hyperemesis gravidarum - nausea, vomiting ,weight loss

supportive treatment - IV fluids, antiemetics

Question 19

maternal increase in thyroid binding globulin due to

Answer 19

increase production and decreased clearance of TBG mediated by increse in estrogen

Question 20

presence of Tg or TPO autoantibodies in mother associated with

Answer 20

pregnacy loss

recurrent miscarraiges

preterm

(thyroid destruction no suffeicient in most to casue hypothyroidism)

Question 22

HELLP syndrome

Answer 22

severe HTN plus

Hemolysis

Elevated Liver enzymes

low platelets

Question 23

stillbirh =

Answer 23

death of>20wk fetus

Question 25

impact of greater fetal glucose supply in gestational diabetees

Answer 25

macrsomia

extra glucose sotred as fat

increased insulin production

Question 26

hyperthyroidism and thyrotoxicosis associated with increase risk of (6)

Answer 26

spontaneous abortion

permature labor

low birth weight

still birth

preeclmapsia

heart failure

Question 27

PREECLAMPSIA =

Answer 27

SEVERE htn 160/110 PLUS

proteinuria

visual disturbances, headaches

epigastric pain

thrmobocytopenia

abnl liver fxn

Question 28

betamethasone mechanism

side effects

Answer 28

accelrate devo of type 1 and 2 pneomocytes > improve lung mehcnacis andsurfactant production

fluid retention in mother and transient increasse in fetal heart raet possible

Question 29

risk factors preeclmapsia

Answer 29

primiparity

Hx or Fhx

Diabetes, high BMI, kidney disease, antiphospholipid ABs

multiple gestations

Maternal age below 20 or above 35

Question 30

hypothyroidism in pregnancy most often due to (in area of adequate iodine)

Answer 30

presence of TPO or thryoglobulin antibodies (hashimotos)

Question 31

indirect obstetric death

Answer 31

deat due to preexisting disease or new diseae aggravated by effects of pregnancy

Question 32

heyodynamic and renal hallmarks of pregnancy

Answer 32

increased capactiy and reduced resistance

Question 33

amino acid concentration fetus vs mother

Answer 33

hgiher in feuts

Question 34

gestational diabetees attributed to (pathophys)

Answer 34

insuf compensatory capcity to increase beta cell mass and insulin secretion

pre-existing insulin resistance if obese

crculating islet cell antiboies (“latent” type 1)

Question 35

sheehan syndrome characterized by

Answer 35

failure of lactation

failure of hair growth over areas shaved for delivery

poor wound healing after C-section

weakness

Question 36

fetal sequalae of pregnacy HTN disorders

Answer 36

growth restriction

oligohydramnios

indicated preterm delivery

metabolic or CV disorders