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OBGYN Pathology > Maternal Illness > Flashcards

Maternal Illness Flashcards

1
Q

What does IDDM stand for?

A

Insulin dependent diabetes mellitus

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2
Q

What is the most common effect of diabetes mellitus in pregnancy?

A

Fetal overgrowth

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3
Q

What does macrosomia mean?

A

When the baby is really big for dates

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4
Q

Macrosomic fetuses are at increased risk for:

A

Birth trauma

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5
Q

What is shoulder dystocia?

A

When the shoulders are too wide for the birth canal

A possible risk when fetus is macrosomic

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6
Q

Organogenesis is done by what week?

A

By 15th week.

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7
Q

High glucose levels during organogenesis may:

A

Cause anomalies

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8
Q

Which type is IDDM?

A

Type 1 diabetes

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9
Q

What is type 1 diabetes?

A

Inability of pancreas to produce insulin, resulting in excessive glucose levels

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10
Q

During the first trimester, glucose may act as:

A

A teratogen

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11
Q

What are some anomalies associated with type 1 diabetes?

A

Neural tube defects
Cardiac anomalies
Renal abnormalities
Gastrointestinal

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12
Q

Neural tube defect associated with IDDM

A

Spina bifida
Anencephaly
Caudal regression syndrome

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13
Q

Cardiac anomalies associated with IDDM

A

Transposition of great vessels

Tetralogy of Fallot

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14
Q

Renal abnormalities associated with IDDM

A

Hydronephrosis

Renal agenesis

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15
Q

GI abnormalities associated with IDDM

A

Duodenal atresia

Anorectal atresia

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16
Q

Vascular damage from diabetes can cause impaired uteroplacental circulation resulting in:

A

IUGR

Oligohydramnios

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17
Q

Exposure to excess glucose not only can cause macrosomia but also:

A 
Placentomegaly
Polyhydramnios
Stillbirth
Hypoglycemia in neonate 
Erythroblastosis
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18
Q

What is it called when diabetes is onset during pregnancy?

A

Gestational diabetes

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19
Q

When does gestational diabetes usually occur?

A

During the second trimester

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20
Q

Gestational diabetes is associated with fetal anomalies.

T/F

A

False

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21
Q

Gestational diabetes can cause:

A

Macrosomia
Polyhydramnios
Placentomegaly

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22
Q

What is considered hypertension for pregnant women?

A

140/90

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23
Q

Chronic hypertension is present when?

A

Before 20 weeks

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24
Q

What are the types of chronic hypertension?

A

Primary essential hypertension

Secondary hypertension

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25
What can cause secondary hypertension?
Renal, endocrine or neurological disorders
26
What causes pregnancy induced hypertension?
Prostaglandin abnormalities
27
What are the types of pregnancy induced hypertension?
Preeclampsia | Eclampsia
28
What will be seen with preeclampsia?
High blood pressure Proteinuria Edema Rapid weight gain
29
What may be seen with eclampsia?
``` Seizures or coma in preeclampsic patient Headaches Blurred vision, sometimes blindness in mother if left unchecked long enough Maternal death Fetal death ```
30
What is HELLP syndrome?
A severe variant of preeclampsia
31
What does HELLP stand for?
``` Hemolysis Elevated Liver enzymes Low Platelets ```
32
S/S of HELLP
Hypertension Edema Abdominal pain (from hepatic hemorrhage and rupture)
33
What are some conditions associated with uteroplacental insuffiency caused by impaired circulation?
``` Oligohydramnios IUGR Premature labor Increased incidence of placental abruption Placental infarcts Small/thin placenta Grade 3 placenta before 34 weeks High resistance umbilical artery Low resistance middle cerebral artery Flow reversal during atrial contraction in ductus venosus ```
34
What does TORCH stand for?
``` Toxoplasmosis Other transplacental infections Rubella Cytomegalovirus Herpes simplex virus ```
35
TORCH is:
A group of maternal intrauterine infections
36
What is toxoplasmosis caused by?
A protozoan
37
When does toxoplasmosis cause fetal infection?
During the third trimester
38
What fetal effects are associated with toxoplasmosis?
``` Hydrocephalus Intracranial calcifications Seizures Cerebral palsy Erythroblastosis Anemia Jaundice Hepatosplenomegaly ```
39
What other infections are transplacental?
Syphilis Chlamydia Varicella-zoster virus (chickenpox)
40
What causes syphilis? | What effects are associated with it?
``` A spirochete Congenital malformations Prematurity Stillbirth Fetal Hydrops ```
41
What effects are associated with chickenpox?
Spontaneous abortion | Limb hypoplasia
42
Rubella is the most common cause of intrauterine infections. T/F
false, it used to be but immunization programs have decreased the incidence
43
What is congenital rubella syndrome?
``` Fetal malformations during the first trimester which include: Cardiac disease Abnormal long bones Deafness Cataracts IUGR Encephalitis ```
44
Other effects associated with rubella infection:
``` Spontaneous abortion Neonatal hepatosplenomegaly Obstructive jaundice Neurological deficits Mental retardation ```
45
What is the most common cause of intrauterine infections?
Cytomegalovirus
46
What effects are associated with cytomegalovirus?
``` IUGR Microcephaly Intracranial calcs Seizures Blindness Neonatal hepatosplenomegAly Neonatal jaundice Neonatal thrombocytopenia ```
47
Associated effects of herpes simplex virus?
``` IUGR Hydranencephaly Cerebellar necrosis Cataracts Microphthalmia Hepatosplenomegaly Premature delivery ```
48
Most common red cell antigen for maternal alloimmunization
RHD antigen
49
With Rh isoimmunization, the mother is Rh+ and the fetus is Rh- T/F
False, mother is - baby is +
50
What happens when fetal and maternal blood mix when there is Rh isoimmunization?
Maternal response is to produce IgG antibodies to destroy the Rh+ RBCs
51
What is sensitization?
Maternal exposure to fetal blood
52
When does sensitization occur?
Typically during first delivery
53
If sensitization occurs, it affects subsequent pregnancies. | T/F
True
54
What is it called when there is an over abundance of immature RBCs?
Erythroblastosis fetalis
55
What is the new name for erythroblastosis fetalis?
Hemolytic disease of fetus and newborn (HDFN)
56
When the IgG antibody attaches to fetal RBC what occurs?
Hemolysis, which can lead to fetal anemia
57
What are effects of fetal anemia?
CHF Hepatosplenomegaly Fetal Hydrops Eventual fetal acidosis
58
When does fetal Hydrops occur?
When fetal hemoglobin is below 7g/dL
59
Fetal death results within _____________ with fetal acidosis.
24-48 hours
60
What would we look for sonographically when evaluating for fetal Hydrops?
``` Scalp edema Tissue edema Pericardial effusion Pleural fluid Ascites ```
61
When trying to evaluate fetal anemia what artery do we look at?
Middle cerebral artery
62
What effects does anemia have on the MCA?
Decreased blood viscosity will result in velocities increasing
63
Where else may you see increased velocities with fetal anemia?
The umbilical vein | The ductus venosus
64
A value greater than what multiples of the median indicates anemia?
1.5
65
What may cause thrombophilias in pregnant women?
Too much of protein “blood clotting factors” | Too little of anti-clotting proteins
66
Most thrombophilias are inherited. | T/F
True
67
A few examples of inherited thrombophilias:
Factor V Leiden | Prothrombin mutations
68
What does APS stand for?
Antiphospholipid syndrome
69
Is APS inherited?
No
70
What is APS?
Autoimmune disorder that attacks proteins that attach to fat on surface of cells Antibodies damage blood vessels and lead to clots
71
Most women with thrombophilias have healthy pregnancies. | T/F
True
72
What are some consequences of thrombophilias?
More likely to develop DVT or pulmonary embolism Fetal loss Placental abruption IUGR
73
What is systemic lupus erythematosus?
A chronic autoimmune disease
74
What does systemic lupus erythematosus affect?
Placenta
75
Effects associated with systemic lupus erythematosus?
Spontaneous abortion IUGR Stillbirth Congenital heart block
76
Hyperemesis gravidarium
Excessive vomiting that results in dehydration and electrolyte imbalance
77
Why do we check for trophoblastic disease when the patient has hyperemesis gravidarum?
Because trophoblastic disease causes high levels of hCG which can cause hyperemesis
78
Urinary tract disease may cause _____________ to develop.
Pyelonephritis
79
How often is asymptomatic bacteriuria present in pregnancies?
4-5%
80
Multiple births are less common in obese women. | T/F
False

OBGYN Pathology (10 decks)

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