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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
Q

What can cause secondary hypertension?

A

Renal, endocrine or neurological disorders

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26
Q

What causes pregnancy induced hypertension?

A

Prostaglandin abnormalities

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27
Q

What are the types of pregnancy induced hypertension?

A

Preeclampsia

Eclampsia

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28
Q

What will be seen with preeclampsia?

A

High blood pressure
Proteinuria
Edema
Rapid weight gain

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29
Q

What may be seen with eclampsia?

A 
Seizures or coma in preeclampsic patient
Headaches
Blurred vision, sometimes blindness in mother if left unchecked long enough 
Maternal death
Fetal death
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30
Q

What is HELLP syndrome?

A

A severe variant of preeclampsia

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31
Q

What does HELLP stand for?

A 
Hemolysis
Elevated
Liver enzymes
Low
Platelets
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32
Q

S/S of HELLP

A

Hypertension
Edema
Abdominal pain (from hepatic hemorrhage and rupture)

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33
Q

What are some conditions associated with uteroplacental insuffiency caused by impaired circulation?

A 
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
Q

What does TORCH stand for?

A 
Toxoplasmosis
Other transplacental infections
Rubella
Cytomegalovirus 
Herpes simplex virus
35
Q

TORCH is:

A

A group of maternal intrauterine infections

36
Q

What is toxoplasmosis caused by?

A

A protozoan

37
Q

When does toxoplasmosis cause fetal infection?

A

During the third trimester

38
Q

What fetal effects are associated with toxoplasmosis?

A 
Hydrocephalus
Intracranial calcifications
Seizures
Cerebral palsy
Erythroblastosis
Anemia
Jaundice
Hepatosplenomegaly
39
Q

What other infections are transplacental?

A

Syphilis
Chlamydia
Varicella-zoster virus (chickenpox)

40
Q

What causes syphilis?

What effects are associated with it?

A 
A spirochete
Congenital malformations
Prematurity
Stillbirth 
Fetal Hydrops
41
Q

What effects are associated with chickenpox?

A

Spontaneous abortion

Limb hypoplasia

42
Q

Rubella is the most common cause of intrauterine infections.
T/F

A

false, it used to be but immunization programs have decreased the incidence

43
Q

What is congenital rubella syndrome?

A 
Fetal malformations during the first trimester which include:
Cardiac disease
Abnormal long bones
Deafness
Cataracts
IUGR
Encephalitis
44
Q

Other effects associated with rubella infection:

A 
Spontaneous abortion
Neonatal hepatosplenomegaly
Obstructive jaundice
Neurological deficits
Mental retardation
45
Q

What is the most common cause of intrauterine infections?

A

Cytomegalovirus

46
Q

What effects are associated with cytomegalovirus?

A 
IUGR 
Microcephaly 
Intracranial calcs
Seizures
Blindness
Neonatal hepatosplenomegAly
Neonatal jaundice
Neonatal thrombocytopenia
47
Q

Associated effects of herpes simplex virus?

A 
IUGR
Hydranencephaly
Cerebellar necrosis
Cataracts
Microphthalmia
Hepatosplenomegaly
Premature delivery
48
Q

Most common red cell antigen for maternal alloimmunization

A

RHD antigen

49
Q

With Rh isoimmunization, the mother is Rh+ and the fetus is Rh-
T/F

A

False, mother is - baby is +

50
Q

What happens when fetal and maternal blood mix when there is Rh isoimmunization?

A

Maternal response is to produce IgG antibodies to destroy the Rh+ RBCs

51
Q

What is sensitization?

A

Maternal exposure to fetal blood

52
Q

When does sensitization occur?

A

Typically during first delivery

53
Q

If sensitization occurs, it affects subsequent pregnancies.

T/F

A

True

54
Q

What is it called when there is an over abundance of immature RBCs?

A

Erythroblastosis fetalis

55
Q

What is the new name for erythroblastosis fetalis?

A

Hemolytic disease of fetus and newborn (HDFN)

56
Q

When the IgG antibody attaches to fetal RBC what occurs?

A

Hemolysis, which can lead to fetal anemia

57
Q

What are effects of fetal anemia?

A

CHF
Hepatosplenomegaly
Fetal Hydrops
Eventual fetal acidosis

58
Q

When does fetal Hydrops occur?

A

When fetal hemoglobin is below 7g/dL

59
Q

Fetal death results within _____________ with fetal acidosis.

A

24-48 hours

60
Q

What would we look for sonographically when evaluating for fetal Hydrops?

A 
Scalp edema
Tissue edema 
Pericardial effusion
Pleural fluid
Ascites
61
Q

When trying to evaluate fetal anemia what artery do we look at?

A

Middle cerebral artery

62
Q

What effects does anemia have on the MCA?

A

Decreased blood viscosity will result in velocities increasing

63
Q

Where else may you see increased velocities with fetal anemia?

A

The umbilical vein

The ductus venosus

64
Q

A value greater than what multiples of the median indicates anemia?

A

1.5

65
Q

What may cause thrombophilias in pregnant women?

A

Too much of protein “blood clotting factors”

Too little of anti-clotting proteins

66
Q

Most thrombophilias are inherited.

T/F

A

True

67
Q

A few examples of inherited thrombophilias:

A

Factor V Leiden

Prothrombin mutations

68
Q

What does APS stand for?

A

Antiphospholipid syndrome

69
Q

Is APS inherited?

A

No

70
Q

What is APS?

A

Autoimmune disorder that attacks proteins that attach to fat on surface of cells
Antibodies damage blood vessels and lead to clots

71
Q

Most women with thrombophilias have healthy pregnancies.

T/F

A

True

72
Q

What are some consequences of thrombophilias?

A

More likely to develop DVT or pulmonary embolism
Fetal loss
Placental abruption
IUGR

73
Q

What is systemic lupus erythematosus?

A

A chronic autoimmune disease

74
Q

What does systemic lupus erythematosus affect?

A

Placenta

75
Q

Effects associated with systemic lupus erythematosus?

A

Spontaneous abortion
IUGR
Stillbirth
Congenital heart block

76
Q

Hyperemesis gravidarium

A

Excessive vomiting that results in dehydration and electrolyte imbalance

77
Q

Why do we check for trophoblastic disease when the patient has hyperemesis gravidarum?

A

Because trophoblastic disease causes high levels of hCG which can cause hyperemesis

78
Q

Urinary tract disease may cause _____________ to develop.

A

Pyelonephritis

79
Q

How often is asymptomatic bacteriuria present in pregnancies?

A

4-5%

80
Q

Multiple births are less common in obese women.

T/F

A

False

OBGYN Pathology (10 decks)

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