MFM

Question 1

How much does maternal cardiac output increase by? Blood volume?

Answer 1

CO 30-50%, blood volume 30-50%

Question 2

What promotes increased renal blood flow during pregnancy?

Answer 2

RBF inc 50%

Via inc: ADH, renin, angiotensin II, aldosterone

Question 3

What causes fibrinogen to increase during pregnancy?

Answer 3

Estrogen, fibrinogen increases by 30-50%. Leading to increased risk of clots

Question 4

How do thyroid hormones change during pregnanch?

Answer 4

Increased thyroxine binding globulin -> increased total T4, decreased TSH = euthyroid

Question 5

How is calcium regulation changed during pregnancy?

Answer 5

Increased PTH related hormone -> increased calcitriol -> increased mat intestinal Ca absorption -> allows mom to give more Ca to fetus

Question 6

What is a risk of placenta previa?

Answer 6

Bleeding, 2.5 fold greater risk of anomalies

Question 7

What makes hcg? What is the purpose?

Answer 7

Made by syncytiotrophoblasts. To prevent corpus luteum involution

Question 8

What is hPL? Function?

Answer 8

Human placental lactogen
Increases as GA increases
Induces lipolysis and has anti insulin effect

Question 9

Which placental cells touch maternal blood? Fetal blood?

Answer 9

Maternal: syncytiotrophoblasts
Fetal: cytotrophoblasts
Touching uterus: decidua basalis

Question 10

What is the difference between partial and complete molar pregnancy?

Answer 10

Complete (worse): no fetus, 46 XX, paternal, large uterus. 20% have trophoblast tumors
Partial: 69 XXX, XXY, XYY; small uterus, nonviable fetus

Question 11

What is significance of single umbilical artery?

Answer 11

Incidence 0.5-1%, inc in twins, associated with GU/cardiac anomalies

Question 12

What is pre E BP cutoff? Severe range?

Answer 12

Pre E: >140/90 (either) x 2
Severe: > 160/110

Also with proteinuria, >300mg in 24 hrs, severe > 5000 mg

Question 13

How common is eclampsia? How long are women at risk?

Answer 13

0.1% of all pregnancies, can be up to 7 days postpartum

Question 14

What are prenantal screening markers for trisomy 21? 18? 13?

Answer 14

Trisomy 21: low AFP, high B HCG *, low unconjugated estradiol, high inhibin A
Trisomy 18: low AFP, low B HCG, low unconjugated estradiol, normal inhibin A
Trisomy 13: not impacted by quad screen (tiny bit dec uE)

Question 15

What is the major hormone for fetal growth?

Answer 15

Insulin
Minor: IGF1 and IGF2, epidermal growth factor
*GH is not involved

Question 16

What is most common type of twins?

Answer 16

Mono di (70-75%): division 3-8 days
Mono mono (1-2%): 8-13 days
Di di (25-30%): before day 3

Question 17

What happens to start labor?

Answer 17

1. Decreased progesterone receptors
2. Increased estrogen
3. Increased prostaglandins E and F
4. Increased maternal corticotropin releasing hormone

Question 18

What impact due maternal ace inhibitors have on fetus?

Answer 18

Leads to oligo, limb deformities. Skull hypoplasia. Pulmonary hypoplasia