MFM Flashcards
what can phenobarbital cause in pregnancy?
can cause neonatal abstinence syndrome. Newborns may develop poor feeding, high-pitched crying, diarrhea, hyperacusis, irritability, tremors, restlessness, hyperreflexia, and hypertonia.
congenital heart defects, craniofacial abnormalties, facial clefts.
What type of antibodies cross the placenta?
IgG
What happens to maternal blood pressure during pregnancy?
Decreases
at lowest point in 2nd trimester
What happens to hormones PTH and TSH in pregnancy?
PTH increases
T4 increases, TSH decreases (pregnant woman remain euthyroid)
What does human placental lactogen do?
increases lipid utilization, and has anti-insulin affect.
What crosses placenta via pinocytosis?
IgG 2nd trimester, some proteins
What crosses placenta via active transport?
amino acids, Calcium, Mag, Phos, iron iodine
What crosses placenta via facilitated diffusion?
glucose, keflex
what are some issues with velamentous cord insertion?
increase risk of intolerance to labor with some causes, due to lack of Wharton’s Jelly, vessels can be compressed during contraction
(umbilical cords inserts into chorio-amniotic membranes outside placental margin, and vessels travel within membrane of placenta)
What are issues with vasa previa?(fetal)
occurs with velamentous insertion of cord many times, membranes cross internal os and present prior to fetal head
Myasanthea Gravis can lead to what in neonate if antibodies directed to fetal Ach receptor?
fetal arthrogryposis
What electrolyte abnormality in infant do you see in Maternal diabetes?
hypocalcemia
(decreased placental transfer, PTH production, hypomagnesimia, decreased CA absorption in intestine)
What defects might you see with elevated AFP?
Open neural tube defects
What defects might you see with lower AFP
Trisomies
What are components of quad screen?
AFP, unconjugated Estriol, maternal B-hcg, inhibin A
What does echogenic bowel usually mean on Us
usually non-specific
most cases normal
When does the hypertrophic and hyperplastic phase of fetal growth take place?
16-32 weeks GA, increase in cell number, increase in cell size
What is the major hormone for intrauterine growth?
Insulin produced by fetus
Difference between SGA and IUGR
SGA less than 10% of population
IUGR less than fetus’s predetermined potential
(OB only use term IUGR if fetus is less than 10%)
What trimester will show poor growth of fetus in malnourished mother??
3rd trimester
(not important first 2 trimesters)
What can placing woman in left lateral recumbent position accomplish?
increase uterine blood flow
How does Magnesium work on mother?
Decreases uterine contractility by decreasing Ach release from neuromuscular junction and acts as Ca antagonist
How does nitrazine test work?
alkaline ph of amniotic fluid differentiates from acidic vaginal fluid
(false positive with blood, semen or BV)
(false negative if not enough vaginal fluid)
What does conservative management of PPROM less than 34 weeks increase risk of?
chorio, placental abruption and cord compression
How are Calcium, Mag and phos transported in placenta?
Active Transport
How are fat soluble vitamins transported in placenta?
simple diffusion
how is IgG transferred in placenta?
endocytosis
Where does abnormal placentation occur in
normal, accreta, previa, abruption
Basic mechanism of action for IVH
obstruction of blood flow leading to infarction
(either through increased pressure or vasoactive compounds that are released)
Order cell types most susceptible to HIE
neuron> oligodendroglia > astrocyte > microglia
Benefits of diffusion weighted MRI after HIE
more sensitive than conventional, will show decreased diffusion (or INCREASED SIGNAL) if injury
