MFM Flashcards
Marfan’s syndrome:
a) maternal risks
b) fetal risks
a) cervical insufficiency, aortic rupture, uterine rupture,
operative delivery, PPH, death
b) inheritance (AD), PTB, IUGR, IUFD
key features of herpes gestationis (aka pemphigoid)?
- presents in T2/T3
- papules/vesicles everywhere
- C3 +/- IgG deposition in BM
- 50-75% risk of recurrence
fetal risks: SGA, PTB, IUFD (30%), transient neonatal rash (5%)
Tx:
- increased FHS
- prednisone +/- IVIG
- delivery by 37wks
Causes of increased AFP on MSS? (7)
1) wrong dates
2) oNTD
3) abdo wall defect
4) twins
5) cystic hygroma
6) IUFD
7) non-OB (e.g. ovarian pathology)
Cardiac conditions where pregnancy is contraindicated? (10)
1) pulmonary arterial HTN
2) NYHA 3/4 or EF < 30%
3) severe (re)coarctation
4) severe aortic root dilation
a) Marfan’s: AR > 4.5cm
b) bicuspid AV or TOF: AR > 5cm
c) Turner’s ASI > 25mm/m2
5) Eisemenger’s syndrome
6) previous peripartum CM + current EF < 45%
7) vascular EDS
8) severe MS
9) severe symptomatic AS
10) Fontan circulation, with any complication
Derm conditions in pregnancy associated with increased fetal risks? (3)
1) pemphigoid (herpes gestationis)
2) pustular psoriasis (impetigo herpetiformis)
3) pruritis gravidarum (cholestasis)
Abnormal value for uterine artery Doppler?
PI > 2.5 (bilateral)
Indications for PPx for infectious endocarditis? (3)
1) prosthetic valve or material to repair valve
2) previous infectious endocarditis
3) structural valve regurgitation with prosthetic material, in the setting of …
- unrepaired/residual shunt
- cyanotic heart disease
- cardiac transplant
Risk factors for striae in pregnancy?
- increased gestational weight gain
- increased BMI
- LGA
- multiples
- young maternal age
- non-white ethnicity
- FHx
US findings of oNTD? (5)
1) lemon head sign
2) banana cerebellum
3) ventriculomegaly
4) open defect along spine
5) talipes
When to deliver SGA + IUGR?
IUGR with abnormal Dopplers:
- absent/reversed DV a-wave: 26-30wks
- UA REDF: 30-32wks
- UA AEDF: 32-34wks
- at any GA, if maternal indication for delivery (e.g. abnormal NST, abruption, HELLP)
IUGR with normal Dopplers:
- by 37wks
- vs at 37wks for “uncomplicated”
SGA: 37-39wks
Hyperthyroidism:
a) maternal risks
b) fetal risks
a) maternal tachycardia, palpitations, sweating, heat intolerance, PET, CHF, thyroid storm, PP flare
b) hypothyroidism, goiter, fetal tachycardia, PTB, hydrops, IUFD
Triad of findings for congenital rubella syndrome?
- sensorineural hearing loss
- ocular defects
- cardiac defects
Finding most associated with BPP score of 2?
persistent pulmonary HTN
Key features + fetal risks of pustular psoriasis in pregnancy (impetigo herpetiformis)?
features:
- pustules on erythematous plaques
- flexural surfaces
- onset in T3
fetal risks:
- PTB
- IUGR
- IUFD
facial features of FASD?
- epicanthal folds
- short palpebral fissures
- small eyes
- smooth philtrum
- thin upper lip
- absent maxilla
- small head
- CNS abnormalities
abnormal value for MCA Doppler for fetal anemia?
> 1.5 MoM
which acne Tx options are NOT safe in pregnancy?
- retinoids
- tetracyclines
which Tx options for psoriasis are SAFE in pregnancy?
- steroids: topical or PO
- UV light therapy
rash on extensor surfaces?
psoriasis
rash on flexor surfaces?
eczema
signs of MgSO4 toxicity?
- decreased/absent reflexes
- hypotension
- low RR (<12/min)
- low O2 sats (<94%)
- low urine output (< 30cc/hr)
- bradycardia
- cardiac arrhythmias
- muscle weakness
- excessive drowsiness
antidote = calcium gluconate 10%, 10cc IV over 3 min
melasma in pregnancy:
a) incidence
b) Tx
a) 70%
b) avoid sun, use sunscreen, PP retinoic acid, consider laser if persistent (70% resolve PP)
normal derm changes in pregnancy?
- increased pigmentation: linea nigra, new nevi
- telangiectasias
- brittle nails
- nail bed coming off
- transverse grooves in nails
- PP hair loss
parvo B19 in pregnancy:
a) when does MOST hydrops occur following infection?
b) what GA would parvo infection be the worst?
a) 2-4 weeks
b) 13-16wks GA
