MFM Flashcards
Low estriol can signify what?
Most common: placental sulfatase deficiency (XR ichthyosis)
less common: CAH, anencephaly, molar pregnancy
Estriol results in inc/dec TBG?
increase in TBG
Increase in minute ventilation is from what?
Increased tidal volume
No change in RR, FEV1/FVC
Decrease in FRC
*respiratory alkalosis with metabolic compensation
Maternal hydronephrosis on what side?
R>L due to uterine dextrorotation (same side as neonatal adrenal hemorrhage)
Maternal myasthenia
- what percentage of fetuses get TNMG?
- symptoms?
- when does it present and resolve?
- 10-20%
- poor suck, facial diplegia, DTR’s present; can be worsened with some meds (vanc, gent)
- present ~3 days, recover by 2 months
Maternal hyperthyroidism
- what percentage of fetuses get hyperthyroid?
- what do you measure?
- symptoms?
- when does it present and resolve?
- treatment?
- 1-5%
- tachycardia, IUGR, preterm, craniosynostosis
- TRAb in cord blood
- presents at 1 week (after antithyroid meds have worn off), recover at ~1 month
- “SIMBA down:” steroids, iodine, MMA, b-blocker
What is the first trimester screen?
nuchal translucency (>3 mm), hcg, PAPP-A
5 components of NST?
- 1 episode of extension/flexion
- 2 HR accelerations (10 bpm if <31, 15 bpm if >32)
- 3 discrete movements
- 30 seconds of fetal breathing
- Amniotic Fluid (MVP 2-7 cm or AFI 6-24 cm)
- Smoking during pregnancy causes?
- Second-hand smoke causes?
- asthma, SIDS
- ADHD, fire-related death
Placenta can remove which:
- conjugated bilirubin
- unconjugated bilirubin
- biliverdin
Unconjugated bilirubin
MCC for symmetric and asymmetric IUGR
symmetric: maternal sickle cell
asymmetric: UPI
Antiphospholipid antibody syndrome - what to give mom?
Heparin improves live birth rate, but doesn’t decrease associated complications (pre-E, IUGR, preterm birth)
hormones secreted by synctiotrophoblast?
estrogen, progesterone, hcg, hPL, IGF, leptin
Maternal hyperthermia increases risk of what 2 things?
neural tube defects and miscarriage
KBT equation?
(fetal cells/maternal cells) x100 x50
aka: every % counts for 50 mls
A mother is being treated with radioactive iodine for Graves - after what week should she stop?
12 weeks
Difference between complete and partial molar pregnancies?
Complete mole - 46 XX of paternal origin; there is NO fetus or amnion
Partial mole - 69 X_/_; there is a nonviable fetus
Medication contraindications to breastfeeding?
Lithium, radioactive agents, methotrexate (lose radioactive milk)
Infectious contraindications to breastfeeding?
active TB, HIV, HSV on breast, active breast abscess, VLBW infant AND mother with CMV or HSV
Peak fetal AFP production at what gestational age?
Peak maternal AFP concentration when?
peak fetal production at 13 weeks, then decreases; continues to be excreted into urine/amniotic fluid; absorbed by maternal concentration and peak is at 32 weeks
