MFM II Flashcards
what is vaginal pH vs amniotic fluid pH? how is this used in nitrazine test?
AF pH is alkalotic (>7) vs vaginal pH is acidotic (V is sharp)
Nitrazine test is used to test pH for ROM –> turns from yellow to blue
what is a molar vs partial molar pregnancy?
molar: 46 XX (usually paternal) –> no fetus or amnion
partial molar: 69 xxy/xxx/xyy - usually two sperm one egg, usually some fetus and/or amnion
how much radiation is okay to fetus?
<5 rad (1 rad = 10 milligray) is considered okay
how is fetal weight estimated? which 4 components?
femur length, biparietal diameter, head circ and abdominal girth
which system has least accuracy in 2nd trimester anatomy scan?
GI anomalies
where does a spinal block go?
subarachnoid space (where CSF is). least maternal serum analgesia.
maternal use of SSRI is associated with what?
ADHD in baby, and +/- autism
PT neonate surface area:mass vs T in comparison to adult?
PT: 4x adult
T: 3x adult
What is an abnormal s/d?
> 3.0 is bad
Bad in growth restricted, hypertrophy of colloid arterioles causes increased svr causes lower D bc decreased venous return
What is perinatal Mortality vs early neonatal vs neonatal vs infant vs post neonatal?
Perinatal: 0-7d including stillbirth Early neonatal: 0-7d Neonatal: 0-1m Infant: 0-1y Postneonatal: 1m-1y
what passes through placenta via pinocytosis?
Immunoglobulins, primarily IgG. IgM and IgA cannot
what passes through placenta via facilitated diffusion?
glucose via primarily GLUT 1 receptor
what passes through placenta via active transport?
active transport uses energy to have carrier-mediated transfer of compounds against concentration gradient.
the following are higher on fetal side, so need active transport: AA, Ca/Mg/Ph and water soluble vitamens
what passes through placenta via simple diffusion?
- O2, CO2
- H2O, Na, Cl
- most maternal meds
- lipids, fat soluble vitamins
what are Hofbauer cells?
stromal histiocytes typically found in placental villi
- lymphocytes and plasma cells indicate chronic inflammation
how does CRH and progesterone effect pregnancy?
CRH: increased during onset of labor - rate of increase is most important, not absolute amount
progesterone: receptors and co-activators decreased to start labor and remove uterus from quiescent state
what is the difference between infertility and subfertility?
subfertility is not being able to get pregnant for 6m, 50% still get pregnant in next 6m
infertility is not being able to get pregnant for 1y (or 2y by WHO definition)
what is vanishing twin vs IUFD in twin pregnanices?
what is appropriate management and risk?
vanishing twin is if twin fetus dies in 1st trimester –> no increased risk to mother
considered IUFD if twin fetus dies in 2nd/3rd trimester –> increased risk of demise to other twin and hypotension at time of twin death, especially causing cycstic encephalomalacia
mgmt: if periviable and impending death, can do fetoscopic cord ligation
what is appropriate ett and iv epi dosing?
always 1:10,000
ETT: 0.5 - 1ml/kg
IV: (1/10th of that) 0.01 ml/kg
where is cf DNA derived from? higher or lower in early gestation?
comes from placenta, detectable by 4 weeks EGA. Increases with increasing EGA. It is shorter than maternal cfDNA and has half life of 15 minutes.
what teratogenic effects does phenobarb have?
cleft, cardiac, decreased vit K absorption
is preE more likely with first pregnancy or later?
more likely with first pregnancy
whats the difference between pre E and severe preE
preE: pressure > 140/90 and 300mg proteinuria in 24 hours
severe preE: pressure >160/110 and 5 g proteinuria in 24 hours
Kleinhauer betke test calcluation
fetal cells/maternal cells
for every 1% –> 50 ml of fetal blood lost
