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Ob/Gyne 3 > Module 4 : Maternal Diseases > Flashcards

Module 4 : Maternal Diseases Flashcards

1
Q

what is the function of the placenta

A
  • exchange gas, nutrients and waste products between the mother and fetus
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2
Q

is the placenta a barrier

A
  • yes but not always
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3
Q

in what two ways can harm be done to the fetus

A
  • directly or indirectly
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4
Q

how is harm directly done to the fetus

A
  • by transmission of the disease to the fetus
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5
Q

how is harm indirectly done to the fetus

A
  • by diseases affecting placenta

- causing decreased placental flow which will compromise fetal growth or IUGR

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6
Q

how does timing of infection affect the severity of the infection

A 
- earlier 
  \+ result in spontaneous abortion 
  \+ during organogenesis results in large number of adverse fetal effects
- later
  \+ result in IUGR or still birth
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7
Q

what are the three different types of infections

A
  • viral
  • bacterial
  • parasitic
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8
Q

what does TORCH stand for in torch infections

A 
T = toxoplasmosis 
O = other Transplacental infections 
          \+ syphillis, chlamydia, varicella-zoste, HIV, measles, parvo virus 
R = rubella 
C = cytomegalovirus
H = herpes simplex
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9
Q

what are sonographic signs of TORCH infections

A
  • small head
  • cataracts
  • conjunctivitis
  • heart disease
  • enlarged spleen
  • hepatitis and jaundice
  • pneumonia
  • small eyes
  • brain calcifications
  • skin hemorrhages
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10
Q

what are the the 7 viral infections that can affect the fetus

A
  • cytomegalovirus CNV
  • herpes simplex virus type II
  • varicella zoster virus chicken pox
  • Epstein Barr virus MONO
  • parvovirus
  • rubella
  • zika
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11
Q

is cytomegalovirus common or uncommon

A
  • very common
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12
Q

where is cytomegalovirus commonly found

A
  • largely populated areas
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13
Q

how do patients typically present with cytomegalovirus

A
  • mild infection
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14
Q

do women who have had CMV typically contract it again or no

A
  • they will not contract it again because they have the antibodies against it
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15
Q

when is a CMV infection most dangerous to the fetus

A
  • when a primary infection occurs in pregnancy
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16
Q

what are the sonographic features of CMV in the fetus

A
  • hydrops
  • brain atrophy = ventriculomegaly, microcephaly
  • intracranial calcification
  • hyperechoic bowel/calcifications
  • IUGR
  • polyhydramnnious
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17
Q

how is fetal herpes virus type II acquired

A
  • acquired from herpes type II (maternal genital herpes)
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18
Q

when is the greatest risk of transmission of maternal genital herpes to the fetus

A
  • occurs in initial maternal infection contracted in the second half of pregnancy
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19
Q

what decreases risk of transmission with fetal herpes virus

A
  • decreases with antiviral drugs or C section
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20
Q

what is the method of transmission of herpes type 1 to the fetus and is it common or rare

A
  • oral

- rare

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21
Q

what is the sonographic characteristics of of a fetus infected with a primary maternal infection of herpes

A
  • increased rate of spontaneous abortions

- increased rate of still birth

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22
Q

what are the sonographic appearance of herpes in the fetus

A
  • microcephaly
  • ventriculomegaly or hyradnechephaly
  • IUGR
  • cataracts
  • micropthalmia
  • hepatosplenomegaly
  • premature delivery
23
Q

what is varicella Zoster virus

A
  • chicken pox
    + 1st and 2nd trimester maternal infection
    + congenital abnormalities
24
Q

what is the affect of chicken pox as a postnatal newborn disease and when does it infect the fetus

A
  • occurs with 3rd trimester maternal infection

- benign to fatal

25
Q

when can shingles occur

A
  • can occur months to years after birth
26
Q

what are the fetal features of chicken pox

A
  • demise
  • IUGR
  • MSK abnormalities (club feet, limb aplasia)
  • hydrops and polyhydramnios
  • microcephaly
  • ventriculomegaly
  • brain calcs
  • microphthalmia
27
Q

what is Epstein-barr virus

A
  • common childhood viral infection but not commonly associated with pregnancy
28
Q

what does Epstein Barr virus cause

A
  • mononucleosis
29
Q

what are the fetal sonographic features of Epstein Barr virus

A
  • spontaneous abortion
  • still births
  • IUGR
  • microcephaly
  • congenital heart abnormalities
  • microphthalmia
30
Q

what two things is parvovirus not

A
  • not the virus that effects pets

- not transmitted between humans and pets

31
Q

what is parvovirus also referred to as

A
  • slapped cheek virus

- children present with red cheeks

32
Q

is parvovirus common or uncommon

A
  • common among children
33
Q

what are the features of parvovirus in the fetus

A
  • non immune hydrops fetalis anemia
  • heptosplenomegaly
  • poly hydro
  • placental enlargement
  • heart failure
  • MCA doppler performed
34
Q

what velocity is measure of the MCA to diagnose fetal anemia

A
  • peak velocity
35
Q

how are children infected with HIV

A
  • result from transmission from mother to infant which occurs near or at delivery
36
Q

what does transmission of HIV depend on

A
  • number of maternal HIV particles
  • effectiveness of the placental barrier
  • maternal/fetal immune response
37
Q

what 4 things does HIV cause in the fetus

A
  • IUGR
  • hepatomegaly
  • lymphadenopathy
  • premature delivery
38
Q

what does rubella/German measles causes for the fetus

A
  • malformations in the first trimester
39
Q

what affects the severity of rubella on the fetus

A
  • the earlier the infection is transmitted
40
Q

what are the congenital defects that occur due to rubella

A
  • cataracts
  • cardiac defects
  • deafness
41
Q

what are 4 other nonspecific abnormalities that occur form rubella infection

A
  • IUGR
  • cardiac and great vessel abnormalities
  • microcephaly
  • microphthalmas
42
Q

what is the associated risk to the fetus with mother diagnosed with zika virus

A
  • microcephaly
43
Q

what can syphilis lead to early on

A
  • early infection can lead to spontaneous abortion
44
Q

what can syphilis lead to later on in pregnancy

A
  • hepatomegaly
  • hyperbilirubinemia
  • evidence of hemolysis (hydrops)
  • generalized lymphadenopathy
  • still born
45
Q

what 4 things can gonorrhoea cause in the fetus

A
  • IUGR
  • chorioamnionitis
  • PROM
  • prematurity
46
Q

what can gonococcal infections cause in neonates

A
  • meningitis

- and arthritis

47
Q

can gonorrhoea and syphillis be treated

A
  • yes with penicillin or other antibiotics
48
Q

what is the most common complication in pregnancy

A
  • urinary tract
49
Q

what can result in the fetus from urinary tract complications

A
  • IUGR
  • perinatal mortality
  • PROM
  • premature delivery
50
Q

what are the two parasitic infections

A
  • toxoplasmosis

- malaria

51
Q

where does toxoplasmosis usually originate from

A
  • cat feces

- undercooked or raw meat

52
Q

when is there risk of transferring toxoplasmosis to the fetus the lowest and highest

A
  • 1st trimester low

- later in pregnancy much higher

53
Q

what are the fetal features of toxoplasmosis

A
  • ventriculomegaly
  • cerebral calcifications
  • microcephaly
  • hepatosplenomegaly
  • general hydrops
  • IUGR
  • demise
54
Q

what does malaria due to the fetus and how does it occur

A
  • placental insufficiency resulting in IUGR
  • low birth rate
  • abortion
  • still birth

Ob/Gyne 3 (10 decks)

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