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Women's Health > OB > Flashcards

OB Flashcards

0
Q

Parity?

A

of live births a woman has had

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1
Q

Gravidity?

A

of times a woman has been pregnant, including current pregnancy

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2
Q

EDD

A

Estimated date of delivery

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3
Q

EDC?

A

Estimated date of confinement

Another term for delivery date

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4
Q

Miscarriage?

A

First trimester pregnancy loss, considered an abortion

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5
Q

When is a threatened abortion suspected?

A

First trimester bleeding

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6
Q

What’s a spontaneous abortion? When does it usually occur?

A

Pregnancy loss caused by natural or unanticipated events

Around 8 weeks gestation

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7
Q

What’s recurrent spontaneous absorption?

A

2 consecutive spontaneous abortions or 3 total

Aka habitual abortion

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8
Q

What’s gestational age based off of? What’s another name for it?

A

Date of last menstrual period (LMP), sonogram dating methods are based on this

Aka menstrual age (MA)

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9
Q

What does GA equal?

A

Embryologic (conceptual) age + 2 weeks

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10
Q

What’s Embryologic age? What’s another name for it?

A

Based of time of conception (embryology references use this age)

Aka conceptual age

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11
Q

How do you get gestational age from embryological age?

A

Add 2 weeks to embryological age

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12
Q

Which age do we use in clinical practice?

A

Gestational age

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13
Q

What does serum pregnancy test?

A

Beta subunits of hCG (human chorionic gonadotropin)

Urine pregnancy tests are qualitative -detect the presence of hCG

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14
Q

What produces hCG?

A

Trophoblast if cells that make up the placenta and burrow into the endometrium

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15
Q

What are the 2 quantitative lab tests to detect the amount of b-hCG in maternal blood?
How are they related?

A
  1. Second international standard (2nd IS): 1/2 the value of IRP
  2. International reference preparation (IRP): twice the value of 2nd IS
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16
Q

What does the discriminary zone of the 2nd IS and IRPean?

A

Threshold amount oh hCG at which there should be sonographic evidence

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17
Q

What’s the discriminatory zone for 2nd IS?

A

500-1200 miu/ml for endovaginal imagining

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18
Q

What’s the discriminatory zone for IRP?

A

1000-2000 miu/ml for endovaginal imaging

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19
Q

How often does hCG double?

A

Every 48 hours for the first 6 weeks of a normal pregnancy

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20
Q

What happens to hCG in ectopic pregnancies?

A

Plateaus or rises at a subnormal level

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21
Q

What happens to hCG with abortions?

A

Falls to zero

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22
Q

What happens to hCG with gestational trophoblastic neoplasia?

A

Excessively high levels

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23
Q

How does an obstetrical wheel work?

A

Align arrow to first day of LMP, other arrows points to EDD

Can also align known gestational age to current date to determine LMP or EDD

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24
Q

What’s Naegele’s rule?

A

EDD = LMP - 3 mo + 7 days

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25
Q

What are some reasons for doing first trimester sonogram?

A

Vaginal bleeding of unknown cause, suspected ectopic, estimate gestational age for pts undergoing repeat C-section/induced labor/elective pregnancy termination
Pelvic mass, suspected uterine abnormality, significant uterine size/clinical date discrepancy
Suspected hydatidiform mole, adjunct to amniocentesis or chorionic villus sampling (CVS), IUD localization, suspected multiple gestation

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26
Q

What happens in the gestational/menstrual age week 1-2?

What phase is it?

A

Proliferative phase
FSH stimulates ovarian follicular development
Estrogen produced by follicles, stimulates endometrial repair

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27
Q

What’s the sonogram appearance of the early and late Proliferative phase (weeks 1-2 gestational/menstrual age)

A

Early prolif phase: endometrial double-layer thickness 4-8mm

Late prolif phase (periovulatory) triple endometrial appearance, 6-10 mm

28
Q

What happens in the gestational/menstrual age week 3-4?

What phase is it?

A

Conceptus period
Ovulation: approx 14 days post LMP, can vary. Stimulated by LH surge, ovum released into peritoneum and swept into ampullary part of tubes
Corpus luteum: LH causes ovarian follicle to form this. MC adnexal mass in 1st trimester. It produces progesterone that peeped and maintains secretory endometrium. Also produces estrogen

29
Q

During the conceptus period (gestational/menstrual age week 3-4) what’s going on with the endometrium and what’s the purpose?

A

Secretory phase

Endometrial glands secretion is rich in glycogen, source of nutrients for embryo til placenta takes over around week 12

30
Q

How does the secretory endometrium look on a sonogram?

A

Hyperechoic

Thick - 7-14 mm

31
Q

What does pregnancy cause in the endometrium?

What’s it’s purpose?

A

Decidual reaction
Increased endometrial thickness and glandular changes caused by progesterone stimulation
Need it for early preg nourishment
It occurs during intrauterine and ectopic pregs

32
Q

When does fertilization occur in relation to ovulation and LMP? And where

A

12-24 he after ovulation
Day 14-15 LMP
Usu occurs in ampulla of tubes

33
Q

What’s a zygote

A

Fusion of sperm and ovum creates this two cell zygote

34
Q

What the so a pellucida?

A

Forms around conceptus zygote, prevents other sperm penetrating

35
Q

Where do conceptus become a morula and how?

A

Cells undergo cleavage and develop into a morula while traveling thru tube toward uterus

36
Q

What’s a morula? What are the individual cells called?

A 
18 cells (cell number doubles but maintains it's size)
Individual cells are called blastomeres
37
Q

When does the morula enter the uterus?

A

Approx day 17 GA

38
Q

What’s a blastocyst?

A

Fluid collects btwn blastomeres of morula, forms fluid filled cyst with clump of cells at one end

39
Q

Where is the blastocyst located?

A

In uterine cavity, floats for about 2 days

40
Q

What happens to the cells of the blastocyst?

What will they form?

A

Organize into inner and outer cell mass
Inner cells at one end will become embryo (bilaminar disk), yolk sac and amnion
Outer cells: trophoblastic cells, surround the cavity and inner cell mass. Form chorion and placenta

41
Q

When does implantation occur?

A

Days 20-23 LMP

6-7 days post fertilization.

42
Q

What happens to the blastocyst during implantation

A

Blastocyst sheds zone pellucida to begin implantation

Trophoblasts burrow into decidualized endometrium

43
Q

When will preg tests be positive?

A

When trophoblasts burrow into decidualized endometrium for implantation bc they produce hCG

44
Q

Whats the outer membrane of the gestational sac during implantation?

A

Chorion (trophoblastic cells)

45
Q

What’s the chorion frondosum?

A

Early chorionic villi that attach to endometrium, anchoring the placenta and will become fetal side of placenta

46
Q

What’s the chorion laeve

A

Part of the chorion not involved in implantation

47
Q

What’s the decidua basal is

A

Maternal part of the placental attachment

48
Q

What’s the decidua capsularis

A

Layer of the endometrium that heals over the implanted gestational sac

49
Q

What’s the decidua Vera (parietalis)

A

Endometrium not in direct contact with the gestational sac

Next to the decidua capsularis, creates a double echogenic rim known as the double decidual sign (DDS)

50
Q

When should a double decidual sign (DDS) be seen?

A 
Early pregnancy 4-6 weeks 
Suggests IUP (intrauterine pregnancy)
51
Q

When does the amnion, yolk sac and primitive chorionic villi develop?

A

Around day 23-28 LMP

52
Q

Where does the amnion form around days 23-28 LMP?

Is it seen on sonogram then?

A

Btwn bilaminar disk and chorion

Early amnion is not seen well on sonogram, a tiny amnion (2mm) may be seen around week 5.5 gestation

53
Q

What’s the transient finding of the amnion adjacent to the yolk sac called?

A

Double-bleb sign

54
Q

Where does the amnion first expand to and what’s it responsible for?

A

Surrounds the embryo

Responsible for embryonic folding

55
Q

When does the amnion become more apparent on ultrasound? Where will it be seen?

A

Around week 8 gestation

Surrounds the embryo but not in contact with the chorion

56
Q

When does the amniotic membrane fuse with the chorion?

A

Week 14-16

57
Q

What does the amniotic cavity contain?

A

Amniotic fluid

58
Q

When does the primitive yolk sac form?

Is it seen on sonogram?

A

Day 23 LMP

Not seen

59
Q

When does the secondary yolk sac form?

When is it seen on sonogram

A

Days 27-28 it forms from the primary yolk sac

Visible on sonogram around week 5.5

60
Q

What’s the first structure to be seen within the gestational sac? What does it confirm?

A

Secondary yolk sac

Confirms IUP

61
Q

What are the 4 fxn of the yolk sac?

A
  1. Transfers nutrients
  2. Hematopoiesis (forms blood cells)
  3. Angiogenesis
  4. Forms digestive tract (dorsal part forms primitive gut)
62
Q

What is the yolk sac connected to and where’s it located?

A

Connects to the embryonic midgut by the vitelline duct, it’s outside the amniotic cavity

63
Q

What’s the allantois?

What’s it the source for?

A

Part of the yolk sac incorporated into the umbilical cord

Source of allantoic cysts (umbilical cord cysts)

64
Q

In multiple pregs, how many yolk sacs for each amnion?

A

1/1

65
Q

What size should yolk sacs measure? What if it’s abnorm?

A

< 6 mm
Measure inner borders
Abnormalities are assoc with poor preg outcomes
Echogenic or calcified yolk sac is abnormal

66
Q

Where does the primitive chorionic villi form?

A

Around entire chorion

67
Q

What’s the purpose of the primitive chorionic villi?

A

Invades the decidua basics of the endometrium, anchoring the placenta

Site of transfer of nutrients from maternal to fetal blood

Women's Health (5 decks)

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