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TIRED YEAR > OB AF, TERA AND FETO > Flashcards

OB AF, TERA AND FETO Flashcards

1
Q

Amnionic fluid volume increases from approximately :

10 weeks:
16 weeks:
midterm:
Third term:
Full term:

A

10 weeks: 30 mL
16 weeks: 200 mL
midterm: 800 mL
Third term: reaches 4 liters
Full term: 2,800 mL

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2
Q

Placenta contains how much water?

A

400 mL

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3
Q

abnormally decreased fluid volume

A

Oligohydramnios

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4
Q

abnormally increased fluid volume i

A

Hydramnios or Polyhydramnios

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5
Q

transfer of water and other small molecules takes place across the amnion

A

Transmembranous flow

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6
Q

across the fetal vessels on placental surface

A

Intramembranous flow

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7
Q

Flow across fetal skin

A

Transcutaneous flow

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8
Q

Fetal urine production:
begins between what weeks of gestation, but it does not become a major component of amnionic fluid until the second trimester

A

8 and 11 weeks

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9
Q

Water transport across the fetal skin continues until keratinization occurs at what week

A

22 to 25 weeks

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10
Q

TRUE OR FALSE

extremely preterm neonates can experience significant fluid loss across their skin

A

True

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11
Q

What is the primary source of amnionic fluid in the second half of pregnancy

A

Fetal urination

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12
Q

True or falsehood I

fetal urine production may exceed 1 liter per day

A

True

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13
Q

TRUE OR FALSE

entire amnionic fluid volume is recirculated on a weekly basis

A

False

On a daily basis

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14
Q

TRUE OR FALSE

Fetal urine osmolality is similar to that of amnionic
• hypertonic to that of maternal and fetal plasma

A

FALSE

HYPOTONIC

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15
Q

Approximate osmolality of maternal and fetal plasma

A

280 mOsm/mL

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16
Q

Amniotic fluid in fetal urination is approx. how much?

A

260 mOsm/mL

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17
Q

WHAT ARE THE FOUR PATHWAYS THAT PLAY A MAJOR ROLE IN AMNIONIC FLUID VOLUME REGULATION?

A

A.) Fetal urination
B.) Fetal swallowing
C.) Respiratory tract
D.) Transmembranous and transcutaneous flow

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18
Q

primary mechanism for amnionic fluid resorption which averages 500 to 1000mL per day

A

Fetal swallowing

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19
Q

TRUE OR FALSE

Impaired swallowing, secondary to either a central nervous system abnormality or GI tract obstruction, can result in an impressive degree of hydramnios

A

True

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20
Q

third source of amnionic fluid regulation
• Approxi 350 mL of lung fluid is produced daily late in gestation
• half of this is immediately swallowed

A

Respiratory tract

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21
Q

account for a far smaller proportion of fluid transport in the second half of pregnancy

A

Transmembranous and Transcutaneous flow

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22
Q

What dye is injected to the amnionic cavity in measuring amniotic fluid

A

Aminohippurate

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23
Q

average fluid volume was between 22 and 30 weeks

A

approximately 400 mL

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24
Q

When is Sonographic assessment is done?

A

Second or third trimester

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25
Q

a fluid pocket must be at least how many cm in width to be considered adequate?

A

1cm

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26
Q

used to verify that umbilical cord is not within the measurement

A

Color doppler

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27
Q

also called the largest or maximal vertical pocket of amnionic fluid.

A

Single Deepest Pocket

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28
Q

TRUE OR FALS

the ultrasound transducer is held perpendicular to the floor and parallel to the long axis of the woman.

A

TRUE

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29
Q

Normal range for single deepest pocket measurement

A

Above 2cm and less than 8cm

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30
Q

It is the sum of the single deepest pocket from each quadrant

A

Amnionic Fluid Index (AFI)

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31
Q

normal AFI

A

greater than 5 cm and below 24 or 25

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32
Q

TRUE OR FALSE

mean AFI was found to be between 12 and 15 cm from 16 weeks until 40 weeks’ gestation

A

TRUE

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33
Q

the uterus may feel tense, and palpating fetal small parts or auscultating fetal heart tones may be difficult

A

Hydramnios

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34
Q

Category of Hydramnios

25 to 29.9 cm

A

Mild AFI

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35
Q

Category of Hydramnios

30 to 34.9 cm

A

Moderate AFI

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36
Q

Category of Hydramnios

35 cm or more

A

Severe AFI

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37
Q

Single deepest pocket of amnionic fluid defines mild hydramnios as how many cm?

A

8 to 9.9cm

38
Q

Single deepest pocket of amnionic fluid defines moderate hydramnios as how many cm?

A

10 to 11.9 cm

39
Q

Single deepest pocket of amnionic fluid defines severe hydramnios as how many cm?

A

12 cm or more

40
Q

Impaired swallowing (CNS) can lead to?

A

Anencephaly
Hydranencephaly
Holoprosencephaly

41
Q

Impaired swallowing (craniofacial) can lead to

A

Cleft lip/palate
Micrognathia

42
Q

Tracheal compression or obstruction can lead to?

A

Neck venolymphatic abnormality
CHAOSa

43
Q

Thoracic etiology (mediastinal shift) can lead to?

A

Diaphragmatic hernia
Cystic adenomatoid malformationa
Pulmonary sequestrationa

44
Q

High-output cardiac state can lead to?

A

Ebstein anomalya
Tetralogy of Fallot with absent
pulmonary valvea
Thyrotoxicosis

45
Q

Functional cardiac etiology

A

Cardiomyopathy,
myocarditisa

46
Q

Cardiac arrhythmia

A

Tachyarrhythmiaa: atrial
flutter, atrial fibrillation,
supraventricular tachycardia

Bradyarrhythmiaa: heart block

47
Q

GI obstruction

A

Esophageal atresia
Duodenal atresia

48
Q

Renal-Urinary

A

Ureteropelvic junction
obstruction (“paradoxical
hydramnios”)
Baarter syndrome

49
Q

Neurological or muscular etiology

A

Arthrogryposis, akinesia
sequence
Myotonic dystrophy

50
Q

Neoplastic etiology

A

Sacrococcygeal teratomaa
Mesoblastic nephromaa
Placental chorioangiomaa

51
Q

TRUE or FALSE

The amniotic fluid glucose concentration is higher in diabetic women

A

TRUE

52
Q

MULTIFETAL GESTATION:

What is the severity if a single deepest pocket measures 8 cm or more

A

MILD

53
Q

if the single deepest pocket is atleast 10cm

A

Severe

54
Q

MULTIFETAL GESTATION:

What is the severity if the pocket is at least 12 cm

A

Severe

55
Q

hydramnios of one sac and
oligohydramnios of the other are diagnostic criteria for twin-twin transfusion syndrome

A

Monochorionic gestations

56
Q

up to 70 percent of cases of hydramnios
* 1 % of pregnancies
* rarely identified during midtrimester sonography but as incidental finding later in gestation

A

IDIOPATHIC HYDRAMNIOS

57
Q

sonographic detection of idiopathic hydramnios is usually at what weeks?

A

32 and 35 weeks

58
Q

COMPLICATIONS:

fluid accumulates gradually and
a woman may tolerate excessive abdominal distention
with relatively little discomfort

A

CHRONIC HYDRAMNIOS

59
Q

tends to develop earlier in
pregnancy
* May result in preterm labor before 28 weeks
* symptoms may become so debilitating as to
necessitate intervention

A

Acute hydramnios

60
Q

it is a consequence of major venous system compression by the enlarged uterus - most
pronounced in the lower extremities, vulva, and
abdominal wall

A

EDEMA

61
Q

results from ureteral obstruction by the
enlarged uterus

A

oliguria

62
Q

-result from the rapid
decompression of an overdistended uterus that follows
fetal-membrane rupture or therapeutic amnioreduction
* With prematurely ruptured membranes, a placental
abruption occasionally occurs days or weeks after
amniorrhexis.

A

Placental abruption

63
Q

symptoms of hydramnios

A

Dyspnea and orthopnea
Edema
Oliguria
placental abruption
uterine dysfunction
postpartum hemorrhage

64
Q

largest contributor to amniotic fluid volume

A

fetal urine

65
Q

Pregnancy outcomes of hydramnios

A

*growth-restricted fetus
* associated with trisomy 18
* preterm delivery (not for idiopathic hydramnios)
* Small for-gestational age newborn
* perinatal mortality

66
Q
  • done with a larger needle, 18- or 20-gauge
  • uses either an evacuated container bottle or a larger
    syringe.
A

Amnioreduction

67
Q

Goal of amnioreduction

A

to restore amnionic fluid volume to the upper
normal range

68
Q

initial amnioreduction is performed at what week of gestation?

A

31 weeks

69
Q

Complications of amnioreduction within 48 hours:

A
  • delivery in 4 %
  • ruptured membranes in 1 %
70
Q

it is the abnormally decreased amount of amnionic fluid
* 1 to 2 percent of pregnancies

A

OLIGOHYDRAMNIOS

71
Q

when no measurable pocket of
amnionic fluid is identified

A

ANHYDRAMNIOS

72
Q

The sonographic diagnosis of oligohydramnios is
usually based on an AFI of? or a single
deepest pocket of amnionic fluid of?

A

AFI less than 5 cm or a single
deepest pocket of amnionic fluid below 2 cm

73
Q

Management for oligohydramnios

A

vesicoamnionic shunt placement

  • especially for fetuses with bladder outlet
    obstruction
74
Q

Intake of NSAID may result to?

A

Fetal skull bone hypoplasia and limb
contractures
* fetal ductus arteriosus constriction and with
lower fetal urine production

75
Q
  • refers to an AFI between 5 and 8 cm
  • between 24 and 34 weeks with AFI between 5 and 8
    cm
A

“Borderline” oligohydramnios

76
Q

Borderline oligohydramnios is complicated by?

/

A

Hypertension, stillbirth, neonatal death

77
Q

defined as any agent that acts
during embryonic or fetal development to
produce a permanent alteration of form or
function

A

Teratogen

78
Q

it is an agent that interferes with organ maturation
and function

A

Hadegen

79
Q

Substances typically affect
development in the fetal period or after
birth - more difficult to document.

A

Trophogen

80
Q

2 weeks between fertilization and implantation
* known as the “all or none” period

A

preimplantation period

81
Q

extends from the second through the eighth
week postconception. It encompasses
organogenesis
* the most crucial period with regard to structural
malformations

A

embryonic period

82
Q

beyond 8 weeks postconception characterized by continued maturation and functional
development

A

Fetal period

83
Q

it is an antiemetic which have a combination of doxylamine and
pyridoxine, with or without dicyclomine

Safe and effective for nausea and vomiting in early pregnancy

target of numerous lawsait leading to it’s withdrawal from the market

A

Bendectin

84
Q

the combination of doxylamine and pyridoxine was
subsequently remarketed under what brand name
and was approved by the FDA in 2013.

A

Diclegis

85
Q

Which category where Studies in pregnant women have not shown an increased
risk for fetal abnormalities if administered during the first (second, third, or all) trimester(s) of
pregnancy, and the possibility of fetal harm appears remote

A

Category A

86
Q

Which category where Animal reproduction studies have been performed and have revealed no evidence of impaired fertility or harm to the fetus OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus during the first trimester of pregnancy, and there is no evidence of a risk in later trimesters

A

Category B

87
Q

What category where Animal reproduction studies have shown that this medication is teratogenic (or embryocidal or has other adverse effect), and there are no adequate and well-controlled studies in pregnant women.

There are no animal reproduction studies and no
adequate and well-controlled studies in humans

A

Category C

88
Q

Category

This medication can cause fetal harm when administered
to a pregnant woman. If this drug is used during pregnancy
or if a woman becomes pregnant
while taking this medication, she should be apprised of the
potential hazard to the fetus.

A

Category D

89
Q

Category

This medication is contraindicated in women who are or
may become pregnant. It may cause fetal harm

A

Category X

90
Q

considered the leading cause of preventable
developmental disabilities worldwide

A

Alcohol

TIRED YEAR (16 decks)

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