OB Ch 55-57 Flashcards

Question

Placental abruption

Answer 1

Refers to the separation of a normally implanted placenta prior to term delivery - Occurs in 1 in 120 pregnancies - Bleeding into the decidua basalis

Answer 2

- Retroplacental abruption | - Marginal abruption

Answer 3

Results from the rupture of spiral arteries and is a "high pressure" bleed. Associated with hypertension and vascular disease. -Hematoma is between the placenta and uterus

Answer 4

Most common type; also known as subchorionic bleeds. Results from tears of the marginal veins and represents a "low pressure" bleed. Hemorrhage arises from the edge of the placenta, dissects beneath the placental membranes Associated with little placental detachment

Answer 5

Does not cover the os, but its edge comes to the margin of the os

Answer 6

The cervical internal os is completely covered by placental tissue -20% of patients

Answer 7

Only partially covers the internal os

Answer 8

Is implanted in the lower uterine segment, its edge does not reach the internal os

Answer 9

- IUGR - Intrauterine infection - Aneuploidy

Answer 10

Potentially life-threatening fetal complication that occurs when large fetal vessels run in the fetal membranes across the cervical os. -Occurs in 1 of 2500 deliveries

Answer 11

- Velamentous insertion of the umbilical cord into placental membranes - When a succenturiate lobe is present and the connecting vessels traverse the cervix

Answer 12

Chorioangioma | -1% of pregnancies

Answer 13

- True knots | - False knots

Answer 14

Arise from fetal movements and are more likely to develop during early pregnancy when relatively more amniotic fluid is present. Associated with advanced maternal age, multiparity, and long umbilical cord

Answer 15

Seen when the blood vessels are longer than the cord. Folded on themselves and produces nodulations on the surface of the cord

Answer 16

Most common cord entanglement in the fetus, seen around the fetal neck - Single loop 20% of deliveries - Two loops 2.5%

Answer 17

Atrophy of one of the umbilical arteries in the early development stage Associated with congenital anomalies in 20-50% of cases

Answer 18

Occurs when the cord lies below the presenting part. Exist when presenting part does not fit closely and fails to fill the pelvic inlet

Answer 19

<35 cm in length | may predispose the fetus to inadequate descent, cord compression, fetal distress, and oligohydraminos

Answer 20

>80 cm in length

Answer 21

Normal and related to fetal movement. May coil as many as 40 times, usually to the left and near the fetal insertion site

Answer 22

Umbilical vein

Answer 23

Forms during the first 5 weeks of gestation. Fusion of omphalomesenteric (yolk sac) and allantoic ducts

Answer 24

Same length as the CRL

Answer 25

Cystic lesion in the umbilical cord caused by persistence and dilatation of a segment of the omphalomesenteric duct lined by epithelium of gastrointestinal origin. Found closer to the fetal cord insertion More common in females (5:3)

Answer 26

Focal dilatations of the umbilical vessels affecting the umbilical artery and vein. Appears as a dilated intra-abdominal, extra hepatic portion of the umbilical vein

Answer 27

Results in failure of the intestines to return to the abdomen. Hernia may consist of a single loop of bowel or contain most of the intestines. -1 in 5000 births

Answer 28

Right paraumbilical defect involving all layers of the abdominal wall, 2-4 cm. Never covered by membrane; directly exposed.

Answer 29

Multiple fibrous strands of amnion that develop in utero that may enable fetal parts to cause amputations malformations of the fetus

Answer 30

When one artery is smaller than the other. Discordant blood flow seen in umbilical artery Doppler. Resistive index is higher in the smaller artery, and end-diastolic flow may be absent Associated with placental pathology, polyhydramnios, congenital heart disease, fetal growth restriction, and stillbirth

Answer 31

It is produced by the umbilical cord, the membranes, lungs, skin and kidneys

Answer 32

8-11 weeks gestation *urine production is most significant at 18-20 weeks

Answer 33

The kidneys; fetus swallowing

Answer 34

Excessive amount of fluid that causes the uterine size to be larger than expected for gestational dates. Volume greater than 2000 mL *Also known as hydramnios

Answer 35

Diabetes melitus, obesity, Rhesus incompatibility, anemia, congestive cardiac failure, and syphilis

Answer 36

Reduction in the amount of amniotic fluid resulting in fetal crowding and decrease fetal movement

Answer 37

Identified as echogenic nonfloating bands that cross through the amniotic cavity. Thicker bands associated with amniotic band syndrome. Doesn't cause fetal malformations and most likely signify uterine synechiae

Answer 38

Subjective assessment; "eye-ball"

Answer 39

Slightly lower AFI

Answer 40

- Cushion to protect fetus - Allows embryonic and fetal movements - Prevents adherence of the amnion to the embryo - Allows symmetrical growth - Maintains constant temperature - Acts as a reservoir to fetal metabolites before their exertion by the maternal system

Answer 41

20-30 weeks

Answer 42

AFI method | RUQ+RLQ+LUQ+LLQ=AFI

Answer 43

Central Nervous System and Gastrointestinal system | *Box 57-2 p. 1255

Answer 44

Poor prognosis regardless of its cause

Answer 45

Scars within the uterus

Answer 46

- vernix caseosa | - Amniotic sludge-used to describe dense collection of echogenic particles within the fluid at the level of the cervix

Answer 47

10-20 cm (2 cm pocket) - Low: 5-10 cm - High: 20-24 cm

Answer 48

Assessment of amniotic fluid is done by identifying the largest pocket of amniotic fluid, should measure greater than 1 cm Measured at right angles to uterine contour - Oligo: <2cm - Normal: 2-8 cm - Poly: >8cm

Answer 49

- IUGR - Premature rupture of membranes - Postdate pregnancy (42 weeks) - Chorionic villous sampling