OB Procedures

Question 1

Ultrasound–Abdominal v. Transvaginal V. Doppler

Answer 1

Doppler tells you fetal blood flow

Question 2

Indications for U/S

Answer 2

ectopic pregnancy (location) & Viability 
gest age dating 
multiple gestation 
amniotic fluid volume (oligohydramnios)
fetal growth (HTN, DMII)
Fetal wellbeing (breathing)
fetal anomalies 
placenta previa
fetal anemia

Question 3

Genetic Ultrasound

Answer 3

done betw 18-20 wks to ID fetal markers of aneuploidy
-looks for structural (nuchal skin fold [strongest] thickness; shortened limb bones; pyelectasis; heart echogenecity; hyperechoic bowel)

Question 4

Nuchal Translucency

Answer 4

measures fluid behind the neck

-thickened NT increases likelihood of aneuploidy and cardiac disease

Question 5

First trimester screening has

Answer 5

two blood tests (PAPP-A, hCG) and NT measurement

Question 6

Second trimester screening (Expanded X-AFP) has

Answer 6

four blood tests (MS-AFP, beta-hCG, estriol, inhibin)

Question 7

Chorionic Villous Sampling

Answer 7

done trans abd or transcervically
10-12 wks
-under ultrasound guidance
-takes placental tissue -risk of pregnancy loss

Question 8

Amniocentesis is done

Answer 8

10-14 weeks
after 15 weeks (not enough amnioic fluid)
-needle does into amniotic sac and aspirated containing living fetal cells to get karyotypes

Question 9

What is the screening performed on the amniotic fluid?

Answer 9

AFP

Question 10

PUBS- percutaneous umbilical sampling

Answer 10

needle into umbilical vein after 20 wks gestation and you analyze the blood gases, karyotype, antibodies, electrolytes
-can give transfusion if fetal anemia

Question 11

Fetoscopy perfomed after 20 weeks

Answer 11

indication - intrauterine surgery

-lasering umbilical for twin-twin transfusion